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How long does it take to recover from vitamin B12 deficiency?

If you have Vitamin B12 deficiency, it can take months or even years to correct it. Vitamin B12, or cobalamin deficiency, is common in older adults and vegetarians. Every 1 in 10 aged 75 or more, while every 1 in 20 aged between 65-70, is affected by vitamin B12 deficiency in the UK.

Vitamin B12 is a water-soluble vitamin that is not present in all foods. Meat, fish, and dairy are rich in vitamin B12. Vitamin B12 is an essential vitamin required for nerve and brain function. Vitamin B12 deficiency can cause muscle weakness, fatigue, headache, and depression.

This deficiency can arise due to two main reasons. Either the diet is deficient in vitamin B12 or it is not absorbed from the intestines due to any underlying pathological condition.

Vitamin B12 deficiency can be tricky to differentiate from other diseases because the symptoms are common and often confused with other conditions.

Role of Vitamin B12 in the Body:

Vitamin B12 has a widespread role in the body, affecting almost every body system directly or indirectly. Vitamin B12 plays a role in the following:

• Normal functioning of nerves and brain.

• It plays an essential role in cognitive function (ability to think)

• Maintain normal red blood cell count and prevent anaemia

• Help regulate DNA functions

• Maintain healthy developmental processes in children.

• Prevents congenital abnormalities

• Prevents macular degeneration in the eyes

• Role in energy production

The optimum amount of vitamin B12 is essential for red blood cells, which are necessary to constitute blood. Vitamin B12 deficiency leads to decreased red blood cell count and impairs oxygen transport in the body.

Vitamin B12 or folate deficiency may lead to megaloblastic anaemia or nutritional deficiency anaemia. In this condition, abnormally enlarged and immature red blood cells are delivered for circulation.

Vitamin B12 deficiency symptoms:

Since B12 deficiency has multiple roles in the body, its deficiency causes complex yet common symptoms that can cause complications that are often mistaken as general diseased conditions. Generally, vitamin B12 causes the following symptoms.

Fatigue

Vitamin B12 is associated with decreased red blood cell count. Since red blood cells specialize in oxygen transport, a lack of red blood cells in the circulation causes exhaustion and fatigue because circulation toward muscles becomes poor.

Paleness

Vitamin B12 deficiency results in immature red blood cells being unable to supply oxygen efficiently. The optimum concentration of healthy red blood cells controls the reddish appearance of mucosal surface and skin. Vitamin B12 deficiency can lead to jaundice in which skin and mucosal surfaces become pale.

Headache

Vitamin B12 affects the nervous system and mental health. Increased homocysteine level causes depression and oxidative stress, killing different cells in the body. Moreover, it leads to psychosis and mood disorders.

Mental impairment and difficulty concentrating

Some people may experience dizziness, foggy head, and difficulty concentrating. All these signs erupt from degenerative changes in the nervous system due to a lack of vitamin B12.

Inflammation in the mouth

Vitamin B12 deficiency can cause glossitis, which is marked by a red, inflamed, painful tongue. Apart from the tongue, sores can develop in the cheeks.

Paresthesia

Rarely do some people experience a burning pin-and-needles situation in different parts of the body.

Other Symptoms:

Apart from the other symptoms, vitamin B12 deficiency may also lead to:

• Decreased white blood cell count

• Low platelet cell count

• Weight loss

• Walking problems

Vitamin B12 Deficiency Complications

Although Vitamin B12 deficiency affects almost all systems in the body, mainly the following four systems are involved in the complication. There are four main complications caused by vitamin B12 deficiency these include:

Anaemia

It is the loss of circulating red blood cells in the body. Anaemia that arises from vitamin B12 deficiency is called pernicious anaemia, which causes fatigue, paleness, dizziness, and rapid breathing symptoms.

Neuropathy

It is damage to the nerves. Vitamin B12 deficiency may cause numbness, tingling, weakness, and balance problems.

Myelopathy

It refers to damage to the spinal cord. Vitamin B12 deficiency-induced myelopathy causes tingling, numbness, and sensory issues.

