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A woman holding books with her hand up to her forehead indicating she is fatigued

Feeling Fatigued? It Might be a Vitamin B12 Deficiency

Vitamin deficiencies can be sneaky and subtle. Especially with symptoms like fatigue because, well, who isn’t fatigued nowadays? But if you’re spending most days feeling exhausted despite how many hours of sleep you’re getting, the fix may be as simple as including more vitamin B12 in your diet.

Vitamin B12 is one of those vitamins that Canadian adults tend to miss out on—an estimated 40% fall in the low-normal range. While “low normal” might sound fairly benevolent, consider that vitamin B12 levels within this range are low enough to cause you to experience neurological symptoms.   

While we should all be taking essential vitamins seriously, vitamin B12 is one we definitely want to catch before we reach deficiency levels, as they might start mild (think feeling more tired than you know you should) and end severely (think heart palpitations and decreased mental abilities).

What is Vitamin B12?

Vitamin B12 is also known as cobalamin, and it’s one of eight other B vitamins. Its primary functions include:

  • red blood cell formation
  • brain and nerve cell function
  • protein digestion
  • DNA production

It is an essential vitamin, meaning the human body doesn’t produce it and needs to acquire adequate amounts from animal food sources since plants are not a typical source. This is because vitamin B12 is only synthesized by a particular bacteria found in the bodies of animals that are found high in the food chain. We’ll talk more about this later. 

Symptoms of a Vitamin B12 Deficiency

As we mentioned before, symptoms can start mild and progress to more severe.

The following symptoms characterize a true vitamin B12 deficiency:

  • extreme fatigue and lethargy
  • trouble catching your breath
  • headaches
  • lightheadedness
  • paleness
  • heart palpitations
  • weight loss
  • reduced appetite
  • tinnitus

However, symptoms of a much more common lower blood levels of vitamin B12 can include:

  • numbness or tingling in upper and lower extremities
  • anemia
  • mental fog or difficulty thinking
  • memory issues
  • fatigue
  • anxiety
  • depression
  • muscle weakness

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Who is at Risk for a Vitamin B12 Deficiency?

Dr. Angela Hunt, ND, argues that the ranges by which vitamin B12 deficiencies are measured are set far too low. This means that people suffering from a deficiency might be much higher than the 40% we noted earlier.

This also means that many more people might be suffering from symptoms of sub-optimal vitamin B12 levels. Therefore, the solution to problems they might perceive as “normal” could be cured as easily as adding a supplement to their daily nutritional habits.

Obviously, 40% is already a huge chunk of the population; however, there are groups that are most at risk for a vitamin B12 deficiency. They are:

  • people who do not eat meat daily, vegans, and vegetarians
  • people who use OTC drugs such as Nexium, Prevacid, Pepcid, or Zantac
  • people taking metformin
  • people who have had gastric bypass surgery
  • those who drink lots of alcohol regularly
  • those with leaky gut syndrome, intestinal dysbiosis, gastritis, low stomach acid, or pernicious anemia 

In addition to these conditions, the aging population is also at an increased risk for deficiency. Children who don’t enjoy eating meat or are picky eaters may also be at an increased risk, as well as pregnant women. 

Common Vitamin B12 Foods

While several essential vitamins may be more readily available from animal products, most can be found in adequate amounts from plant-based foods. But in the veg world (meaning vegans and the various versions of vegetarians), B12 is well-known as the only vitamin not available from plant-based foods.

That’s because vitamin B12 is only synthesized by specific bacteria, mainly found in predators’ bodies who are located higher in the food chain. With that being said, the best food sources for B12 include:

  • tuna
  • beef
  • shellfish
  • eggs
  • dairy products like cottage cheese

Vitamin B12 Supplements

When we look at the foods with the highest concentrations, it’s easy to see why vegans and vegetarians aren’t consuming enough foods with vitamin B12. However, it’s also important to note that people who struggle with low stomach acid cannot absorb vitamin B12 even if they consume these vitamin B12 foods.

In these cases, supplementation may be necessary to relieve and prevent the adverse effects of a deficiency and to reap the benefits of vitamins B12. Supplements can be found in one of two forms.

What are the Forms of Vitamin B12 Supplements?

The two forms of this essential vitamin in supplement form are methylcobalamin and cyanocobalamin.

Both forms are similar, but methylcobalamin is the naturally occurring version that you would find in vitamin B12-rich foods like meat and fish. On the other hand, cyanocobalamin is synthetically created and not found in the vitamin B12 foods.

It’s easiest to find vitamin B12 supplements made with cyanocobalamin, as it’s generally regarded as more shelf-stable and cost-effective. However, there are conflicting studies about which form is more easily absorbed and retained, and more research is necessary on the subject.

What about Vitamin B12 Injections?

If you recognize you need supplementation to avoid a deficiency, you might have heard that injections are an option as well. They used to be mainly prescribed when a deficiency reached a severity that required immediate restoration.

These days, celebrities and regular people alike are using injections to boost their levels at the spa or even at pop-up events all over town.

Both pills and shots are equally effective at restoring levels, preventing deficiencies, and producing the benefits of the essential vitamin. Injections do tend to work faster and are used less frequently, so it really comes down to personal preference.

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How Much Vitamin B12 is Necessary?

