Millions of Britons may be living with a hidden vitamin B12 deficiency, a condition that experts warn is often overlooked by general practitioners and can lead to severe health problems if left untreated. The deficiency, sometimes called 'hidden hunger,' affects an estimated one in 20 adults, with the risk increasing significantly for those over 50, where it impacts as many as one in five.
Vitamin B12, also known as cobalamin, is crucial for producing red blood cells, repairing DNA, and maintaining a healthy brain and nervous system. It is primarily found in animal and dairy products, with vegans and strict vegetarians being at higher risk of insufficient intake. While the recommended daily intake is 1.5 micrograms, many people struggle to absorb the nutrient adequately as they age.
Symptoms of B12 deficiency can be subtle and slow to develop, often leading to misdiagnosis or delayed detection. These can include fatigue, brain fog, difficulty concentrating, pale skin, and a sore tongue. Some individuals, like Zita Wells, a 45-year-old pet carer, experienced extreme tiredness and a sudden, disorienting weakness that caused her to collapse. After blood tests, she was diagnosed with a severe B12 deficiency.
Another individual, Lucy Smith, 54, initially attributed her fatigue, irritability, and sleep problems to menopause, only to discover through blood tests ordered due to heart rate irregularities flagged by her smartwatch that she had a severe B12 deficiency. B12 injections quickly alleviated her symptoms.
Contributing Factors and Risks
The prevalence of B12 deficiency is rising, partly due to the non-specific nature of its symptoms, which are commonly mistaken for other conditions. Experts point to several factors contributing to the increase. As people age, the body produces less stomach acid, which is necessary to break down food and release B12. This, combined with potentially reduced food intake in older adults, exacerbates the risk. Professor Martin Warren of the Quadram Institute notes that older adults are particularly vulnerable, especially if they are taking medications that interfere with B12 absorption, such as proton-pump inhibitors and metformin.
Furthermore, diets high in ultra-processed foods can 'crowd out' more nutritious staples, potentially leading to deficiencies. The condition gained public attention following the death of university student Georgina Owen, who had a severe B12 deficiency linked to her vegan diet and lack of supplements, which contributed to 'delusional beliefs'.
Diagnostic Challenges
Detecting B12 deficiency presents a significant hurdle. The most common test, measuring B12 levels in blood serum, is considered unreliable by experts, correctly identifying deficiency less than 50% of the time. This unreliability means many individuals, like Catherine Watkin, 57, who experienced debilitating fatigue and neurological symptoms for over two decades, may undergo numerous tests without a diagnosis. Watkin spent an estimated £100,000 on various treatments before finally being diagnosed and treated with B12 injections, which resolved her symptoms.
More accurate, though more expensive, tests exist that measure byproducts of B12 metabolism, but these are less readily available within the National Health Service. Experts advocate for increased awareness among both patients and healthcare professionals, and for GPs to consider B12 deficiency even with borderline test results, potentially proceeding with treatment to observe symptom improvement.
Treatment and Prevention
For most cases caused by dietary restrictions, simple over-the-counter B12 supplements can be effective. However, individuals with absorption issues, such as those with pernicious anaemia or certain medical conditions, may require regular B12 injections. For those concerned about their B12 levels, particularly individuals over 50 or those on plant-based diets, consulting a doctor and requesting a B12 test is advised. Taking supplements with a meal can aid absorption due to the increased stomach acid production required for digestion.
While diagnosis can be challenging, experts emphasize that B12 deficiency is highly treatable once identified, offering a path to recovery for those affected.