Many of us are taking steps to improve our health and boost our immune system. We’ve previously written about the importance of nutrients like iron and vitamin D in maintaining immune health, but vitamin B12 is another key nutrient our body relies on.
Vitamin B12 deficiency is more common in older adults – affecting around one in 20 people aged 65 to 74 and one in 10 people aged 75 or over. But given the wide range of symptoms and the gradual rate at which they can appear, the condition is often overlooked or confused with something else.
Luckily, there are plenty of foods that can be added to your diet to make sure you’re getting enough of this essential vitamin.
Below, we’ll explore the benefits of vitamin B12, how to spot the signs of deficiency, and which vitamin B12-rich foods you could add to your diet.
What is vitamin B12?
Vitamin B12, also known as cobalamin, is one of eight B vitamins that play an essential role in keeping our bodies healthy.
It’s important for supporting nerve cell function, making red blood cells, DNA formation, and producing energy. But vitamin B12 has many other benefits, which we’ll look at in more detail below.
Our bodies can’t produce vitamin B12, so we need to get it from our diet. B12 is found naturally in animal products, but it’s also added to certain foods and available as a supplement. People with very low B12 levels may also get a B12 injection at the recommendation of their GP.
Vitamin B12 is only needed in very small amounts. According to the NHS, the recommended daily allowance of vitamin B12 is around 1.5 micrograms a day for healthy adults.
Why is vitamin B12 important?
Vitamin B12 plays a critical role in several of the body’s key processes, and there are powerful health benefits to making sure we consume enough. For example…
1. It can help produce red blood cells
Without enough B12, your body can’t produce red blood cells as efficiently. If red blood cells aren’t developed properly, they can’t move from the bone marrow into the bloodstream fast enough. This can lead to anaemia and cause symptoms like muscle weakness and fatigue.
2. It supports healthy skin, hair, and nails
Because vitamin B12 is so crucial for producing new cells, you need adequate levels for healthy hair, skin, and nails.
B12 deficiencies can lead to skin hyperpigmentation, vitiligo, hair changes, nail discolouration, and angular stomatitis (where the corners of your mouth become red and cracked).
Our article, 7 important vitamins and minerals for hair, skin, and nail health, has more information.
3. It may support bone health and prevent osteoporosis
One study found that people with low B12 levels had a lower bone mineral density. This can increase the risk of osteoporosis. However, recent studies highlight that the correlation is still inconsistent.
To learn more about how diet can improve bone health, you might like to read our article: 12 of the best foods for bone health.
4. It may help keep your eyes healthy
Vitamin B12 is thought to reduce the risk of age-related macular degeneration (AMD), a disease that impacts your central vision.
Studies suggest that B12 may lower levels of homocysteine, an amino acid in the blood that’s linked to the condition. In support of this, other research shows that supplementation of folic acid and vitamins B6 and B12 may reduce the risk of AMD.
5. It may help reduce depression
Vitamin B12 plays a crucial role in producing serotonin, also known as the ‘happy hormone’ due to its effect on mood. Vitamin B12 deficiency is linked to decreased serotonin production, which can result in a depressed mood.
Studies show that people suffering from depression showed improved symptoms when receiving both B12 supplements and antidepressants, compared to people who received antidepressants alone.
To find out more about how to ease the symptoms of depression, take a look at our article: 10 things you can do to help yourself through feelings of depression.
6. It may promote brain health and improve memory
Vitamin B12 is thought to lower the risk of brain atrophy, which is the loss of neurons in the brain and is linked to memory loss and dementia.
One study of patients with dementia showed that supplementing vitamin B12 and omega-3 fatty acids slowed mental deterioration. Another study found that low B12 levels can cause poor memory performance.
7. It may help improve energy levels
While there’s no solid evidence that vitamin B12 boosts energy, all B vitamins play an essential role in the body’s energy production.
Plus, one of the most common signs of vitamin B12 deficiency is tiredness and a lack of energy.
8. It may improve heart health
Aside from being linked to macular degeneration, the amino acid homocysteine is linked to an increased risk of heart disease.
Studies show that B12 helps decrease homocysteine levels, which may lower the risk of heart disease.
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Signs of vitamin B12 deficiency
Making sure we get enough vitamin B12 is incredibly important for our health, and the good news is that, because our bodies can store B12 for several years, a serious B12 deficiency is rare.
Some of the most common signs of B12 deficiency include…
1. Pale or jaundiced skin
Because low B12 levels disrupt the body’s red blood cell production, a common symptom of B12 deficiency is looking pale.
Being deficient in red blood cells can also cause an excess of bilirubin – a red/brown-coloured substance the liver produces – to circulate in the blood. Large amounts of bilirubin can also cause the skin and whites of the eyes to have a yellow tinge.
2. Weakness or fatigue
Because red blood cells transport oxygen to the body’s cells, when you’re deficient in B12, you may feel tired and weak.
3. Pins and needles
Because B12 supports nerve cell function, long-term B12 deficiency can put you at risk of nerve damage.
One of the first signs of nerve damage is a pins-and-needles sensation.
4. Changes to mobility
If left untreated, B12 deficiency can damage the nervous system and affect balance and coordination, even leading to changes in walking and movement. It can also increase your risk of falling.
