platter of foods that are rich in b12

5 Reasons Your Vitamin B12 Levels May Be Low

In this article, we will explain what vitamin B12 is and its function in the body. We will also take a look at what may cause vitamin B12 deficiencies, the negative effects of these lower levels, and some ways we can regain a healthy balance of vitamins in the body.

What even is a vitamin?

We all remember taking vitamins as kids – but what exactly is a vitamin and what does it do? Vitamins are ‘vital amines,’ also known as organic molecules or macronutrients. Vitamins help the body function normally. They are helpful for healing injuries, turning food into energy, forming blood cells, making DNA, and the list goes on and on.

Vitamins are essential to nearly every system in the body, and while there are 13 recognized vitamins, this article will be focusing on one of them: vitamin B12.

What is vitamin B12?

Vitamin B12, also known as cobalamin, is an important vitamin that is required for all individuals. Having the proper levels of B12 in the body is essential to maintain the best health possible. Vitamin B12’s range of functions aid in the body’s production of red blood cells and DNA, as well as in essential processes in the nervous system.

Where does B12 come from? It is actually produced by bacteria, not by animals, plants, or fungi even though we take it in through the consumption of animal products. Our natural stores of vitamin B12 can be found in our liver and can last up to 3 to 10 years.

When it comes to vitamin B12 deficiency and its causes, it narrows down to two main reasons: a decrease in food consumption and a compromise in the body’s normal absorption of the vitamin. While most of the symptoms can be attributed to these two reasons, there are a variety of complexities within each of these groups.

What causes vitamin B12 deficiencies?

Everything in the body should be balanced to function properly. A decrease in any vitamin level in your blood will lead to a vitamin deficiency. This could be causing anything from bone loss to weight loss and even issues in the immune system. An increase in vitamin levels in your blood will lead to hypervitaminosis, which is connected to toxic symptoms.

Let’s take a closer look at some of the causes of vitamin B12 deficiencies.

1. Having a “strict” vegan/vegetarian diet

One of the main dietary causes for B12 deficiencies is something that doctors call a ‘strict’ vegan diet. People who may have a B12 deficiency in this case are individuals that completely eliminate animal products from their diet without getting B12 from some other source, like a supplement. Another cause could even be from a vegetarian diet, especially in the case of pregnancy. Women require higher levels of B12 during pregnancy. The fetus absorbs vitamin B12, so improper or imbalanced levels of the vitamin could lead to a deficiency. This is also likely for women that are breastfeeding an infant due to the increased uptake of vitamins from the infant. While vegan and vegetarian diets can cause vitamin B12 deficiencies, lower levels can also occur if there are issues with the body’s natural absorption of vitamins.

2. Medications that reduce stomach acidity

Some medications can lead to problems with the body’s absorption of vitamin B12. These medications are ones that will reduce the acidity in the body’s stomach. This is a problem for B12 absorption because the acidity in the stomach is what helps us break down food and gain access to B12.

These medications can also be known as H2 receptor blockers or proton pump inhibitors. H2 blockers are normally used to help with issues like stomach inflammation, gastritis, or even certain types of ulcers. Proton pump inhibitors similarly reduce stomach acid and are used typically to help with issues related to acid reflux.

Other types of medications include metformin and neomycin. Metformin is commonly used to treat type 2 diabetes, and neomycin is used in combination with other medications. In a variety of cases, it is used to lower the risk of bacterial infections.

These are just some of the examples of medication that can lead to decreased or compromised absorption of vitamin B12 in the body and can actually worsen a B12 deficiency.

3. Pancreatic Diseases

In some cases, the pancreas can have problems with the glands it uses to secrete chemicals into the bloodstream. This can cause symptoms related to jaundice and can be noticed in the yellowing of the eyes or the skin. There are pancreatic enzymes that we need in order to help with vitamin B12 absorption. A lack of B12 can cause issues with the body’s red blood cells such as a decrease in the production and circulation throughout the body. This is what can lead to the discoloration of the eyes and skin.

4. Neuropathy

This is more of a symptom than a cause, but it’s important to note because it happens to many people. Problems with the body’s absorption of B12 can lead to issues with the body’s peripheral nerves, which you may experience in the form of tingling, numbness, or weakness in areas like your hands and feet (i.e., neuropathy).

Vitamin B12 is essential for your body in this context because it aids in the strengthening of your nerves. Your nerves need to transfer signals safely, which explains why a lack of B12 will cause your nerves to weaken and work improperly. This can be a vague symptom at times, experienced even through a burning sensation in the hands or the feet.

5. Gastrointestinal Disease

This last one is probably the most directly related issue to your body’s absorption of B12 in your stomach. Gastrointestinal diseases can include anything from Crohn’s disease, Celiac disease, gastritis, or malabsorption syndrome. Another cause could be a gastric bypass, which is where portions of the intestinal tract are taken out. This will cause issues with your body’s absorption rates. Other GI diseases that we may not generally hear about can be an infection from a fish tapeworm, which will lead to lower B12 levels due to the tapeworm feeding on the vitamin.

How do I know if my B12 levels are low?

While we have covered many of the causes and some of the symptoms of B12 deficiency, there are some proven ways to test your B12 levels. Doctors will diagnose B12 deficiency by simply checking your blood’s B12 levels with a standard blood test. This would check for the presence of antibodies or of an elevated level of a substance called methylmalonic acid (MMA). MMA is directly related to patients with B12 deficiency.

While there are some home tests and over-the-counter solutions, some of these methods may have not been fully tested or not as effective as more thorough treatments. The best option is to consult with your primary healthcare provider for the most accurate results and treatments for any deficiencies that may be present.

Treating B12 deficiency with IV infusions

There are a few ways to treat a B12 deficiency. It depends on whether it was caused by impaired absorption or from a nutritional deficiency.

B12 shots and dietary changes in combination with B12 supplements are commonly used to treat both major causes of B12 deficiencies. B12 supplements come in the form of oral pills or through injection. However, some individuals may not see the best absorption results from vitamins taken orally. Though injectable vitamins are not for everyone, they may be the more effective route for restoring your B12 levels.

To learn more about how injectable vitamins can provide direct boosts to your metabolism and improve your health and brain functions, you can schedule an appointment here, or visit for more information on what may be best for your individual situation.

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