Are you getting enough Vitamin B12?
Vitamin B12, also called cobalamin, is an essential dietary micronutrient and is commonly deficient in those that suffer with Fibromyalgia. According to NHS information, the absorption of vitamin B12 may be affected by certain medicines, including anti-convulsant medication commonly prescribed to treat fibromyalgia and PPIs, a regular treatment for heartburn and stomach acid problems, both a common side effect of over the counter pain killers. Already this is ringing my alarm bell!
Vitamin B12, like most other vitamins, is not produced in the body which means we have to get it from the nutrients in certain foods we eat or in supplement form. The main food sources are animal foods, including meat, fish, poultry, dairy and eggs, fortified products such as breakfast cereals, milk, mushrooms, soya products such as tempeh. There’s confusion as to whether vitamin B12 is present in sea plants and algae which contain a pseudo B12, known as analogues, which are chemically similar to real B12 but they have little vitamin effect on the body. Interestingly on conventional B12 testing can’t differentiate between the two which surely must raise an eyebrow or two if you are vegan and relying on seaweed as a source of your vitamin B12.
How much Vitamin B12 should I be getting?
Studies reveal that poorer communities have a higher prevalence of deficiency and the answer to this will depend on which country you live. In the UK, the RDA is 1.5 mcg (NHS), however the European Food Safety Authority advises 4 mcg, whilst the US advises 2.4 mcg.
The causes of Vitamin B12 deficiency includes:
- Diet – vegan or high carbohydrate diets where there is little or no animal protein are at a higher risk of developing a deficiency. However those who include fish, dairy and fortified foods in their diet are less at risk.
- Some medications inhibit the absorption of Vitamin B12.
- Gut health conditions that affect the small intestine such as Crohn’s or Coeliac disease, also inflammatory disorders and imbalance of gut bacteria.
- Weight loss surgery.
- Intrinsic Factor is a protein made by the cells in the gut lining and is necessary for the absorption of B12 in the small intestine. Some people don’t make enough Intrinsic factor or they have a condition that destroys it which can develop into a B12 deficiency called pernicious anaemia.
Symptoms of Vitamin B12 Deficiency
It’s possible that you might not know you have a deficiency as some of the symptoms cross over with fibromyalgia where it’s pretty much part and parcel to feel fatigue, pain, anxiety or depression, balance problems etc., but the main symptoms of B12 deficiency include:
Pins and needles and numbness, especially in hands and feet
Nerve pain and or Peripheral Neuropathy
Brain Fog, cognitive impairment – difficulty concentrating and memory problem
Anxiety, low mood or depression
Shortness of breath
Mouth ulcers, sore or swollen tongue
Anaemia is also quite common in fibromyalgia and occurs when there is fewer red blood than normal or an abnormal level of haemoglobin in each red blood cell. The symptoms of anaemia include fatigue, pale skin, sensitivity to cold temperature, feeling faint / dizzy, headaches, breathlessness and palpitations, loss of appetite and tinnitus.
As you can see many of these symptoms are difficult to separate from fibromyalgia symptoms. If you’re unsure it’s always worth raising the subject with your doctor where a supplement or even B12 injections may be prescribed. I use a supplement from BetterYou, a vitamin B12 oral spray which is easier absorbed and I’m careful that my diet includes fish, meat, eggs and poultry, however if you are vegan and have any of the above symptoms maybe best to check your B12 levels with your doctor.