Feeling wiped out and tired despite a good night’s sleep? Tongue feeling sore or looking red and smooth, like raw steak? Placed your keys in the fridge or struggling to remember what you did yesterday? Sudden changes to your vision? Or is every single thing making you cry or feel worried? You could be low in Vitamin B12!

What is vitamin B12?

Vitamin B12 belongs to the B-group of vitamins that are essential in the production and functioning of cells in our bodies. Vitamin B12 is mainly used in processes involving the brain, the nervous system as well as the production of blood cells. In fact, Vitamin B12 is used in the metabolism of every single cell in our body. Yet, despite being needed for so many vital functions in our bodies, we do not actually produce this vitamin and have to obtain it from our food.

Foods that naturally contain vitamin B12 are animal based – such as meat, fish, eggs and dairy products. Plant-based foods do not naturally contain any vitamin B12, however there are some products that have been fortified with vitamin B12 which make them a much-needed alternative for vegans and vegetarians.

I’m not a vegan, so it’s all good right?

It’s true that the chances of developing a vitamin B12 deficiency is pretty low for most people who consume a balanced diet containing animal products (such as meat, dairy or eggs). However, you could still develop a deficiency if you are not able to absorb the vitamin B12 from foods that you eat. The process of digesting and absorbing vitamin B12 is quite complex!

It begins with your stomach, which produces gastric acid and intrinsic factor. The gastric acid helps to ‘free’ vitamin B12 from the foods eaten, and together with intrinsic factor they then make their way to the first part of your small intestine (a.k.a. the duodenum). It’s here in the duodenum where vitamin B12 binds with intrinsic factor, forming a combo that your small intestine is able to absorb. If this combination doesn’t happen, vitamin B12 on its own passes through unabsorbed.

Your risk of a vitamin B12 deficiency is higher if you identify with the following:

Stomach or small intestine surgery e.g. weight loss surgery

Weigh loss surgery such as sleeve gastrectomy and gastric bypass removes up to 85% of the stomach; significantly reducing the amount of gastric acid and intrinsic factor produced. This directly affect vitamin B12 absorption. A gastric bypass also skips the duodenum, which means vitamin B12 is unable to combine with intrinsic factor and passes through the small intestine unabsorbed.

Gastritis

Atrophic gastritis is a condition where the cells of the stomach are destroyed and no longer able to produce intrinsic factor. This directly affects vitamin B12 absorption. The risk of developing this condition increases as we age; 1 in 10 elderly Australians will have some form of this condition. Atrophic gastritis can also be autoimmune related.

Long-term use of the medication Metformin

Metformin, a medication commonly used in the management of Type 2 diabetes and insulin resistance, has been associated with a higher incidence of Vitamin B12 deficiency. It may be worth checking your levels yearly if you are taking this medication.

Crohn’s disease or poorly managed/undiagnosed Coeliac disease

These conditions affect the surface of the small intestine and commonly result in poor absorption of nutrients from food, including Vitamin B12.

I’m a vegan – can I avoid a deficiency by eating mushrooms?

The amount of vitamin B12 in mushrooms can vary significantly depending on how and where they were farmed, and are usually not present in levels high enough for mushrooms to be considered a good source of this essential vitamin (unless you eats lots of it, and regularly!). The best choice for a vegan or vegetarian is to consume foods fortified with vitamin B12 such as soy milks, yeast spread, bread and breakfast cereals.

Alternatively, you could take a vitamin B12 supplement. The daily requirement for adults is 2.4 micrograms. This requirement is higher for women who are pregnant or breastfeeding. This is because the mother’s intake and stores is the only source of vitamin B12 for the baby as it grows in the womb, as well as after birth where the baby continues to rely on breastmilk (or formula) as a source of vitamin B12. Babies too can develop vitamin B12 deficiencies!

If you are a vegan or  have been experiencing symptoms of a vitamin B12 deficiency, it may be worth getting your B12 levels checked and adjusting your diet. The Team at The Healthy Eating Hub can save you a trip to the doctor by referring you for a B12 test and help you to tweak your food choices to meet your needs.

If you’d like further help with your nutrition please click below: