Vitamin B12: I Wish I’d Known

After feeling increasingly yucky for months on end, I finally sought the help and advice of my doctor. I’m not typically one to leave things for a long time without looking into them, but my symptoms seemed so vague and almost bizzare, that I felt stupid trying to explain how I felt. For about 2 years, I have felt like my eyes are always tired and puffy….almost like I’m wearing some sort of a mask that makes the simple task of opening and closing my eyes seem like hard work. Some days the visible pockets of fluid under my eyes were alarming and yet I could never seem to trace the fluid retention to a food I’d eaten or a change in routine. Over time, I felt like more and more like I was under this constant cloud that resulted in low energy and lack of motivation . (This of course, is completely opposite of my personality. In fact, I have often been the brunt of jokes and remarks because I’m generally known for juggling many things at once and always being “on the go”.)

Of course, hitting my head and suffering a concussion only compounded my frustration of not feeling well. My summers are generally packed full of DIY projects and I thrive on getting things done around the house. For me, the measure of a good holiday or weekend is often summed up by what I accomplished, so having a summer in which I achieved little was not easy for me. During the school year life is very busy and I just don’t have the time to do all the things that need to get done to maintain the house or give it the little extras I love to do. Despite the head injury, I was feeling better when I stepped onto the court for my first Thursday night volleyball game in September. It was on this evening that I would suffer a shoulder injury that still has me sidelined and using heat/ice when I take on too much. The two injuries have forced me to take it easy and I couldn’t help but wonder how much the injuries were impacting my overall attitude and lack of motivation. None the less, my symptoms seemed to be heightening and by the time I finally went to the doctor in early December, I was “fit to be tied” as my mom would have said.

My Symptoms:

  • Daily swollen, puffy eyes (some days worse than others).  I feel like I’m wearing a mask and just can’t ever get it off.
  • Low energy and no motivation which is very out of character for me.
  • Memory loss – I was seriously feeling like I was in such a brain fog that I could barely remember my name sometimes. I just couldn’t seem to “hang on to things” as I should, and my family was even beginning to get frustrated….I was hearing a lot of “I already told you that!”.
  • Lack of strength. I’m generally a pretty tough cookie. I generally don’t ask for help unless it’s absolutely necessary, but I noticed that I was lacking the strength to do simple tasks like open jars.
  • I became increasingly concerned when my limbs would fall asleep several times per day. It seemed like whenever I was in a sitting position for more than a couple of minutes, something would fall asleep. On more than one occasion, I stumbled when my ankle/foot gave out when I stood up without realizing it had fallen asleep.

It was at this point, that I went to my doctor and she ordered a full blood panel. I met with her before Christmas and she told me that the only thing that really showed up was that my B12 was low. Although no one ever wants bad news, I have to admit that I was hoping for some answers. To me having low B12 seemed quite insignificant. However, she went on to explain the levels and that my counts could actually be having a huge impact on my over all health. She also encouraged me to “google it”.  Here’s what I learned from my own doctor about the counts and ranges followed in Canada:

  • Below 148 is considered a deficiency
  • 148 to 220 is considered to be in the insufficient range
  • Over 220 is sufficient

My count was 152, so according to the above scale, I am just shy of what is considered to be a deficiency and at the very bottom of the insufficient zone. However, in doing some research, what I learned was that this scale varies greatly from country to country. According to Chris Kresser, many people go undiagnosed because their levels are deemed to be in the “normal range” for that particular country. Here are some of the ranges that were shared in his article:

Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL.

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.

Interestingly, I also read that people deficient in vitamin D often have a B12 deficiency as well. I have been taking 10,000 IU’s of D for several years now, but was unaware of my vitamin B12 issue until now. I started taking a “sublingual” tablet that dissolves under your tongue for improved absorption. My doctor recommended 1000 MCG, but I opted for 5000. I go back for another blood test in March and will adjust my supplement dosage accordingly.  The one thing that seems very clear from my research is that some individuals can suffer from symptoms even when they are told their levels are within the normal range. Based on how I have been feeling and the symptoms I’ve read about, this is not something to mess around with. If left untreated, the result can be severe permanent damage. The lists of symptoms seem to vary depending on the source and I obviously did not have all of the symptoms. However, some of the things I was experiencing indicate that it probably had been left untreated for some time. I’m just so thankful that I finally got it checked-out and am hopefully on the road to feeling better. Of course, I will also be mindful of including B12 rich foods in my diet. B12 comes from animals and animal by products, so diet can be a strong predictor of deficiencies, although there are other possible causes as well. I do eat meat, but eat very little dairy and get most of my protein from eggs, nuts and seeds.

Some of the Symptoms that May Indicate a B12 Deficiency:

  • strange sensations, numbness, or tingling in the hands, legs, or feet
  • difficulty walking (staggering, balance problems)
  • anemia
  • a swollen, inflamed and/or sore tongue
  • yellowed skin (jaundice)
  • difficulty thinking and reasoning (cognitive difficulties), or memory loss
  • dry and/or itchy skin
  • weakness and fatigue
  • rapid heartbeat
  • shortness of breath
  • easy bruising or bleeding, including bleeding gums
  • stomach upset and weight loss
  • diarrhea or constipation

I’m actually overwhelmed by the research and especially by the broad range of symptoms that can result for inadequate B12 levels. The scariest part is that many people are being misdiagnosed or getting no answers at all. Remember, you know yourself best. If you are feeling “off” get it checked out. I take several supplements every day and would have never imagined that I could be suffering from a deficiency. I just wish I’d known as I’m sure I would have gone and got my blood checked long before the symptoms got so bad. Trust yourself and your own judgement.

There are many great articles, but here are a few I found to be very good and they have links to other great sources as well. If you suspect you may be deficient, the first step is to get a blood test and find out exactly what your levels are at.

Could it be b12?

Do you suffer from vitamin B12 deficiency?  (this site actually has a little quiz with a long list of symptoms)

Six Commonly Missed Diagnoses: B12 Deficiency

Can’t Beat Fatigue? You May Be Low in B12