Do I Have a B12 Deficiency?


One of the many essential nutrients for the body includes B12. This powerful nutrient plays an enormous role in various parts of your body, including DNA, red blood cells, hormones, and nerves. While there are many causes for a B12 deficiency, some people are at higher risk. Health and chosen lifestyle significantly affect the body’s B12 levels.

Am I at Risk of Vitamin B12 Deficiency?

As mentioned above, various causes increase the risk of a B12 deficiency. Some of these factors include: 

Strict Vegans and sometimes vegetarians 

The LARGEST dietary sources of this vitamin are animal products, like meats, poultry, fish, and eggs, which vegans don’t consume. Dr. Coppola and Dr. Montiero recommend including a B12 vitamin to supplement your diet. 

Elderly Adults

Elderly adults may experience B12 deficiencies due to poor absorption of nutrients from the natural aging process.


People with eating disorders like anorexia nervosa can be at risk due to malnutrition. 

Taking Certain Medications

Some medications can deplete the B12 from your body. Antacids for Heartburn or GERD, such as PPI’s (like Nexium, Prilosec, or Prevacid), and H2 blockers such as Zantac, Pepcid, or Tagamet can increase your risk of B12 deficiency.

Other medications that will deplete this vitamin include: 

  • Metformin
  • Antibiotics
  • Methotrexate
  • Colchicine 
  • Anti-seizure medications
  • Cholestyramine
  • Corticosteroids 

Others at risk are:

There are various other reasons someone may develop a B12 deficiency, including: 

  • People who consume caffeine daily
  • Chronic Alcohol users
  • People consuming processed food or junk food regularly
  • Smokers and potentially vapers
  • Women taking oral contraceptives or birth control pills

What Medical Conditions Can Cause B12 Deficiency?

Certain medical conditions can cause a B12 depletion, causing a breakdown in the myelin sheath of the nerve. Conditions that can cause B12 depletion include:

  • Celiac disease–a severe reaction to eating gluten-containing grains
  • Gastritis–inflammation of the stomach lining.  
  • IBS or Inflammatory bowel diseases like Crohn’s or Ulcerative colitis
  • Short bowel syndrome 
  • Pancreatic disease like pancreatitis or pancreatic insufficiency, where the pancreas isn’t producing enough enzymes to break down your food.
  • Bariatric surgeries are huge culprits for not only B12 deficiencies but also many vitamin and mineral deficiencies.
  • H. Pylori infection–a bacteria that can infect the stomach. It’s prevalent in about two-thirds of the world’s population and is the most common cause of ulcers.

There are also a few genetic and autoimmune conditions that result in B12 deficiency, such as:

  • Pernicious anemia is a specific decrease in red blood cells because the body can’t absorb enough Bee twelve.  
  • Transcobalamin II deficiency is a rare genetic disorder that impairs cobalamin transport [vitamin B12] within the body.
  • SNiPs (snips)–a disorder only found on genetic testing

The most commonly overlooked cause, however, is stress or high activity. Various activities can cause elevated stress, from an overloaded schedule to a lack of sleep. The greater the stress load on your body, the greater the demand for vitamin B12 drains your levels, especially when combined with a diet lacking this critical nutrient.

How Do I Know If I Have a B12 Deficiency?

When a doctor runs a vitamin B12 lab test, called a Serum B12 test, they do not realize that this test, which measures molecules known as cobalamin, isn’t sensitive or specific. This means the test does not accurately determine how much cobalamin is in the blood. 

Numerous research studies have pointed out how flawed this test is, and it produces the most significant number of incorrect findings. Doctors use this test because they’re unaware of better options that more accurately identify the cobalamin levels in the blood and body.

Scientific literature shows the most accurate way to determine a B12 deficiency is by running an MMA (methylmalonic acid) test in conjunction with a homocysteine test and the Serum B12 test.

What B12 Supplements Are Available?

There are four different types of Vitamin B12:

  • Cyanocobalamin
  • Methylcobalamin
  • Adenosylcobalamin
  • Hydroxocobalamin

You should never take Cyanocobalamin. First, it’s synthetic and has a poor absorption rate into the cells. Second, Cyanocobalamin gets broken down into two molecules: cobalamin and cyanide. Researchers have suggested that over time, cyanide can build within the tissues. 

In small doses, the liver usually clears the buildup out of the body; however, our modern livers are so overburdened with a tremendous load of toxic chemicals that large amounts get stored within the tissues of our bodies. 

Furthermore, Cyanocobalamin is the most common form used to fortify processed and packaged foods, and it’s frequently the form used when you get a regular B12 injection. However, not all injections are dangerous.

If the injection is intramuscular and they use hydroxocobalamin, it is the best form for your health. Hydroxocobalamin is a highly bioavailable form of vitamin B12, but it’s only available by prescription, usually in an IV drip or an intramuscular shot for life-threatening deficiencies. 

Lastly, Adenosylcobalamin and methylcobalamin are the naturally occurring forms found in foods. Adenosylcobalamin is mainly found in red meats, especially organ meats like liver, while methylcobalamin is found in meat, fish, eggs, dairy, and vegetarian sources that I mentioned earlier.

For vitamin supplements, Dr. Coppola and Dr. Monteiro recommend methylcobalamin. Since this is the natural form of cobalamin, methylcobalamin has the best absorption rate and body retention. It will stay in the body longer before being excreted in the urine.

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