Medicines for Vitamin B12 deficiency

What it is

Vitamin B12 deficiency means the body does not have enough vitamin B12, which is essential for making red blood cells, keeping the nervous system healthy, and other functions. It can develop for several reasons: a lack of B12 in the diet (B12 comes mainly from animal foods, so vegans and some vegetarians are at higher risk without supplementation), and — a common cause — problems absorbing B12 from food, including pernicious anaemia (an autoimmune condition that stops B12 being absorbed), conditions affecting the stomach or bowel, some medicines (such as certain long-term acid-reducing or diabetes medicines), and gastric surgery. Symptoms develop gradually and can include tiredness and lack of energy, breathlessness, a pale or slightly yellow tinge to the skin, a sore or red tongue, mouth ulcers, and — importantly — neurological symptoms such as pins and needles, numbness, problems with balance and walking, and effects on memory, thinking and mood. B12 deficiency can cause a type of anaemia (megaloblastic anaemia). The neurological effects are important because, if a marked deficiency is left untreated for a long time, some nerve damage can become permanent — which is why recognising and treating it matters.

How it is treated

B12 deficiency is diagnosed with blood tests, and further tests may help find the cause (for example checking for pernicious anaemia). Treatment replaces the B12 and is usually very effective, with the method depending on the cause and severity. Where the deficiency is due to a problem absorbing B12 (such as pernicious anaemia), it is usually treated with B12 injections — initially more frequently to build up the level, then at regular intervals long-term, since the underlying absorption problem persists. Where the deficiency is dietary, it may be treated with B12 supplements (tablets) and dietary advice, or injections, depending on the situation. Treating the deficiency usually improves the symptoms, and correcting it promptly is particularly important where there are neurological symptoms, to give the best chance of full recovery. Any underlying cause is managed, and ongoing monitoring or maintenance treatment is arranged where needed. The reassuring message is that vitamin B12 deficiency is usually straightforward to treat with supplements or injections, and treating it promptly — especially when there are nerve symptoms — gives the best outcome.