The government recommends a daily allowance of 2.4 mcg of cobalamin. While pregnant, the allowance raises to 3.5 mcg. They also note that the body can store anywhere from 2-5 mg, and these stores often last for 2-5 years, meaning that it’s relatively difficult to reach deficiency levels.

Now, when we look at an individual’s blood levels, the “normal” blood volume range is between 170-600 pmol/L. Dr. Hunt notes that this massive range used by most Canadian labs is from averages of the local population and not on any research indicating that these are ideal levels.

She notes that in other countries, like Europe and Japan, if blood levels are anywhere below 500 pmol/L, doctors will recommend supplementing vitamin B12. This level is correlated with deficiency symptoms based on research, not just averages from the population (who may all be chronically deficient, anyway).

Can You Have Too Much Vitamin B12?

Vitamin B12 is a water-soluble vitamin, which means it’s very hard (if not impossible) to consume toxic levels. As with most water-soluble vitamins, the body takes what it needs and expels all extra through the urine.

Megadoses of about 2,000 mcg/day are even considered safe to supplement. So, while this isn’t an essential vitamin you need to be overly concerned about accidentally taking too much of, it’s still a good idea to do a little research and talk with your primary care physician to decide what an appropriate dose for you would be. 

Vitamin B12 Benefits

Now that you understand what cobalamin is, what foods provide it, and a bit about supplementation options, let’s discuss the benefits of optimal vitamin B12 levels.

1. Boosts Energy

2. Improves Hair, Skin, and Nails

3. Supports Strong Bones

4. Eye Health

5. Mood

6. Prevent Brain Atrophy

7. Reduce Risk of Anemia

1. Vitamin B12 Boosts Your Energy 

Using vitamin B12 doesn’t give you a high like caffeine does, blocking neurons in your brain that tell you how tired you are. Instead, one of the benefits of B12 is it helps produce energy at the cellular level.

This is especially noticeable if your blood levels are on the lower side, as your body hasn’t been able to produce energy effectively. Still, with the onset of supplementation and more ideal levels, suddenly, you’ll feel more energetic and peppier.

However, it’s for this reason that you should take your supplement in the morning rather than before heading off to bed.

2. Improve Hair, Skin, and Nail Appearance with Vitamin B12 

In addition to helping cells produce energy, another benefit is cellular production. Lower B12 levels can cause hyperpigmentation, hair changes, nail discolouration, and more.

Improving your vitamin B12 levels supports the cellular health of the hair, skin, and nails, and therefore, supports their overall appearance.

3. Vitamin B12 Supplements Support Strong Bones 

In the same way that cell production is important to the health and appearance of the hair, skin, and nails, it’s also critical to the bones. So, another benefit of vitamin B12 is a decreased risk of osteoporosis, especially in the older-women category.

Studies have shown that many people with vitamin B12 deficiencies have lower bone mineral density, meaning their bones are weaker than they should be.

4. Keep Eyes Healthy with a Daily Vitamin B12 

Unfortunately, macular degeneration is an age-related eye disease that affects your central vision and can lead to partial or complete blindness.

One factor contributing is elevated levels of homocysteine, an amino acid found in the blood. Researchers believe that using B12 supplements can lower the homocysteine levels, reducing the risk of developing age-related macular degeneration and keeping your peepers healthy.

5. Vitamin B12 Can Improve your Mood and Lift Symptoms of Depression 

Cobalamin is significantly involved with the production and use of serotonin in the brain. Serotonin is responsible for mood regulation, so you can see how suboptimal cobalamin might contribute to moodiness.

What’s more, studies support vitamin B12 supplements lifting symptoms of depression in those suffering from the common mental health condition.

6. Keeps your Brain Sharp 

Vitamin B12 is important for neural health, and the body’s largest concentration is in the brain. Neurons are one of those body parts that, unfortunately, fall victim to the “use it or lose it” law.

That’s why as we age, we can lose significant amounts of neurons contributing to memory loss and dementia. Vitamin B12 deficiencies are strongly associated with memory loss in the aging population.

Fortunately, supplementation and optimal B12 levels have been shown to minimize the risk and prevent brain atrophy, which is the wasting away of unused neurons in the brain.

7. Reduce Risk of Anemia with Vitamin B12

One of B12’s most important roles is red blood cell production. When vitamin levels are suboptimal, the body cannot produce enough quality red blood cells adequately.

Red blood cells are responsible for carrying oxygen to your organs, and when they aren’t present enough, or when the cells lack integrity, oxygen fails to make it to the vital ingredients, which has many risks and symptoms, including weakness and fatigue.

What About the Vitamin B Complex Supplements?

If you’re now convinced you need to supplement with vitamin B12, you will undoubtedly notice that there are many options, including vitamin B complex supplements. 

These are supplements that contain all eight B vitamins. The vitamins are:

  • B1
  • B2
  • B3
  • B5
  • B6
  • B7
  • B9
  • B12

Each is essential to healthy body function but in different quantities. There are pros and cons to using either a complex supplement or B12 alone, as with anything else. Which will work best for you depends on your diet and your situation. If you spend time researching the necessary quantities versus what you likely get from your food, you may find that a complex helps cover all your bases.

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On the other hand, you might find that you get most other B vitamins and only lack vitamin B12 as we’ve discussed here. The bottom line is essential vitamins are vital to your health and wellness, and vitamin B12 is one that can be especially difficult to get from food alone in many instances. If you suspect you’re not consuming enough, supplementation is a fast and convenient way to help you feel the benefits fast.

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