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Do You Know Your Vitamin B12 (Cobalamin) Levels?

Have you ever been tested for vitamin B12? Do you know the symptoms of a deficiency? This nutrient is essential for good health. Several drugs can lead to low levels. Are you taking one?
Do You Know Your Vitamin B12 (Cobalamin) Levels?
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Most people do not think much about Vitamin B12, also known as cobalamin. It does not get the attention of vitamin D, vitamin K or vitamin C. And yet this water-soluble nutrient is crucial for every cell in your body. Red blood cells require cobalamin. So do nerve cells. Without adequate levels of vitamin B12, people develop pernicious anemia. They may also experience neuropathy or nerve pain. The brain does not function well without adequate levels of B12. Sadly, though, many health professionals do not order vitamin B12 testing. That can lead to disastrous consequences, as this reader points out.

Nerve Problems from Vitamin B12 Deficiency:

Q. In 2016 I was admitted to the hospital with numbness in my groin, legs, arms and hands. A week of blood work and CT scans did not show a reason for the problem. After that week I was released with no treatment and no improvement.

I subsequently reviewed my blood tests and noticed that my vitamin B12 level was extremely low. I went to my primary care doctor who started giving me B12 shots.

The problem cleared up within a couple weeks. I continue the shots today and have had no further trouble with this.

Symptoms of Vitamin B12 Deficiency:

A. Inadequate vitamin B12 levels can trigger neurological problems such as numbness and tingling (BMC Research Reports, Sep. 18, 2015).  Vegans, who consume no animal products whatsoever, are at particular risk of this condition. Patients who have had gastric bypass surgery are also vulnerable to this vitamin deficiency and usually need supplements (GE Portuguese Journal of Gastroenterology, April 2018).

People taking powerful acid-suppressing drugs called proton pump inhibitors (PPIs) or the diabetes drug metformin may also be vulnerable to a cobalamin deficiency. We think people who take such medications should routinely get tested for B12 levels.

You might ask your doctor if you could switch to oral vitamin B12 supplements. Some research suggests that pills can be as effective as shots but less expensive (Cochrane Database of Systematic Reviews, March 15, 2018).

Other Symptoms of Low Levels of Cobalamin:

  • Anemia can manifest as pale skin and tiredness
  • Nerve damage (numbness or tingling in feet and hands)
  • Dizziness, fatigue, shortness of breath
  • Weakness, weight loss and depression
  • Irregular heart rhythms (arrhythmias)
  • Psychological side effects (mood changes, dementia)

How to Restore B12 Levels:

Lee points out some important caveats:

“Often there is a B12 deficiency due to lack of production of intrinsic factor in the parietal cells in the fundus of the stomach. I’ve observed doctors giving B12 shots when the root cause was stomach cancer, especially around the gastroesophageal junction.

“Taking proton pump inhibitors that suppress the production of stomach acid can also cause lead to low levels of B12. It is better to determine the cause of the deficiency rather than just supplement.”

Blood Tests Are Essential:

Ann in North Carolina encourages testing:

“I had problems after having been first on Prilosec and then Nexium for over 20 years. I was being treated for acid reflux. I literally crashed and burned because of pernicious anemia. My B12 level was very low. In addition to the numbness and tingling in my hands upon waking, I experienced shortness of breath and unbearable fatigue and weakness.

“My doctor finally tested for cobalamin. I had to get vitamin B 12 shots for a year. I also needed extra iron.

“I had been complaining for a decade that I was very tired all the time. I was told my thyroid was ‘normal’ which it wasn’t. Anything over 2 is too high for me and I was a 6! I went to an endocrinologist who tested my thyroid and discovered I had Hashimoto’s which was also wreaking havoc.

“I finally weaned myself off the Nexium due to the other problems associated with it. I continue to take Vit B12 liquid supplement, Vit D3 & CoQ10 since I’m on a low dose statin. Shame on these doctors who prescribe medications without following up with blood testing!”

Learn more about vitamins and testing in the book, Fortify Your Life by Tieraona Low Dog, MD. This is the best book on nutrients that we know of. You can listen to Dr. Low Dog and Dr. JoAnn Manson at this link.

They have differing perspectives on the value of vitamin supplements.

Share your story about vitamins in general and vitamin B12 in particular in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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