Signs of Vitamin B12 Deficiency & What Type of B12 Is Best?

Vitamin B12 DeficiencyThere are a wide range of symptoms of vitamin b12 deficiency. From mild to severe. Which can affect your body your mind and your mood. Now in general you want to look for signs of fatigue or lack of energy, muscle weakness and or tingling in your extremities (your hands or your feet).

You also need to be aware of mental fogginess or problems with your memory or trouble sleeping & mood swings. Especially feelings of apathy or lack of motion are also things to be aware of. Now here’s the important part.

Even though vitamin b12 is water-soluble, it doesn’t exit our body quickly like other water soluble vitamins. B12 is stored in your liver kidneys and other body tissues and as a result a deficiency may not show itself for a number of years. This time lag is a serious concern because after about seven years of b12 deficiency, irreversible brain damage can result.

Other symptoms of long term chronic b12 deficiency can include:
  • depression
  • dementia
  • Alzheimer’s disease
  • anemia
  • neurological and neuropsychiatric conditions
  • female fertility and childbearing problems
  • and also heart disease and cancer

So what causes this vitamin b12 deficiency in the first place

what causes this vitamin b12 deficiencyFirst of all the risk of b12 deficiency increases as we age. Since b12 is found in animal products if you are vegan or a vegetarian who does not consume enough eggs, plant based vitamin b12 or dairy products, it is likely that you will not get enough vitamin b12.

Unless you are getting it in supplement form, heavy drinking can also cause a deficiency of vitamin b12. Long term use of acid reducing drugs such as antacids or proton pump inhibitors like nexium prevacid or Prilosec, greatly reduce your body’s ability to absorb b12.

Blood sugar drug metformin

Another prescription drug that causes serious risk for b12 deficiency is the blood sugar drug metformin which is also known as glucophage . B12 can also be decreased by conditions affecting the small intestine such as Crohn’s disease, celiac disease a bacterial overgrowth or a parasite.

Bariatric surgery or weight loss surgery

Bariatric surgery or weight loss surgery where part of the stomach is removed is a major cause of vitamin b12 deficiency. People who have had the gastric bypass or gastric sleeve surgeries definitely need to be concerned about vitamin b12 deficiency.

Autoimmune disease – Pernicious anemia

An autoimmune disease called pernicious anemia in which your immune system attacks something called intrinsic factor makes it extremely hard for your body to absorb vitamin b12. Other autoimmune or immune system disorders such as lupus or graves disease also cause vitamin b12 deficiency.

Now supplementing with vitamin b12 is simple and inexpensive. so if you are deficient it’s not too difficult to get your levels back to where they should be.

Medications That Cause B12 Deficiency

AntacidsPoor diet and various health conditions or an illness can be important factors in causing b12 problems. However, in today’s society one of the biggest causes of b12 deficiency is medications. Both prescription and over-the-counter drugs.

Antacids – B12 Deficiency

First of all antacids such as tums and Rolaids neutralize the acid in your stomach. The thing is, your body needs this stomach acid to be able to extract and absorb b12 from your food. So regular use of antacids has been linked to b12 deficiency.

Proton pump inhibitors

Other drugs prescribed and recommended for conditions like reflux and GERD are called proton pump inhibitors and they actually block your stomach’s ability to produce proper amounts of stomach acid. Nexium prilosec and prevacid have all been linked to vitamin b12 deficiency.

H2 inhibitors

Another class of stomach acid reducing medications are known as h2 inhibitors. These are forms of anti histamines that act as acid reducers and have been shown to make one prone to vitamin b12 deficiency. Example these medications are zantac pepcid and Tagamet.


Metformin, which is also known as Glucophage is a widely prescribed drug to people who are insulin resistant pre-diabetic or are in fact already type 2 diabetics. Many of these studies have shown that metformin can be a major factor in causing vitamin b12 deficiency.

Oral contraceptives and hormone replacement therapy have been linked to vitamin b12 deficiency as well.


And finally one of the most widely used drugs on the face of the earth. Alcohol can cause vitamin b12 deficiency. Now I’m not saying you should never have a beer a glass of wine or a cocktail. After all, Like Jimmy Buffett says, it’s always five o’clock somewhere.

But chronic regular alcohol use or should I say overuse will definitely cause b12 deficiency. Alcohol is hard on all B vitamins actually.

So, if you’re on any of these drugs and are showing signs of vitamin b12 deficiency such as weakness, fatigue, numbness or tingling in your arms or legs, forgetfulness, depression, mood swings or any of the other vitamin b12 deficiency symptoms, you may want to consider consulting with a health care professional.

The best solution would be to actually fix the problems your taking the medications for, instead of just masking them. But at the very least you should be considering supplementing with vitamin b12 if you’re gonna remain on those medications.

What Type of Vitamin B12 Is Best?


What Type of B12 Is Best?Let’s start off by looking at cyano-cobalamin first. This is the most common form of vitamin b12 found in supplements and it’s the form usually used in b12 injections given by a medical doctor.

It’s the most common form because it’s the cheapest form and is considered the most stable in supplement form. It is a synthetic form of b12 though and it’s also an inactive form of b12.

Meaning your body must turn it into something else before it can use it. Now some people can activate this form of b12 but many can’t, which is why it’s not the most efficient way to take b12 for many people.


Next we’re going to talk about hydroxo-cobalamin. It’s the form of b12 found in your food. So it’s natural but it’s also inactive. It’s sometimes used in b12 injections as well but it’s not very commonly found in most supplements.

Again millions of Americans have difficulty converting this form into an active form of b12 that your body can use.


Methyl-cobalamin is both natural and active. It’s used by the body for DNA synthesis and detoxification. It doesn’t need to be converted into anything else for your body to be able to use it.


Finally we have adenosyl-cobalamin. This is another form of b12 that is both natural and active. It’s usually made by your body converting it from methyl-cobalamin.

Your body uses this form to help produce energy, which is usually why people take vitamin b12 in the first place, in the hopes of having more energy.

So, what should you take?

It depends on your body’s needs but most people usually respond to a combination of methyl-cobalamin and adenosyl-cobalamin, taken in a sub lingual form.