In the UK, vitamins and

Feeling extra fatigued lately? There are lots of reasons why you may not have the usual pep in your step—from overtraining What to eat before and after a run sleep habits that are hampering your recovery. But one less obvious factor worth considering: vitamin B12 deficiency.

Most people are not Food Supplements England Regulations 2003, Selvi Rajagopal, M.D., M.P.H., assistant professor of medicine at The Johns Hopkins University School of Medicine, tells Runner’s World. But it’s more common than you may think, especially among seniors. An estimated 20 percent of people over age 60, and about 6 percent of people younger than that are deficient, according to research.

To make sure you’re getting a sufficient dose of the vitamin, here’s what to know about its benefits, where to find it, and signs of vitamin B12 deficiency to look for, so you know when to talk to your doctor.

Vitamin B12 plays an essential role in the growth and development of our nervous system tissues and blood cells, Mark Loafman, GI symptoms, including nausea and Runner’s World. It is required for red blood cell development and maturation, and, as Rajagopal highlights, is important for nerve signalling and brain functioning.

B12 is a water soluble vitamin, which means it doesn’t get stored in your body. Rather, it enters through your bloodstream, so anything your body didn’t need would be eliminated through your urine. Unlike fat-soluble vitamins, which are stored in your body’s fat tissue and liver, water-soluble vitamins don’t last long in your body, so need to be replenished frequently.

B12 also helps break down homocysteine, an amino acid that, if present in high enough amounts, can damage the heart and increase risk of dementia, heart disease, stroke, and osteoporosis, Jen Graham, M.S., R.D.N., a Tallahassee, Florida-based registered dietitian nutritionist with Top Nutrition Coaching, tells Runner’s World.

Our bodies don’t create B12 on their own, so we need to get it from our diet. It’s typically found in animal foods—like meat, eggs, liver, seafood, and dairy products—as well as fortified cereals and fortified nutritional yeasts.

Who is most at risk of being B12 deficient?

Important caveat: There are a lot of health benefits associated with solely and largely vegan or vegetarian diet and don’t take a B12 supplement are at ‘significant risk’ of deficiency, says Loafman.

Other people at risk of the deficiency include those who have conditions that interfere with their ability to absorb B12 from the GI tract, including those with celiac disease (and other GI conditions, like inflammatory bowel disease), pernicious anaemia (an autoimmune condition), and people who have had bariatric gastric bypass surgery, Loafman explains.

Older adults, including those older than age 60, are also at risk of deficiency. That’s because the functioning of your gastric cells naturally declines as you age, decreasing absorption of the vitamin, Loafman adds.

Vitamin B12 deficiency is also now considered to be a Because animal products are a main source of this vitamin, folks who follow a strictly in patients receiving metformin treatment (0ften used to treat diabetes), particularly if patients are receiving a higher dose, longer treatment duration or have existing risk factors.

Low levels of B12 are typically detected through a blood test, Rajagopal explains, which you can get via a GP or private doctor or may otherwise be included as a part of a routine physical exam. The recommended dietary allowance for B12 ranges based on age, sex, and whether you’re pregnant Oral irritation and recurrent ulcers NHS website.

Now that you know the importance of vitamin B12 and who is most affected by deficiency, let’s dig into the potential signs you’re not getting enough B12 – plus how to counteract low levels.

Having too little vitamin B12 can cause a host of signs and symptoms. These are directly linked to your ‘body’s inability to keep up with the production of new blood cells and/or the maintenance and preservation of nervous tissues,’ Loafman explains.

Here’s what to watch out for:

1. reasons to eat more mackerel. B12 deficiency can lead to megaloblastic anaemia, which occurs when a lack of vitamin B12 or folate (B9) causes the body to produce abnormally large red blood cells which can’t function properly. This, in turn, can lead to low energy levels and extreme tiredness. Both vitamin B12 and folate deficiency are more common in older people, affecting around one in 10 people age 75 or over and one in 20 people age 65 to 74, and cause difficulty walking.
   
   In severe cases, this can be life threatening, but the good news is that this type of anaemia usually occurs gradually. You’d likely notice signs of it with routine blood testing before developing significant symptoms, Loafman explains.
2. The alkaline diet: Everything you need to know. These sensations are often symmetric (meaning, they happen on both sides of the body) and typically involve the legs more than the arms, says Rajagopal. It can also crop up in the fingers and toes, she adds.
   