Dementia

An impairment of mental processes is called dementia. Symptoms of behavioural changes, forgetfulness, and cognitive decline occur in this condition.

Daily recommended amount of vitamin B12 to avoid deficiency:

B12 recommended amount varies with age. Different age-group people require additional amounts, like a pregnant woman requires an extra amount for the growth of a fetus.

Here are the daily recommended vitamin B12 in micrograms (mcg).

• Till six months, neonate: 0.4 mcg

• 7-12 months old child: 0.5 mcg

• 1-3 years old child: 0.9 mcg

• 4-8 years old child: 1.2 mcg

• 9-13 years child: 1.8 mcg

• 14-18 years teenagers: 2.4 mcg

• 19 years or older adults: 2.4 mcg

Research suggests that daily vitamin B12 intake should be 5.94 mcg for men and 3.78 mcg for women to maintain healthy levels of vitamin B12. It should be noted that this recommended amount of vitamin B12 is to avoid deficiency. So, these amounts are not solid, and intake should be above the recommended allowance.

Vitamin B12 Requirements During Pregnancy:

During pregnancy or breastfeeding, vitamin B12 needs to increase for the better development and growth of the baby. Taking an extra 2.6 mcg of vitamin B12 during pregnancy is recommended, while breastfeeding women are advised to take 2.8 mcg of extra vitamin B12 daily.

Adequate vitamin B12 in pregnancy is necessary because the deficiency can lead to developmental abnormalities, preeclampsia, and retarded growth.

Causes of Vitamin B12 Deficiency:

Although half a dozen factors contribute to vitamin B12 deficiency, there are four primary reasons leading to vitamin B12 deficiency.

Autoimmune disorder:

Pernicious anaemia is an autoimmune condition that leads to vitamin B12 deficiency. Pernicious anaemia affects intestinal absorption of vitamin B12.

Malabsorption

Some people are unable to absorb the required amount of vitamin B12 through the intestine. It may be because of surgery or any intestinal disease damage which disrupts villi. For instance, people with gastric bypass surgery or who have their intestinal part removed are more prone to acquiring vitamin B12 deficiency.

Diet

Vitamin B12 is abundant in fish, poultry, meat, eggs, dairy, and other animal-origin products. So, if you are not taking such diets, you will likely have vitamin B12 deficiency. Vegetarians are at high risk of cobalamin deficiency because they have eaten plant-based diets for years.

Intestinal bacteria growth

Some disease conditions may decrease intestinal motility, like diverticula, diabetes, strictures, and scleroderma. This increases the food stay time in the intestines. Hence, the intestinal bacteria get the chance to overgrow and utilize the nutrients in food. This may drastically decrease the absorption of vitamin B12.

Medications

There are certain medication has a negative impact on vitamin B12 absorption. Proton pump inhibitors and the diabetes drug metformin are two drugs that interfere with vitamin B12 absorption.

Best Sources of vitamin B12

Although the prime sources of vitamin B12 are animal-based protein diets, some plant-based foods, too, may fulfil the need for vitamin B12.

If you need more vitamin B12, try these diets at regular intervals.

• Animal foods like properly cooked beef liver

• Salmon and tuna fish

• Yoghurt cheddar cheese or any other dairy products.

• Turkey or any other poultry.

• Eggs

Suppose you are vegetarian and not totally into meat and dairy products. Worry not! Some plant-based foods also contain a sufficient amount of vitamin B12, try including these foods in your diet:

• Tempeh

• Fortified yeast

• Non-dairy products like soy milk

• Fortified cereals.

Intrinsic Factor and Vitamin B12 Absorption:

Intrinsic factor is a proteinaceous substance secreted through the stomach lining. When you eat foods containing vitamin B12, intrinsic factors bind with B12 in the stomach before absorption in the small intestine. Intrinsic factor helps in the absorption of vitamin B12.

Reason for Lack of Intrinsic Factor:

Research suggests that autoimmune disorder is the underlying reason behind the lack of intrinsic factors in certain people. Autoimmune disorder mistakenly attacks stomach lining cells. Apart from that, gastric bypass surgery also causes damage to the stomach cell lining, which may affect intrinsic factor-releasing cells.

