Vitamin B12 Deficiency is More Common Than You Think!

by Dr. Scott Schreiber

Who may be deficient?

Those that eat plant-based diets, vegans and vegetarians, and the elderly are two of the most common subtypes.  In addition, approximately 2% of the population cannot metabolize B12 efficiently.  Medications that decrease the production of stomach acid also decrease the absorption of B12.

What does B12 deficiency look like?

Everyone experiences different symptoms.  Some patients will have none.  Others may have one or more of the following: anemia, fatigue, poor balance, memory loss, numbness shortness of breath, tingling feet, pale skin, weakness, lightheadedness, smooth tongue, constipation, diarrhea, loss of appetite, gas, muscle weakness, vision loss, depression, and memory loss.  B12 deficiency mimics dementia and multiple sclerosis.

How do you test for it?

A simple blood test can diagnose B12 deficiency.  The most common blood test is serum B12.  This test evaluates the amount of B12 in the blood, however, this is not the most sensitive.  Methymalonic acid and Homocysteine levels need also be evaluated.  Methylmalonic acid will be high if B12 is low.  This is a great test for detecting early B12 deficiency.  B12, along with B6 and folate, are needed in the metabolism of homocysteine.  Homocysteine will be low if B12 if low levels of B12 are present.  Many practitioners will only test for serum levels; this does not give you the whole picture.  Serum B12 will be high if seaweed is consumed.  This is a false positive as seaweed contains ineffective forms of B12.

How do you treat it?

B12 supplementation in the form of a high dose oral or intramuscular injection, depending on the severity.  Frequent lab monitoring is usually required.


Dr. Scott Schreiber has been practicing in Newark, Delaware for over eleven years. He is a chiropractic physician that is double board certified in rehabilitation and clinical nutrition. He is a certified nutrition specialist and a licensed dietitian/nutritionist.