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Feeling fatigued?
You may be suffering from vitamin B12 deficiency
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By Diana Doyle-Zebrun
May/June 2019

We all feel a little tired from time to time.

But when fatigue is accompanied by other symptoms, such as shakiness or trouble walking, tingling in your hands and feet, or shortness of breath, it may be time to consider whether your lack of energy could be tied to something more than just another busy day.

There are a number of health issues that can cause you to feel tired and down. One problem that sometimes sneaks up on people, especially those over the age of 50 or who follow a vegetarian diet, is vitamin B12 deficiency. The following Q&A is designed to provide you with some background on this condition as well as steps you can take to avoid it.

What is vitamin B12 deficiency?

As the name suggests, the condition is caused by a lack of vitamin B12. Simply put, vitamin B12 is essential to the building of red blood cells that circulate oxygen through your body. The lack of oxygen causes fatigue. Vitamin B12 also helps keep your nervous system healthy. A lack of B12 may cause damage to the fatty substance known as myelin, that covers your nerves and allows the brain to communicate with other parts of your body. The longer this problem persists, the greater chance you have of suffering permanent nerve damage.

A lack of vitamin B12 can also lead to a condition called vitamin B12 deficiency anemia, one of several types of anemia. Others include iron deficiency anemia, hemolytic anemia, and folic acid deficiency anemia.

What are the symptoms of vitamin B12 deficiency?

In addition to the ones listed above, symptoms include confusion, memory loss, a swollen, red tongue, mood changes, and a loss of bladder or bowel control.

Photo of a tired man leaning on a tire

Who is most susceptible to vitamin B12 deficiency?

People at risk for this condition include:

  • Those who are 50 years of age or older. (Our bodies are less able to absorb vitamin B12 as we get older.)
  • Vegetarians. (While vitamin B12 is readily available in a wide range of animal foods, it is not found in plant-based foods. Vegetarians are advised to ensure they get the vitamin B12 they need by choosing fortified foods or a supplement.)
  • People with chronic conditions. (Thyroid disease, pancreatic disease, Crohn's disease and celiac disease are associated with vitamin B12 deficiency.)
  • People who take certain medications. (Cancer medications or those that reduce stomach acid.)
  • Vitamin B12 deficiency can also occur in children, often from birth, and may present as a developmental delay or even autism.

How is it diagnosed and treated?

If you have any of symptoms of vitamin B12 deficiency, talk to your health-care provider. He or she can order a blood test to determine if you have this condition. Treatment will depend on the circumstances. Mild cases can be alleviated by eating more foods with vitamin B12 or by taking supplements. In other cases, your health-care provider may prescribe pills or injections of vitamin B12.

What can be done to avoid vitamin B12 deficiency?

Make sure your diet contains plenty of foods that are high in the vitamin. Meat, fish, poultry, dairy products, and eggs are all good sources of vitamin B12.

According to Health Canada, it is recommended that people over the age of 14 get about 2.4 micrograms (mcg) of vitamin B12 per day, while pregnant and lactating women should get 2.6 and 2.8 mcg per day, respectively.

The amount of vitamin B12 will vary depending on the food source. Two eggs will provide 1.6 mcg, while a cup of milk contains about 1.2 mcg of B12. For more information about good food sources of vitamin B12, visit and search: vitamin B12.

Vegetarians should consult with their doctor or a registered dietitian to discuss ways to ensure they are getting the required amount of vitamin B12. You can call Dial-a-Dietitian at 1-877-830-2892 or 204-788-8248 in Winnipeg for free nutrition information.

People 50 years of age and older should talk to their health-care provider about whether they should take a multivitamin or a vitamin B12 supplement.

Diana Doyle-Zebrun is the Clinical and Quality Initiatives Co-ordinator at the Provincial Health Contact Centre at Misericordia Health Centre. If you have health questions, call Health Links - Info Santé at 204-788-8200, or toll-free at 1-888-315-9257. This column was originally published in the Winnipeg Free Press on Friday, March 22, 2019.