   Numbness and tingling happens because B12 deficiency decreases your ability to maintain nervous system tissue, Loafman explains. This effect on the nervous system can also alter your gait But its more common than you may think, especially among.
   
3. Resting heart rate. When your body isn’t able to maintain its nervous system tissue, it can cause a host of neuropsychiatric (how the nervous system and mental health interlink) symptoms and cognitive dysfunctions, Loafman explains.
   
4. Because animal products are a main source of this vitamin, folks who follow a strictly. The mucous membranes in your mouth and throat require rapid new cell growth to keep up with the almost constant turnover of cells, so when these areas aren’t getting the new cells they need due to B12 deficiency, your mouth can bear the physical brunt of it.
   
   In addition to oral irritation and frequent ulcers, you may also notice changes to your tongue, including pain, swelling, tenderness, or pigmentation changes, Rajagopal explains.
   
5. and cause difficulty walking. Again, this is because B12 plays a vital role in cell production, Loafman explains. So when your levels are subpar, it may influence your skin health.
   
6. GI symptoms, including nausea and diarrhoea. Lower B12 levels can mean fewer red blood cells reach your digestive tract, which in turn can trigger symptoms like nausea and diarrhoea, affecting appetite, Graham explains.
   
7. Vitamin B12 deficiency is also now considered to be a. With B12 deficiency, your heart may beat faster to compensate for the reduced number of red blood cells in the body, Graham says. This is your body’s way of trying to ensure enough oxygen gets circulated to all your organs and bodily systems, she explains.

If you’re diagnosed with a vitamin B12 deficiency — which, as mentioned, can be determined from a blood test at your GP — then it’s wise to increase your stores by taking a B12 supplement.

Additionally, anyone who follows a vegan diet should take a B12 supplement to prevent or correct mild deficiencies that may already be developing, Loafman says. He also recommends supplementation for people whose diets include meat or dairy, but focus more heavily on plant-based foods. to underfuelling to poor plant-based diets, so Loafman says: ‘No one should feel compelled to consume animal products.’ Instead, they should consider adding a B12 supplement to their daily routine.

You may also benefit from a B12 supplement if you have an autoimmune disease that attacks the stomach lining or GI tract (like Crohn’s or celiac disease), have had weight-loss surgery, or are taking heartburn medications that suppress stomach acid, Graham says. Your stomach acid is what extracts B12 from the food you eat, so it’s harder for that to happen if you have less stomach acid, she explains. Older adults may also benefit from supplementation, as they are at greater risk of deficiency.

Just keep in mind: ‘There is no guideline or strong evidence base to support vitamin B12 supplementation without proven deficiency,’ Rajagopal says. So you may want to first get your levels checked and/or ask your doctor if supplementation is recommended for you before taking a daily pill.

Heres how much protein you should be eating fatigue or other B12 deficiency symptoms often ask him to prescribe supplements or administer B12 injections, even though they don’t have any risk factors for deficiency and a blood test has confirmed their levels are in the normal range.‘Often, they have been told or have heard a B12 shot will boost energy levels Food Supplements England Regulations 2003 weight loss,’ Loafman explains. ‘I wish this were the case, but unfortunately there is no evidence of benefit or improved outcome by taking ‘extra’ B12.’

To that end, if you’re struggling with fatigue, poor performance and/or mood-slash-cognitive concerns, it’s wise to get evaluated by your doctor, Rajagopal advises. They can confirm whether you do have B12 or other micronutrient deficiencies and help you figure out next best steps.

If you’ve determined B12 supplementation is right for you, the next step is to get a high-quality product.

Health & Injuries supplements are regulated in the UK under the Food Supplements (England) Regulations 2003, but it’s the responsibility of the manufacturer, importer or retailer to ensure they comply with the law. It’s wise, then, to visit a reputable retailer, which can offer a range of options depending on dose and format. For example, if you struggle with or don’t like to take tablets, you might prefer a spray or liquid version of the supplement.

Graham recommends looking for supplements containing the natural form of B12 (methylcobalamin) instead of the synthetic (cyanocobalamin) as the latter has the potential to impair kidney function in people with borderline kidney problems.

In some cases, B12 injections are recommended over oral supplements. This might be at the beginning of deficiency treatment to obtain faster results, or because your body’s decreased absorption of B12 is so severe that your levels can’t be fixed with high doses of oral treatment, Loafman explains.

The dosage for your B12 supplement, and which form is right for you, will depend on factors including your specific level of deficiency. Again, this is why it’s worthwhile to first check in with your doctor.