Fatigue is one of the main complaints that I hear from new patients at my clinic. The reasons behind fatigue can range from insomnia and excessive stress to food allergies or a hormonal imbalance, but more often than not I find that low levels of vitamin B12 — and often iron, as the two go hand in hand — are partially to blame.
What causes vitamin B12 deficiency?
Vitamin B12 is water soluble, which means that the body is unable to store it in large amounts — this makes it especially important to get it in regular doses, either in your diet or through supplements. This can be difficult for some people, particularly vegetarians, vegans, or those with absorption issues related to conditions like celiac disease or Crohn’s disease. The symptoms of a deficiency in vitamin B12 include muscle weakness, low blood pressure, vision problems, memory issues, macrocyctic anemia (which means you have too few red blood cells that are also too large), fatigue, and mood disturbances.
The good news is that that vitamin B12 is one of the easiest vitamins to supplement, when it’s taken in the right form and dosages. Here are four key tips to make sure you hit your B12 requirements and avoid deficiencies.
1. Get your B12 levels checked
Vitamin B12 affects brain function by lowering homocysteine, an amino acid that can have negative health effects when its levels are too high. Elevated homocysteine is a risk factor for heart disease, osteoporosis, Alzheimer’s disease, stroke, and increased risk of birth defects.
For this reason, I recommend requesting that your B12 levels are checked when you next see your doctor, especially if you’re older than 30. Folic acid/folate and vitamin B6 are also related to keeping your homocysteine levels in check — the optimal value for your fasting homocysteine blood test is less than 6.3, while an optimal blood B12 reading is 600 or higher.
2. Look inside your medicine cabinet
Prescription and over-the-counter medications can help us treat a particular disease or condition, but they sometimes come with a nutritional cost by increasing our need for certain vitamins and minerals. For example, the birth-control pill causes a decrease in B12, along with zinc, folic acid/folate, B6, and vitamin C, while metformin, which is used to treat diabetes, might reduce the absorption of vitamin B12. These and some other medications can interfere with the absorption of vitamin B12 from food by slowing the release of hydrochloric acid into the stomach. If you have inadequate B12 levels to begin with, or take these medications for a lengthy period of time, you may be more susceptible to a vitamin B12 deficiency.
3. Add B12 to your supplement arsenal