By Jacquie EubanksBSN, RN Chances are you may be one of the almost 40% of the U.S. population that have suboptimal vitamin B12 levels. Fully 9% are well below the current deficiency level. Vitamin B12 deficiencies can progress very slowly, as initial signs and symptoms may appear gradually and intensify over time. B12 deficiency can also come on quite suddenly and many times symptoms can be overlooked or chalked up to other factors. Symptoms of deficiency can include, among others, anemia, balance issues, numbness or tingling in the hands or feet, cognitive difficulties, mood swings, muscle weakness, infertility, lack of energy and fatigue. A simple blood test can detect a B12 deficiency. Early detection and treatment are crucial, as untreated deficiency may result in neurological problems, blood disorders or premature death.
B12 is a requirement for a number of bodily functions and is essential for the health of every cell in the body. This powerhouse nutrient is involved in physical, mental and emotional energy production, cognitive function, the regulation of red blood cells, DNA synthesis, healthy immune and nervous system function, proper digestion, cell formation and longevity, hormone production, and myelin formation, which protects nerve endings and allows communication between nerve cells.
The most common causes of deficiencies are inadequate dietary intake and malabsorption issues. Although B12 deficiency can affect all age groups, those who are most at risk for lifetime deficiencies include:
- The elderly or those over 50 years of age who are most likely to have malabsorption issues due to a decrease or gradual loss of gastric acid, which releases the vitamin from food. According to scientists at Rush University Medical Center, elderly people with B12 deficiency are more likely to suffer from cognitive decline.
- Deficiency is very common in strict vegans or vegetarians, as B12 is present only in animal products or fortified foods.
- Those who take prescription or OTC acid reducing medications which lower stomach acid, compromising the body's ability to extract and absorb B12 and other dietary nutrients.
- Diabetics who take diabetes medications such as Metformin©, which may interfere with the metabolism of calcium necessary for B12 absorption.
- Those who have malabsorption issues, such as those with celiac or Crohn's disease.
- Those who may have had gastric bypass weight loss surgery.
- Those with pernicious anemia, an autoimmune condition in which the body is unable to produce intrinsic factor, a binding protein necessary for B12 absorption. Without intrinsic factor, the body simply cannot absorb vitamin B12.
- Those who have or have been affected by Helicobacter pylori, which can damage the stomach cells that produce intrinsic factor.
- Those who consume 4 or more cups of coffee daily are likely to be slightly deficient in B12.
- Medications that can result in B12 deficiencies include antibiotics, anticonvulsants, birth control pills, cholesterol-lowing pharmaceuticals and Parkinson's disease medications.
B12 Liquid by Pure Encapsulations - This highly bioavailable liquid form of vitamin B12 with methylcobalamin supplies 1,000 mcg per dropper. Gluten and soy free vegetarian formula. 
B12-Active™ Cherry by Integrative Therapeutics - These naturally flavored chewables supply 1 mg of highly active and bioavailable vitamin B12 as methylcobalamin. Gluten and soy free. Suitable for vegetarians. 
Vitamin B12 (K-34) by Apex Energetics - This product provides high potency vitamin B12 in a bioavailable liquid form. Ten drops provide 300 mcg per serving. Naturally flavored with orange and tangerine.
Methylcobalamin by Thorne Research - This bioactive form of vitamin B12 provides 1mg per capsule in a gluten, soy and lactose free formula. Non-GMO and suitable for vegetarians.
References:
http://www.pharmacytimes.com/publications/issue/2013/December2013/Vitamin-B12-Deficiency-Serious-Consequences, Sally M. Pacholok, RN,BSN
Patrick J. Skerrett, Executive Editor. http://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780 , January 10, 2013
Dr. Mercola. http://articles.mercola.com/sites/articles/archive/2009/05/19/warning-potentially-life-threatening-vitamin-deficiency-affects-25-percent-of-adults.aspx May 19, 2009
Chris Kresser. http://chriskresser.com/b12-deficiency-a-silent-epidemic-with-serious-consequences
Viatcheslav Wlassoff, PhD. http://brainblogger.com/2014/07/30/vitamin-b12-deficiency-and-its-neurological-consequences/