5. Breathlessness and dizziness
B12 deficiency can cause anaemia, so a common symptom is breathlessness or dizziness, particularly after physical exertion.
6. Changes in mood
Many people suffering from B12 deficiency report changes in mood and may exhibit signs of depression.
7. Mouth ulcers and an inflamed tongue
People suffering from B12 deficiency sometimes have glossitis, a red, inflamed tongue that can look smoother than normal. Other oral symptoms, like mouth ulcers, are also sometimes seen.
12 foods that are high in vitamin B12
Because the body can’t make B12 on its own, we need to get it from our diet or supplements.
Vitamin B12 is mainly found in animal products – like meat, fish, and eggs. However, many common plant-based foods are fortified with B12.
So, which foods are good sources of vitamin B12?
2. Clams
Clams are packed with nutrients and contain very high amounts of vitamin B12. They also contain iron and plenty of antioxidants.
4. Fortified cereals
These days, almost all cereals are fortified with nutrients, so they’re a great source of plant-based B12.
Cereals also usually contain vitamin A, folate, iron, and calcium, which are essential for healthy bones, blood cell production, and immune system health.
5. Sardines
Sardines are especially nutritious because, aside from being high in vitamin B12, they also contain high amounts of the minerals phosphorus, calcium, and potassium.
These help to regulate blood pressure, maintain strong bones and teeth, and manage how your body uses energy. As they’re a good source of omega-3 fatty acids, they also have many other health benefits.
6. Tuna
Tuna contains high concentrations of B12, particularly in the darker muscles right underneath the skin. Tuna is also high in phosphorus, selenium, and vitamins A and B3 – which can protect the eyes, lower LDL cholesterol levels, and help prevent heart disease.
7. Milk and yoghurt
Milk and yoghurt are excellent sources of vitamin B12 and a reliable source of calcium and vitamin D.
Yoghurt also contains probiotics, which are particularly beneficial for digestive health.
8. Cheese
Cheese is another rich source of vitamin B12. Swiss cheese (at 36% daily value per ounce) and mozzarella (at 27% daily value per ounce) have some of the highest amounts.
The daily value is the percentage of the recommended dietary allowance. One ounce of cheese is roughly equal to a slice of cheese large enough to cover the surface of a standard slice of bread.
9. Non-dairy milk
Non-dairy milk – like oat, almond, rice, and soya milk – is fortified with high amounts of B12, making it another great source of plant-based B12.
10. Trout
Rainbow trout contains plenty of healthy fats and B vitamins – including vitamin B12.
It also contains minerals such as manganese, phosphorus, and selenium, which can improve bone health, reduce inflammation, and help grow and repair cells.
11. Salmon
Salmon might be best known for its high levels of omega-3 fatty acids, but it’s also a great source of B12.
12. Nutritional yeast
Nutritional yeast is a key ingredient in any vegan kitchen, and it’s a great plant-based source of many vitamins, (including B12), as well as protein and minerals.
Can you get all the B12 you need from diet alone?
While it’s possible to get all the vitamin B12 you need from the foods you eat, in some cases, a B12 supplement might be useful, particularly if you’re more at risk of vitamin B12 deficiency.
People most at risk of a B12 deficiency are those who don’t get enough in their diet, or who aren’t able to absorb enough from the foods they eat. This can include older adults, pregnant or breastfeeding women, and people who…
- are taking antacids long-term
- are taking the diabetes drug metformin
- have had bowel or stomach surgery
- are following a plant-based diet
However, while vegans are more at risk of B12 deficiency, this doesn’t mean you have to take supplements if you follow a plant-based diet. The daily requirement for B12 is small, and because many plant-based foods are fortified with high levels of B12, you can get enough from your diet alone.
That said, health experts generally advise vegans to check that the foods they eat contain B12.
If you’d like inspiration for recipes rich in vitamin B12, check out these B12 meal ideas from Eat This Much. And, if you follow a plant-based diet, take a look at these vegan recipes that are high in B12 from Live Kindly.
What to do if you're worried you're not getting enough B12
It’s important to be aware that not all vitamin B12 deficiency is caused by health problems or diet. It can also be caused by a lack of intrinsic factors (proteins required to absorb B12).
A lack of intrinsic factors becomes more common with age, and is linked with pernicious anaemia, an autoimmune condition that affects the stomach.
If you’re worried you’re not getting enough B12 from your diet, you should make an appointment with your GP and request a blood test. If your B12 levels are low, your GP can also advise you on supplementation.
Vitamin B12 supplements come in many forms, including liquid, pills, chewable sweets, or even supplements that dissolve under your tongue. If your levels are exceptionally low (which can be determined by a blood test), your GP might offer you a vitamin B injection.
According to the NHS, taking less than 2mg of B12 supplements a day is unlikely to cause any harm.
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Final thoughts...
Vitamin B12 is an essential nutrient the body needs for many purposes, and being deficient can lead to health complications.
Most people can get enough B12 from their diet alone, as it’s found in many animal products and fortified foods. But those at risk of B12 deficiency should talk to their GP or health practitioner about taking supplements, as dosages vary according to individual needs.
For more tips on essential vitamins and minerals, head over to our diet and nutrition section.
Have you taken steps to boost your vitamin B12 levels? What vitamin B12-rich meals do you enjoy? We’re interested to hear from you in the comments below.
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