Telltale signs you’re low in vitamin B12

Vitamin B12 deficiency is most common in people over the age of 60 and has been associated with age-related cognitive decline.

Vitamin B12 is essential for the healthy functioning of your nervous system and the production of red blood cells and DNA. It is found in animal products such as meat, dairy and eggs, and in some breads and plant-based milk that have been fortified with B12.

Most people will get enough of this vitamin naturally through their food if they eat a well-balanced diet. However, you can become B12 deficient by not eating enough of these foods or if your body is unable to absorb it from the food you eat.

People who may be at higher risk of B12 deficiency include seniors, vegans, people who take metformin for diabetes, antacid for heartburn or people who have had surgery to remove parts of the bowel.

B12 deficiency can be hard to diagnose and is sometimes confused with a folate deficiency, as low B12 can cause a drop in folate levels.

Signs of a B12 deficiency

Pale or jaundiced skin

B12 is required for the production of functioning red blood cells. Without it, red blood cells become enlarged and fragile, meaning they cannot leave the bone marrow where they are produced to circulate in the blood. This can cause the skin to appear pale or can cause a condition known as jaundice, recognisable by the yellowing of the skin and eyes.

Feeling weak, tired or dizzy

When you can’t produce enough healthy blood cells to carry oxygen around your body, you feel weak and fatigued. This may also cause people to feel breathless and dizzy, especially when doing physical activity.

Pins and needles

Myelin is a fatty substance that surrounds your nerves, protecting and insulating them. Vitamin B12 is essential for its production, so without it the nerves and nervous system struggle to function properly. This may result in paresthesia – the feeling of pins and needles – though it is rarely associated with a B12 deficiency alone.

Decline in balance and mobility

If damage to the nervous system is allowed to progress, you may experience changes in your coordination, balance and movement, increasing your risk of falls. B12 deficiency is more common in older people, and these symptoms may be overlooked as normal signs of ageing. In fact, low levels of B12 is a predictor of subsequent disability in older women.

Smooth tongue and ulcers

Glossitis, inflammation of the tongue, can cause it to change colour, feel painful and swell, stretching out your tastebuds and making them feel smooth. This can be an early symptom of vitamin B12 deficiency. People may also get ulcers, or a feeling of burning, pins and needles and itching.

Changes in vision

If vitamin B12 deficiency causes damage to the optic nerve, it may result in blurry or impaired vision. This is known as optic neuropathy.


Low levels of vitamin B12 have been linked to mood changes, including depression and a decline in brain function. Fortunately, the use of supplements has been shown to reverse damage in some patients.

If you suspect you are vitamin B12 deficient, consult your doctor. If you are unable to absorb vitamin B12, you may need to receive supplements. These may be regular oral vitamins or recurring injections.

Were you aware of the potential problems caused by low levels of vitamin B12? Why not share your thoughts or experiences in the comments section below?

Also read: What the science says about multivitamins

Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.

Written by YourLifeChoices Writers

YourLifeChoices' team of writers specialise in content that helps Australian over-50s make better decisions about wealth, health, travel and life. It's all in the name. For 22 years, we've been helping older Australians live their best lives.

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