Most people overlook these early signs of B12 deficiency, but doctors say these 8 symptoms mean something serious could be wrong with your nerves, brain, and energy levels.
Fatigue
Strange or persistent tiredness is often the first clue that something isn’t right because B12 is essential for your body to create healthy red blood cells. Red blood cells carry oxygen from your lungs to all of your body’s tissues and organs.
When you have low B12, your body can’t produce enough healthy red blood cells to do their job. Your doctor may call this megaloblastic anemia. The red blood cells are too big and underdeveloped to effectively carry oxygen. Because of this, your muscles and organs don’t receive the oxygen they need to create energy.
Your heart has to pump harder than normal to make up for it. That’s why you feel wiped out, no matter how much sleep you get.
Tingling
If you experience tingling in your hands or feet all the time, your nerves are definitely involved. Physicians regard this symptom as an indicator that the fatty covering around your nerves, called myelin, which acts as an insulator and helps transmit electrical signals rapidly, is starting to wear away.
Vitamin B12 serves as a cofactor for enzymes involved in myelin production. If you have continued numbness, tingling, or burning of your extremities that can lead to permanent nerve damage, you need to get this treated right away.
Pale skin
One of the most common visual clues to an underlying blood problem is pale skin with a yellowish tint. When doctors see this, they identify evidence of both poor hemoglobin structure and faster red blood cell destruction.
Since vitamin B12 deficiency limits DNA production, the red blood cells that your bone marrow produces are very weak. They rupture easily as they pass through your spleen. This sudden increase of cell turnover releases large quantities of a yellow pigment called bilirubin into your bloodstream, which causes your skin and eyes to take on a jaundiced tint.
Brain fog
Trouble focusing, memory loss, and feeling mentally drained can occur when your brain chemistry is out of balance. Vitamin B12 is used by your body to produce neurotransmitters and support myelin in the central nervous system.
Without sufficient levels in your brain, compounds such as homocysteine will build up in your bloodstream, which has been associated with inflammation and risk of neurological decline. This damages your nerve transmissions and chemical responses, which affects your ability to think clearly.
Balance issues
Unsteadiness, dizziness, or difficulty walking are symptoms that may occur over time as nerve damage starts to affect your central nervous system. Neurologists grade your balance as an indication that the disease has started to affect the posterior columns of your spinal cord. This part of your spine carries messages that help you to sense its own position, movement, and spatial orientation (known as proprioception).
If these nerves are affected by B12 deficiency, your brain will receive late or incorrect signals from your legs and feet. This drastically affects your coordination and can make you more prone to falling.
Swollen tongue
A smooth, red tongue or swollen tongue, also called glossitis, is a very specific oral sign that occurs commonly and early on in the deficiency. Doctors say this inflammation occurs due to delayed cell turnover.
The rapidly dividing cells that form your tongue’s tiny, bumpy projections on the surface, called papillae, cannot divide quickly enough to replace themselves as they die off without enough B12. This leaves your tongue smooth as the papillae disappear, extremely tender and sensitive, and can alter taste or make eating and talking painful.
Mood changes
If you find yourself becoming crankier, more anxious, or depressed than usual, blame it on low B12. Physicians say that B12 is required for one-carbon metabolism, which produces the neurotransmitters serotonin, dopamine and norepinephrine.
These neurotransmitters affect your mood, so if B12 levels are low, this cycle will not run efficiently and your body will produce fewer neurotransmitters. As a result, your brain’s chemical messengers become unbalanced, which can lead to changes in mood.
Vision changes
Loss of clear vision, double vision or other vision disturbances are one of the later symptoms you’ll experience as years of deficiency start to damage your nerve pathways. Medically, this is due to optic neuropathy.
Optic neuropathy is the damage to your optic nerve, which is responsible for sending visual information from your eye directly to your brain. As B12 deficiency progresses, the myelin sheath that protects your optic nerve can no longer do its job and electrical signals become weaker or transmit faulty information.
Early signs of damage can cause hazy vision or blind spots and if left untreated, will lead to a loss of vision.
Sources: Please see here for a complete listing of all sources that were consulted in the preparation of this article.