Without intrinsic factors, no matter how much vitamin B12 source diets you consume, vitamin B12 will not be absorbed through the intestine. People having intrinsic factor deficiency are more susceptible to vitamin B12 deficiency.

Treatment of people with intrinsic factor abnormality also differs from people having normal intrinsic levels. The only solution to this is B12 injections. Oral supplementation and diets cannot rectify the situation.

Diagnosis

Diagnosis of vitamin B12 deficiency can be made through a complete blood count (CBC) test. This test shows serum B12 and folate levels in the circulation. Other ways to diagnose is through lab tests to check homocysteine and methylmalonic acid in the blood.

People having vitamin B12 levels less than 200 picograms per ml of blood are considered vitamin B12 deficient (200 pg/ml). While people have serum levels between 200 to 300 pg/ml are evaluated on the verge of vitamin B12 deficiency.

Although people with 300 pg/ml plus vitamin B12 levels are considered safe from vitamin B12 deficiency, some people with high metabolic rates may experience the symptoms of vitamin B12 deficiency. Since symptoms of vitamin B12 deficiency match with multiple other health conditions, you must refrain from self-diagnosis and see a healthcare provider.

Other methods of vitamin B12 deficiency diagnosis is:

• Intrinsic factor antibody test

• RBC count and their shape measurement

• Methylmalonic acid test

• Lactate dehydrogenase level

• Reticulocyte test

• Serum bilirubin level

• Bone marrow biopsy

If you're curious about your complete vitamin profile, look at our Vitamin Deficiency Test home kit, which will allow you to assess your body's essential vitamin levels.

Treatment

Vitamin B12 deficiency is treated through supplementation. Supplements can be taken orally or through injections. The route of supplementation is determined by the cause of vitamin B12 deficiency.

If you have an absorption problem, the doctor recommends taking supplements through injection because oral supplementation does not work due to absorption failure through the intestine.

If you don't have an absorption problem, the doctor would recommend you take oral supplements and eat diets that are the source of vitamin B12.

Some people are recommended to take lifetime vitamin B12 supplementation. This depends upon the cause of the deficiency. Recovery from Vitamin B12 deficiency requires months and even years. You may not feel any improvement during the first few months of supplementation, and the symptoms don't go away quickly. Results appear 6 to 12 months after regular supplementation of vitamin B12.

The best and most efficient source of vitamin B12 is the IV injections which bring back the serum vitamin B12 levels to normal which 48-72 hours. Recovery time decreases if supplementation is through vitamin B12 injection. Otherwise, it may take multiple years to recover from it. You can take a vitamin shot every month, but if the symptoms are severe, you may require various shots in a month, depending on the severity.

Some people are reluctant to take injections regularly; such people can prefer nasal sprays as an alternative. Your doctor may prescribe 500mg nasal spray once a week.

Rehabilitation

Vitamin B12 deficiency symptoms may take different times to recover, depending upon the severity of the damage. Nervous signs take longer than other symptoms to recover. You may experience vitamin B12 deficiency symptoms like numbness, weakness, and tingling even after supplementation. Memory loss recovers as the body's normal vitamin B12 levels are corrected. Thinking skills and cognitive rehabilitation takes longer time than other symptoms.

Bottom Line

Vitamin B12 deficiency is a concern because its complex symptoms and similarity with other diseases sometimes make it challenging to diagnose differential. Animal-based foods are the primary source of vitamin B12. Although some plants still contain a minute amount of vitamin B12, vegetarians and vegans are at risk of developing this condition.

People lacking intrinsic factors or having absorption issues must take vitamin B12 injections regularly for a few months. Due to slow recovery, vitamin deficiency symptoms may take a few months or even a year to vanish. The symptoms of vitamin B12 deficiency may not go at once but may appear on and off due to fluctuating vitamin B12 serum levels. No matter how much time it takes to recover, all you need is to make sure you are getting recommended amount of vitamin B12 either orally or through supplementation.

Order Welzo's B12 Vitamin Deficiency Test here.