Vitamin B12 : Problems and Solution
Vitamin B12 is important for the way the body works, and people who don’t have enough of it may feel tired or have a lack of energy.
Both males & females age 14 or older need 2.4 micro-grams (mcg)/day. Pregnant women age 19 or older need 2.6 micro-grams/day and breastfeeding women age 19 or older need 2.8 micro-grams/day.
Vitamin B12, also known as cobalamin, helps in the production of healthy red blood cells that carry oxygen around the body.
Not having enough vitamin B12 is called vitamin B12 deficiency anemia. This condition makes the body produce larger than normal red blood cells, described as megalomaniac or macrocytic, which don’t do their job as well.
Once diagnosed, vitamin B12 deficiency can usually be treated successfully with B12 injections and sometimes with B12 tablets.
Intake recommendations for vitamin B12 and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender, include:
- Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals.
- Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.
- Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.
It can be difficult to get enough vitamin B12 as a vegetarian, as there is very little of this vitamin in vegetables, fruits, nuts, beans or most grain products. For you, milk and milk alternatives are important sources of this nutrient, as are simulated meat products like soy burgers (read the label).
Food Source of Vitamin B12
Milk & Alternatives Portion size Vitamin B12 (mcg)
Swiss/Em-mental cheese 50g (1 ½ oz) 1.7
Cottage cheese 250mL (1 cup) 1.5
Plain yogurt 200mL (3/4 cup) 1.3
Milk (skim, 1%, 2% or 3.25%) 250mL (1 cup) 1.1 – 1.4
Fortified almond or oat beverage 250mL (1 cup) 1.1
Fortified soy or rice beverage 250mL (1 cup) 1.0
Cheese (Feta, Gouda, Gruyere, 50g (1 ½ oz) 0.8 – 0.9
Brie, Cheddar, Fontina)
Meat & Alternatives Clams 75g (2 ½ oz) 74.2
Oysters 75g (2 ½ oz) 18.2 – 26.3
Mussels 75g (2 ½ oz) 18.0
Organ meat (liver, kidney, etc.) 75g (2 ½ oz) 14.0 – 64.3
Herring 75g (2 ½ oz) 7.2 – 14.0
Sardines, canned 75g (2 ½ oz) 6.8
Salmon, canned 75g (2 ½ oz) 3.7
Salmon, cooked 75g (2 ½ oz) 2.3
Tuna, canned 75g (2 ½ oz) 2.2
Soy burger 75g (2 ½ oz) 1.8
Beef 75g (2 ½ oz) 1.3 – 2.5
Pork 75g (2 ½ oz) 0.8 – 1.1
Egg 1 whole 0.6
Turkey 75g (2 ½ oz) 0.3
Chicken 75g (2 ½ oz) 0.2 – 0.3
Other Red Star nutritional yeast 2 g (1 tsp 1.0 powder /2 tsp flaked)
The answer depends on things including your age, your eating habits and medical conditions, and what medications you take.
The average recommended amounts, measured in micro-grams (mcg), vary by age:
- Infants up to age 6 months: 0.4 mcg
- Babies age 7-12 months: 0.5 mcg
- Children age 1-3 years: 0.9 mcg
- Kids age 4-8 years: 1.2 mcg
- Children age 9-13 years: 1.8 mcg
- Teens age 14-18: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
- Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding).
Symptoms of Vitamin B12 Deficiency
If you have vitamin B12 deficiency, you could become anemic. A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as:
- Extreme tiredness or fatigue
- A lack of energy or lethargy
- Being out of breath
- Feeling faint
- Ringing in the ears (tinnitus)
- Lack of appetite
More specific symptoms linked to a lack of vitamin B12 include:
- Yellowing of the skin
- Sore, red tongue
- Mouth ulcers
- Changes or loss of some sense of touch
- Feeling less pain
- Walking problems
- Vision problems
- Mood changes, irritability, depression or psychosis
- Symptoms of dementia
If you have pernicious anemia or have trouble absorbing vitamin B12, you’ll need shots of this vitamin at first. You may need to keep getting these shots, take high doses of a supplement, or get it nasally after that.
If you don’t eat animal products, you have options. You can change your diet to include vitamin B12-fortified grains, a supplement or B12 injections, or a high-dose oral vitamin B12 if you are deficient.
Blood tests and examination of blood cells under the microscope assess hemoglobin levels, the size of red blood cells and the level of vitamin B12 in the blood. The levels of fol-ate are also usually checked for the related condition fol-ate deficiency anemia.
Once the diagnosis is confirmed, further tests may be carried out to try to find out what’s causing the anemia.
Older adults who have a vitamin B12 deficiency should take a daily B12 supplement or a multivitamin that contains B12.
A referral may be made to a specialist, such as a hematologist for blood conditions, a gastroenterology for digestive disorders or a dietitian for advice on eating food containing more vitamin B12. For most people, treatment resolves the problem. But, any nerve damage that happened due to the deficiency could be permanent.