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Vitamin B12 Deficiency: The Under-Reported Epidemic

by — Last updated: 2023-07-21 in Nutrition & Dieting
Reviewed by Medical Team — 2023-07-21

Table of Contents

It is the most common disease you have never heard of: Vitamin B12 deficiency. Easily corrected once it is detected, vitamin B12 deficiency can cause shocking disability and death, even though the condition can be corrected at a cost of less than $100.

All of these disease conditions have one thing in common, a well-known, well-documented nutritional deficiency.

  • Attention deficit hyperactivity disorder (ADHD).
  • Alzheimer's disease.
  • Anemia.
  • Autism.
  • Bipolar disorder.
  • Cancer.
  • Cardiovascular disease.
  • Depression.
  • Homocysteinuria, high homocysteine levels, leading to inflammation of blood vessels and the brain.
  • Infertility, both male and female.
  • Lupus.
  • Multiple sclerosis.
  • Rheumatoid arthritis.
The symptoms of all of these conditions overlap with vitamin B12 deficiency.

Chronic shortages of available vitamin B12 in the bloodstream are not an obscure condition no doctor has ever heard of. Known as pernicious anemia, every textbook of internal medicine and every introduction textbook of nutrition explains B12 deficiency in detail. However, because the vitamin B12 deficiency used to be detectable only after it had already become "pernicious," that is, the final stages of anemia made death inevitable, many clinicians fail to detect the vague symptoms of deficiency that overlap with many other diseases while the deficiency can be easily corrected.

Just How Common Is Vitamin B12 Deficiency?

For over 40 years, scientists at Tufts University in Boston have been conducting ongoing observations of lifestyle and nutrition with their health outcomes in the town of Framingham, Massachusets.

When they did vitamin B12 measurements in adults aged 26 to 83, they found that:

  • 40% had "low normal" levels,
  • 16% had "near deficiency" levels, and
  • 9% had clear deficiency of vitamin B12 and needed treatment.

Most common in people of Celtic (English, Scottish, Welsh, Irish) and Scandinavian descent, full-blown pernicious anemia only occurs in 1 in 70 to 1 in 150 peoplein a lifetime.

But milder forms of the disease, scientists now know, can cause a variety of symptoms that masquerade as other diseases, or that aggravate other diseases.

It is not unusual for people to develop lower than optimal levels of B12 and then to develop a psychiatric condition, or have a heart attack, or just to feel or act a little "off" without any obvious reason. And doctors often fail to test for the deficiency.

How Can I Know I Have a B12 Deficiency?

Vitamin B12 levels are measured with a blood test. B12 exists in just picograms, billionths of a gram, in each milliliter of blood.

In Japan and Europe, a B12 level of 500 to 550 picograms per milliliter is recognized as associated with memory loss, attention deficit disorder, and cognitive decline, especially in children (who may not have lived long enough for their livers to store enough B12) and the elderly (who can have digestive disorders than keep their stomachs from producing enough of the intrinsic factor that helps the gut absorb B12).

But in the USA, B12 levels of just 200 to 450 picograms per mililiter are thought to be "normal." Unfortunately, cognitive decline in the elderly is increasingly considered to be normal, too.

When your doctor runs a test for vitamin B12, there may also be orders for testing:

  • Homocysteine, an indication that a deficiency of B12, B6, or folic acid is causing your body to accumulate this inflammatory compound, and
  • Methylenetetrahydrofolate reductase, an enzyme that helps your body use vitamin B12. If you don't have this enzyme, then just getting more B12 won't be enough.

Read More: Vitamin B-Complex: Health benefits

These tests are usually covered by insurance, but even if you arrange them for yourself, they should cost $60 or less.

Testing can be arranged online from testing companies such as Direct Labs even without a doctor's prescription.

Continue reading after recommendations

  • Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. Recognizing subtle symptoms in older adults. Geriatrics. 2003 Mar. 58(3):30-4, 37-8.
  • Watanabe F, Katsura H, Takenaka S, Fujita T, Abe K, Tamura Y, Nakatsuka T, Nakano Y. Pseudovitamin B(12) is the predominant cobamide of an algal health food, spirulina tablets. J Agric Food Chem. 1999 Nov.47(11):4736-41.
  • Mindmap by steadyhealth.com
  • Photo courtesy of Saltanat ebli by Wikimedia Commons : en.wikipedia.org/wiki/Vitamin_B12

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