Vitamin B12, also called Cobalamin, is a water-soluble vitamin like all the other B vitamins. It is primarily found in foods that are derived from animals. It is a vital vitamin required for many bodily processes necessary for a person's normal growth and development.
What does Vitamin B12 do?
Vitamin B12 is an important water-soluble vitamin that helps in:
• Proper functioning of brain and nervous system
• Cognitive functioning (thinking ability)
• Synthesis of red blood cells
• Prevention of anaemia
• DNA synthesis
• Preventing birth defects (congenital abnormalities)
• Protecting the eyes from macular degeneration (distorted vision)
Sources of Vitamin B12:
Vitamin B12 is primarily found in foods that are derived from animal sources such as – beef, ham, poultry, pork, lamb, fish (haddock and tuna), dairy (milk, yoghurt, cheese), yeast and egg, etc.
How much vitamin B12 do you need per day?
| Age group | Recommended dose per day (mcg) |
|
0-6 months |
0.4 |
|
7-12 months |
0.5 |
|
1 to 3 years |
0.9 |
|
4 to 8 years |
1.2 |
| 9 to 13 years |
1.8 |
|
14 to 18 years |
2.4 |
| 19 and older |
2.4 |
| Pregnant women |
2.6 |
|
Breastfeeding women |
2.8 |
As per National Institute of Health (NIH), adults (both men and women) should consume about 2.4 micrograms (mcg) of Vitamin B12 per day, while children should consume 0.4 to 2.4 mcg. The need for vitamin B12 increases to 2.6 mcg during pregnancy and 2.8 mcg during lactation.
Vitamin B12 deficiency
Low levels of Vitamin B12 in your blood is termed as Vitamin B12 deficiency. Research suggests about 20 to 25% of worldwide population have low levels of vitamin B12. Many people such as, older adults and people with gastric disorders have trouble absorbing vitamin B12 from their food which in turn leads to vitamin B12 deficiency.
Symptoms of Vitamin B12 deficiency:
A person deficient in vitamin B12 can have the following symptoms:
• Constipation
• Exhaustion
• Loss of appetite
• Dementia
• Weakness
• Racing heart
• Tingling in the hands and feet
• Depression
• Confusion
• Difficulty concentrating
Who is at risk of Vitamin B12 deficiency?
Your body does not produce vitamin B12 and hence dietary sources of vitamin B12. It is available in the products derived from animals such as fish, meat and dairy at most. People who are at risk of developing vitamin B12 deficiency are:
1. Older adult – Overtime stomach’s ability to absorb food decreases in elderly due to problems with acid and stomach enzymes that are required to process the vitamin.
2. Vegans – A diet that excludes animal-based products is the main reason of vitamin B12 deficiency in vegans. Unless a vegan diet is carefully planned it is difficult to maintain vitamin B12 levels in their body.
3. Children – Malabsorption, reduced intake and few congenital errors are the most possible reasons for vitamin B12 deficiency in children.
4. Diabetics – People with diabetes who take metformin are at high risk of developing vitamin B12 deficiency since metformin reduces the absorption of vitamin B12.
5. Strict vegetarians – Vitamin B12 is typically derived from animal-sourced food. Therefore, people who consume products of only plant origin get deprived of vitamin B12 and they might need external supplementation of vitamin B12 to avoid deficiency.
6. People who had undergone gastric bypass surgery – People who had undergone any gastric related surgeries are at risk of developing vitamin B12 deficiency since these conditions reduce nutrient absorption from food.
New mothers who are breastfeeding and have low levels of vitamin B12, then their baby is at high risk of developing neurological issues and developmental problems.
Vitamin B12 deficiency tests:
Vitamin B12 deficiency is determined in several ways. You can get blood test done or take a home urine test. These tests usually look for the levels of:
• Vitamin B12
• Methylmalonic acid (MMA)
• Homocysteine
• Holotanscobalamin (holoTC)
According to few researches, MMA and holoTC can be considered more accurate to detect low levels of vitamin B12 since they represent active B12.
1.Blood test
Instructions to pre-procedure:
You need to get tested in the fasting state i.e., you will not eat or drink anything for 10-12 hours except water before the test.
Procedure:
During the test, the area from which the blood is drawn is cleaned with an antiseptic wipe or an alcohol pad before drawing blood. Sometimes, an elastic band is also tied around the top of your arm so that there is increase in the blood flow. The needle is then inserted and the blood is drawn. Once the needle is removed, bandage is applied.
Post-procedure:
Your blood sample is then sent to laboratory for measurement of vitamin B12 or other markers like holoTC.
2.Urine test
Vitamin B12 deficiency can also be detected through urine test. In this, urine samples are collected in a container and sent to the laboratory. These kits contain a jar/container and mailing instructions. Others will come with test strips that you can dip into your sample yourself, and wait for the results to appear right away.
Vitamin B12 normal ranges:
Blood test: 200 – 750 picograms per millilitre (pg/ml)
Anything below 160 pg/ml indicates low levels of vitamin B12 (Vitamin B12 deficiency) and anything above 800 indicates high levels of vitamin B12 in your blood.
HoloTC: 23-100 picomole/Litre (pmol/L)
Low levels of holoTC is an early indicator of low vitamin B12.
Urine: A normal range for MMA is <3.8 mcg/mC.
If the level is anything beyond normal then it is an indicator of vitamin B12 deficiency.
Interpretation of results:
Both high and low levels of vitamin B12 indicates an underlying problem. Low levels of Vitamin B12 can be due to anaemia, some internal parasites, hyperthyroidism or neurological abnormalities etc whereas, high levels of vitamin B12 can be a sign of liver diseases, certain leukaemia (a type of blood cancer), diabetes and kidney failure.
High levels of vitamin B12 are usually rare. Generally, excess vitamin B12 is excreted through urine.
How to prevent vitamin B12 deficiency?
To manage your vitamin B12 levels you must first adjust your diet. However, a few additional things can also be practiced to overcome this.
• Vitamin B12 injection – for a more severe vitamin B12 deficiency
• Vitamin B12 supplements – Cyanocobalamin (a man-made Vitamin B12 supplement)
• Vitamin B12 rich diet – Food derived from animals such as meat, fish and dairy etc.
Any underlying cause of vitamin B12 deficiency should also be managed in collaboration with your healthcare provider.
Vitamin B12 is a necessary vitamin for proper body functioning. This vitamin deficiency can be avoided by consuming enough of it through a balanced diet that includes vitamin B12.
