Vitamin B12
This essential nutrient has many functions in your body involving your nervous system, blood cell formation, metabolism, muscle function, hormonal regulation and cardiovascular health. I’m sure you would agree this sounds pretty important, which makes it rather surprising to learn its level is commonly found to be deficient in people.
Signs of deficiency include: low energy, poor cognitive function, lightheaded, tremor, anxiety or depression, hormonal issues, hypothyroid, lack of motivation.
Ideally we are obtaining our required amount of this vitamin from our foods, including clams & liver (the 2 highest foods), trout, salmon, tuna, beef, low fat milk & yogurt, and eggs. As you can see, this makes it challenging for vegetarians and vegans to obtain adequate B12; an extra supplement is often required.
But there are many people who eat from this list daily yet still have signs of deficiency. Some of the causes for low blood levels include:
Intestinal conditions such as Celiac or Crohn’s diseases
Surgeries such as gastric bypass or intestinal resection
Medications including some of those to treat diabetes, reflux / heartburn, and seizures
Low stomach acid &/or intrinsic factor
Inadequate dietary intake for personal needs
Aging
What does age have to do with it? When we eat food, our stomach secretes hydrochloric acid to help breakdown the proteins, and intrinsic factor (IF) to help the body absorb B12 further down our intestinal tract. As we age our production of both of these substances tends to reduce, which leads to the vitamin potentially passing right through us without being absorbed. Some people can be born with a lack of IF, or an autoimmune condition that attacks the cells producing it - this is called pernicious anemia.
How do you know if you are deficient? Have your blood tested! Keep in mind that while the lab lists an adequate level in your blood to be ~200-600, a more optimal value for good health is actually >500.
There are several options for correcting a deficiency. Be sure to eat foods containing B12 on a regular basis. If you are already doing this and your level is still low, then it is worth exploring the possible causes I mentioned above with your Naturopathic Doctor. If you are suspecting the cause may be associated with the medications you are taking you will need to discuss options with your prescribing physician (Eg. some diabetes medications deplete B12 less than others). Options for supplementation* range from oral to injection. For the oral option, I recommend a form you dissolve under your tongue rather than one you swallow - you can absorb some of it through the tissues in your mouth and rely less on IF production in your stomach. Look for methylcobalamin (as opposed to cyanocobalamin); this is a natural form your body can easily use. If you are looking for a quicker boost to your energy or mental focus, talk your Naturopathic Doctor about B12 injections.
I have seen people experience great improvements in their fatigue, anxiety/depression, mental focus and more, simply by making sure they are absorbing adequate amounts of B12. Curious if this important nutrient could make you feel better too? You can start by learning your level with a simple blood test.
*These are general suggestions and should not be interpreted as medical advice. Discuss this with your qualified healthcare practitioner, especially if you are pregnant, taking medications or dealing with a chronic disease.