What Causes Low Vitamin B12

Vitamin B12 is an essential nutrient that plays a key role in producing red blood cells, supporting the nervous system, and helping the body release energy from food. Because it is not made by the body, we need to obtain it through diet or supplements. A lack of vitamin B12 can lead to tiredness, weakness, anaemia, and even nerve problems if it continues for a long time. Understanding the causes of low B12 is important for maintaining overall wellbeing and ensuring the body functions as it should.

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The Importance of Vitamin B12

Vitamin B12, also called cobalamin, is needed to form healthy red blood cells, protect nerve function, and help release energy from food. It is mainly found in animal-based foods such as meat, fish, eggs, and dairy products. Because of this, some groups of people are more likely to become deficient, but there are also medical and lifestyle factors that can contribute.

Dietary Causes of Low B12

One of the most common reasons for low vitamin B12 is diet. Since B12 is naturally present in animal-derived foods, people who follow a strict vegan or vegetarian diet without fortified foods or supplements may struggle to get enough. Even for those who eat animal products, a diet lacking in variety can sometimes lead to shortfalls. Fortified cereals, nutritional yeast, and plant-based milks can help provide B12 for those who avoid animal foods, but supplements are often recommended to ensure reliable intake.

Absorption Problems in the Digestive System

Even if the diet contains enough B12, the body may struggle to absorb it properly. Vitamin B12 absorption depends on a protein called intrinsic factor, which is produced in the stomach. In a condition called pernicious anaemia, the body’s immune system attacks the cells that make intrinsic factor, meaning B12 cannot be absorbed efficiently. Other digestive conditions, such as Crohn’s disease, coeliac disease, or chronic gastritis, can also interfere with how the body absorbs nutrients, making deficiency more likely.

The Impact of Ageing on B12 Levels

As people get older, the stomach tends to produce less acid. Since stomach acid is needed to release B12 from food proteins, this can lead to lower levels over time. This means older adults are at greater risk of deficiency, even if they eat a balanced diet. Because of this, routine checks are sometimes recommended in older age to ensure levels are healthy.

Medication That Can Lower Vitamin B12

Certain medicines can reduce B12 absorption. Long-term use of metformin, a common treatment for type 2 diabetes, has been shown to lower B12 levels in some people. Medications that reduce stomach acid, such as proton pump inhibitors or antacids, can also reduce absorption because acid is needed to release B12 from food. People who take these medicines regularly may benefit from having their levels monitored by their GP.

Lifestyle and Alcohol Consumption

Heavy alcohol intake can contribute to vitamin deficiencies, including B12. Alcohol can damage the stomach lining, reduce the production of intrinsic factor, and affect how nutrients are absorbed. In addition, poor diet choices that often accompany long-term alcohol use can mean lower intake of B12-rich foods, further increasing the risk of deficiency.

Pregnancy and Increased Needs

During pregnancy, the body’s demand for many vitamins increases, including B12. If intake is already low before pregnancy begins, levels may fall further and affect both the mother and the developing baby. This is especially important for women following vegetarian or vegan diets, who may need to pay closer attention to fortified foods and supplements.

Recognising and Managing Low B12

Low B12 can cause a range of symptoms, including extreme tiredness, weakness, breathlessness, numbness or tingling in the hands and feet, memory problems, and pale or yellowish skin. If left untreated, it can lead to serious health problems, including damage to the nervous system. Diagnosis is usually made through a blood test, and treatment depends on the cause. Some people may only need dietary changes, while others may require supplements or injections to restore healthy levels.

Conclusion

Low vitamin B12 can be caused by a lack of animal foods in the diet, problems with absorption, ageing, certain medications, alcohol use, and increased demands during pregnancy. Because this vitamin is so vital for energy production and nerve health, recognising the risk factors is important for keeping the body in balance. If you are concerned about your levels, it is always best to seek advice from a healthcare professional.

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