Vitamin B12 deficiency in Indians: make sure you don’t have it

Vitamin B12 deficiency is common among Indians

Vitamin  B12 is a water soluble vitamin, this is why its reserve lasts only a few days in the body; we have to get it adequately from diet to avoid vitamin B12 deficiency. But B12 is NOT FOUND IN PLANT FOODS AT ALL, so the only source for vegetarians is milk/milk products. Therefore, its deficiency is common in India, especially among the vegetarians, the elderly and pregnant women. Reports from all parts of the country show that vitamin B 12 deficiency could be present in more than 30% of Indians.

Vitamin B12 has very important functions in cell division and therefore its essential for growth, red blood cell synthesis and maintenance of nervous system in the body. In the elderly, deficiency can result in irreversible damage of neurological function therefore checking for vitamin B12 deficiency in people at risk is very important.

Below is a list of common manifestations of vitamin B12 deficiency

Clinical deficiency: (when a disease develops because of vitamin B12 deficiency)

  • Megaloblastic anaemia and/or
  • Neurological symptoms
    • Numbness and tingling in the hands and feet , inability to differentiate hot and cold
    • Difficulty maintaining balance and stumbling
    • Confusion, poor memory, and dementia

Subclinical deficiency: (symptoms are not present or are nonspecific and vague), this is the commoner form of vitamin B12 deficiency

  • Fatigue, weakness, depression; especially in elderly people, which is irreversible so early diagnosis is important
  • Constipation, loss of appetite and weight loss,
  • Soreness of the mouth or tongue

Vitamin B12 deficiency:should you get a blood test done?

We recommend getting tested for vitamin B12 levels in blood, because  The deficiency mild deficiency can be corrected by taking routine multivitamin supplements but in case of severe deficiency you are better off getting vitamin B12 injections/ high dose oral supplements  for 1-2 weeks

The most commonly done tests are

  • CBC (complete blood count) and peripheral smear to detect anaemia or abnormal RBCs
  • Blood level of vitamin B12: the normal range is 200-600 pg/mL. Levels below 150 pg/mL indicate deficiency, whereas levels below 60 pg/dL indicate severe deficiency

Rich dietary sources (Vitamin B12 foods)

Vitamin B12 is found only in food of animal origin: meat, fish, eggs , milk and dairy products, therefore vegetarians who do not drink enough milk or vegans are at risk of vitamin B12 deficiency

Milk, the only source of vitamin B12 for vegetarians, is not consumed enough by Indians; to get enough vitamin B12 you need 2-3 glasses (200 ml glass) of milk everyday. Butter or ghee, although made from milk have very little vitamin B12 because it is a water soluble vitamin

Vitamin B12 supplements

The usual vitamin B12 supplement level in multivitamins is 6-25 mcg/day, which is not enough to correct deficiency, but good for maintaining the normal levels

If Vitamin B12 deficiency is detected on tests but no serious complaints exist,  supplementation at dose of 500-1000 mcg/day for 1-2 two months, followed by maintenance with usual multivitamin supplements is recommended (If there is Vitamin B12 deficiency with pernicious anaemia or as a result of malabsorption syndromes , get medical advice)

In case of severe deficiency ( blood level <60 pg/mL) your doctor may prescribe vitamin B12 injections daily for a week and then maintenance of levels by injection once in three months or oral supplements

Vitamin B12 and folate

Vitamin B12 and folate have shared functions, in synthesis of blood cell and some others, therefore folate supplements can mask vitamin B12 deficiency, but nerve damage due to vitamin B12 deficiency will still progress. Therefore it is important to always take adequate vitamin B1 supplementation along with folate supplements or to make sure that there is no vitamin B12 deficiency

Know about other vitamins of B complex

Find out which supplements you should be taking and what current research says about common supplements and common diseases