The People's Perspective on Medicine

Could Vitamin B12 Deficiency Make You Fall?

A vitamin B12 deficiency has many potential symptoms. Among other things, it could interfere with your balance and make you fall.

Falls are a great fear as people get older and less steady on their feet. And no wonder: a fall can result in broken bones and greatly reduced mobility. More than a fourth of older adults who break a hip die within the year (Panula et al, BMC Musculoskeletal Disorders, May 20, 2011). If you find out what could make you fall, you can take steps to avoid those things. Might a vitamin deficiency be responsible?

Balance Problems Could Make You Fall:

Q. I have no feeling in the lower part of my legs. This has resulted in balance problems leading to falls. X-rays and MRIs show that there is no damage to the nerves exiting the spinal cord, so that is not the cause. Could vitamin B12 deficiency contribute to this problem?

Vitamin B12 Deficiency Is Dangerous:

A. Vitamin B12 is critical for proper nerve function and balance. Deficiencies in this important nutrient become more common with age. Other predisposing factors include medications such as strong acid-suppressing drugs and the diabetes drug metformin. Vegetarians and vegans don’t get vitamin B12 in their diet and thus are also more susceptible to deficiencies. People who have had gastric bypass or weight loss surgery are less able to absorb this vitamin and more prone to deficiency.

Symptoms of vitamin B12 deficiency include fatigue, dizziness, sore tongue, heart palpitations, depression, shortness of breath, weakness, paranoia or other personality changes and tingling and burning in arms and legs. Prolonged lack of this nutrient may lead to anemia, depression, confusion, dementia and weakened immunity.

Correcting a Vitamin B12 Deficiency:

If you suspect that you may be deficient in vitamin B12, ask your doctor for blood tests. You may need a test of methylmalonic acid (MMA) as well as a test for circulating vitamin B12.

A person who is deficient in vitamin B12 should take supplements to correct the deficiency. Studies suggest that high doses of oral vitamin B12 can work as well as injections to reverse the problem (Wang et al, Cochrane Database of Systematic Reviews, March 15, 2018).

In addition to addressing a vitamin deficiency that could make you fall, you might consider exercises to improve your balance. Such programs can reduce the likelihood of falls and improve fitness (Miko et al, Journal of Rehabilitation Medicine, online May 16, 2018).

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I am addressing the person who said they cannot tolerate B vitamins. Perhaps this is a reason. I have two genes for a genetic defect, which is relatively common, called MTHFR. Recently, to address this, I switched to a vitamin with folate and methycobalamin (B-12). These are the natural forms I can absorb. Folic acid is not as well as cyancobalamin. This was never an issue until vitamins were used and food was fortified.

Now, I look at every label and do not consume anything with folic acid or cyancobalamin. I take a vitamin with folate and methycobalamin, I take sublingual daily and I get injections of methylcobalamin monthly due to pernicious anemia, an autoimmune condition.

It’s the first time in my life that life has not been a struggle. Too bad I found this out when I am in my 60’s!!! but at least I did. Consider the form of the B vitamins you are taking.

What is the maximum dosage of B12 an individual may safely consume?

You could safely take 1 mg a day. That is hundreds of times over the recommended daily intake. Here is what the Office of Dietary Supplements says about vitamin B12:

“The IOM did not establish a UL for vitamin B12 because of its low potential for toxicity. In Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline, the IOM states that “no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals” [5].

Findings from intervention trials support these conclusions. In the NORVIT and HOPE 2 trials, vitamin B12 supplementation (in combination with folic acid and vitamin B6) did not cause any serious adverse events when administered at doses of 0.4 mg for 40 months (NORVIT trial) and 1.0 mg for 5 years (HOPE 2 trial)”
Here’s the link:
https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

My doctors have always prescribed Vit B12 injection 1 ML 2-3 X per week (now added B100 (B1+B2+B3+Nicotinamide 100 mg). Note: You can’t overdose, as what’s not needed passes via urine. Always since age 20 receive an “energy boost.” Am now age 79 & under great stress so take 3X a week — helps. Wish more vitamins were available as injectables due to sensitive stomach.

I am upset by the statement that vegetarians do not get B12 in their diets. I have been a vegetarian since 16 (now 60) and have had no problems because as a vegetarian NOT a vegan, I consume eggs, milk, cheese, sometimes fish. It depends on what kind a vegetarian you are. A vegan only eats plant products. Huge difference!

A reminder that sublingual B12 (dissolves under the tongue) is tremendously helpful and can even be as effective as injections (not sure where I read this) because the vitamin is absorbed directly through the mucous membranes and does not require digestion or the sometimes failing digestive enzymes to work. I personally found that vitamin B12 with added folic acid works particularly well. I used to feel so unsteady on my feet that even closing my eyes to rinse shampoo in the shower made me feel like I was ready to fall. Hope this is helpful.

I would like to know the level of oral B-12 that one should consume, or how much oral B-12 would be harmful.

In most cases, a daily oral dose of 1,000 micrograms (1 mg) is adequate to overcome problems with vitamin B12 absorption.

You might check into your 1st-degree relatives. There is a condition caused by genetic mutation called Charcot Marie Tooth. It is the most common form of inherited neuropathy. It takes many forms including some real nasty ones but one of them is numb feet. Nothing much can be done about it, and diagnosis requires genetic analysis.

When I fall, I am unable to get back up. I am in my 50s. I have never been able to take any form of B vitamins, as they make me so ill. (I do try again every few years). I am also unable to have most food sources of B vitamins. Is there anything else I can do?

I complained to doctors for more than 3 years about feeling “light headed.” I changed primary care doctors, and a brain MRI was ordered. I now have brain damage due to B1 and B12 deficiency. Awareness of this potential is to my mind critical. In my searches about “light-headedness” it never mentioned vitamin deficiency.

I have Autoimmune Gastritis, which attacks the area of the stomach where Vitamin B-12 is absorbed. I have been advised that oral B12 will not work, so I need the shots. If you have other autoimmune disorders, especially thyroid disorders, you should check with your Doctor.

I would appreciate anyone else with autoimmune gastritis commenting on their experience with oral supplements and/or advice from their Doctor.

After severe bouts of dizziness which was causing partial vision loss I had my endocrinologist test my blood work. My blood work came back as supposedly normal to him. He suggested that we do a CT scan on my brain, thinking I possibly had a tumor. I did have a CT scan which showed to be completely normal. After I looked at my blood work I did some research on some levels that looked too low. I researched B12 and B6 deficiency which showed in the lab work that was just barely below normal, and my doctor was not concerned.

After doing my research I brought this to the doctor’s attention, and I suggested B12 injections. After 2 months of B12 injections all dizzy spells stopped and my vision is back to normal. I was also experiencing falling incidents and have not had any of those occur since the B12 injections. I strongly suggest if you’re having any of the symptoms you speak with your doctor about testing for the deficiency and possibly getting injections. It improved my life.

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