B12 deficiency: How do you feel in the morning? The ‘common’ and ‘debilitating’ symptom

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 performs several important functions in the body, including keeping the nervous system healthy. The contribution B12 makes comes into sharp relief if you have low levels. B12 deficiency can cause a number of problems, some of which can undermine quality of life.

A telltale sign of low B12 may be spotted first thing in the morning.

According to an overview article in the BMJ, “one of the most common and most debilitating symptoms of vitamin B12 deficiency is extreme fatigue”.

Extreme fatigue, or “tired all the time” as the BMJ article puts it, can be particularly pronounced when waking up in the morning.

If you feel tired despite getting a good night’s sleep, you may have low B12.

Also, “if a patient’s mood is low at the same time, this can easily be interpreted as depression”, states the BMJ article.

“Vitamin B12 deficiency is then easily missed.”

Other possible symptoms include:

  • A pale yellow tinge to your skin
  • A sore and red tongue (glossitis)
  • Mouth ulcers
  • Pins and needles (paraesthesia)
  • Changes in the way that you walk and move around
  • Disturbed vision
  • Irritability
  • Changes in the way you think, feel and behave
  • A decline in your mental abilities, such as memory, understanding and judgement (dementia).

How to respond

According to the NHS, you should see a GP if you’re experiencing symptoms of vitamin B12 deficiency.

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“These conditions can often be diagnosed based on your symptoms and the results of a blood test,” explains the health body.

It’s also important for vitamin B12 to be diagnosed and treated as soon as possible.

The NHS explains: “Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated.”

It adds: “The longer the condition goes untreated, the higher the chance of permanent damage.”

Are you at risk of B12 deficiency?

According to Holland and Barrett, vitamin B12 is only naturally found in animal products such as meat and dairy, so vegans and vegetarians are at risk of low intakes.

Older people and others who don’t produce enough stomach acid to absorb B12 properly, may also be at risk of deficiency.

Pernicious anaemia – whereby your immune system attacks the cells in your stomach that produce the intrinsic factor, which is needed to absorb vitamin B12 – is the most common cause of vitamin B12 deficiency in the UK.

How to treat B12 deficiency

The treatment for vitamin B12 deficiency depends on what’s causing the condition.

Most people can be easily treated with injections or tablets to replace the missing vitamins.

There are two types of vitamin B12 injections:

  • Hydroxocobalamin
  • Cyanocobalamin.

“If your vitamin B12 deficiency is caused by a lack of the vitamin in your diet, you may be prescribed vitamin B12 tablets to take every day between meals,” explains the NHS.

The health body adds: “Or you may need to have an injection of hydroxocobalamin twice a year.”

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