A beginner’s guide to vitamin B12: Benefits, deficiency and diet tips

Over the last year, many of us have taken steps to improve our health and boost our immune system. We’ve recently written about the importance of iron and vitamin D in maintaining immune health, but vitamin B12 is another key nutrient that our body relies on. Around a quarter of people are thought to be mildly deficient in B12, but given the wide range of symptoms, and the gradual rate at which they can appear, the condition can often be 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 vital vitamin.

Here, we explore the benefits of vitamin B12, how to spot the signs of deficiency, and which vitamin B12-rich foods you could include in your diet as we head into winter.

What is vitamin B12?

Vitamin B12, also known as cobalamin, is one of eight B vitamins that play an essential part in keeping our bodies healthy. It’s important for supporting the function of nerve cells, making red blood cells, DNA formation, and producing energy. But there are many other benefits of B12, 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 is available as a supplement. People who have very low B12 levels might also get a B12 injection, under recommendation from their GP.

Vitamin B12 is necessary in only very small amounts – according to the NHS, for healthy adults, the recommended daily allowance (RDA) of vitamin B12 is around 1.5 micrograms..

Why is vitamin B12 important?

Vitamin B12 plays a critical role in several of our body’s key processes. Science tells us that there are powerful health benefits of B12 – for example:

  • It helps to produce red blood cells. If you don’t have enough B12 in your system, your body can’t produce red blood cells as efficiently. Then, because the cells aren’t developed properly, they can’t move from your bone marrow into your bloodstream at a fast enough rate, which can lead to anaemia and cause symptoms like muscle weakness and fatigue.

  • It can support bone health and prevent osteoporosis. One study found that people with low levels of B12 had a lower bone mineral density, which can increase the risk of osteoporosis.

  • It can keep your eyes healthy. Vitamin B12 is thought to prevent the risk of age-related macular degeneration – an eye disease which impacts your central vision. Studies suggest that B12 may lower homocysteine, an amino acid in the blood that’s linked to age-related macular degeneration.

  • It can reduce depression. Vitamin B12 plays a crucial role in producing serotonin, also known as the “happy chemical”, 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.

  • It can 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 that are linked to memory loss and dementia. One study in patients with dementia showed that supplementing vitamin B12 and omega-3 fatty acid slowed mental deterioration, while another study found that low levels of B12 can cause poor memory performance.

  • It can improve energy. While there is no solid scientific evidence proving that vitamin B12 specifically can give you an energy boost, all B vitamins play a crucial role in your body’s energy production. Plus, one of the most common signs of vitamin B12 deficiency is tiredness and a lack of energy.

  • It can improve heart health. Aside from being linked to macular degeneration, the amino acid, homocysteine, is also linked to an increased risk of heart disease. Studies show that B12 helps decrease homocysteine levels, which may lower the risk of heart disease.

  • It supports healthy skin, hair and nails. Because vitamin B12 is so crucial for producing new cells, you need to have adequate levels to support healthy hair, skin and nails. B12 deficiencies can lead to hyperpigmentation of the skin, vitiligo, changes to your hair, nail discoloration, and angular stomatitis – where the corners of your mouth become red and cracked.

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, serious B12 deficiency remains rare. The not-so-good news is that around a quarter of the population may still have a mild B12 deficiency – although this can be remedied. Some of the most common signs of B12 deficiency include:
  • Pale or jaundiced skin. Due to the problems that low levels of B12 cause to your body’s red blood cell production, a common symptom of B12 deficiency is looking pale. The fragility of deficient red blood cells can also cause an excess of bilirubin – a red/brown-colored substance that our livers produce – to circulate in our blood. Having large amounts of bilirubin in your body can cause the skin and whites of your eyes to have a yellow tinge, too.

  • Weakness and fatigue. When you’re deficient in B12, your body can’t produce enough red blood cells, which transport oxygen to your body’s cells. As a result, you can feel tired and weak.

  • Pins and needles. Because B12 supports the function of nerve cells, long-term B12 deficiency can put you at risk of nerve damage. One of the first symptoms that your nerves are beginning to become damaged is the sensation of pins and needles.

  • Changes to mobility. If untreated, the damage that B12 deficiency can cause to your nervous system can affect your balance and coordination, and even lead to changes in the ways you walk and move. It can also increase the risk of falling.

  • Breathlessness and dizziness. B12 deficiency can cause anaemia, so a common symptom is feeling short of breath or dizzy, particularly when you exert yourself physically.

  • Changes in mood. Many people suffering from B12 deficiency report changes in mood, and exhibit signs of depression.

  • Mouth ulcers and inflamed tongue. People suffering from B12 deficiency sometimes have glossitis, which is a red and 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 our body can’t make B12 by itself, we need to get it from our diet, or from supplements. Vitamin B12 is mainly found in animal products, like meat, fish, and eggs. And, luckily for people who follow a vegan diet, many common plant-based foods are fortified with B12, and can be good sources of this vitamin too.

So which foods are good sources of vitamin B12?

  1. Animal liver and kidneys. Organ meats, like liver and kidneys, are very rich in vitamin B12. Lamb liver is also especially high in copper and selenium, which help the body produce red blood cells and act as a powerful antioxidant.

  2. Clams. Clams are packed with nutrients and contain very high amounts of vitamin B12. They also provide iron and plenty of antioxidants.

  3. Eggs. Eggs are a great source of B vitamins, especially B2 and B12. Egg yolks contain more B12 than egg whites, and the B12 in yolks is easier to absorb, too.

  4. Fortified cereals. These days almost all cereals are fortified with nutrients, including B12, so these are a great source of plant-based B12. Cereals also usually contain vitamin A, folate, iron and calcium, which are essential for building healthy bones, making red and white blood cells, and supporting immune 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, which help regulate blood pressure, maintain strong bones and teeth, and manage how your body uses energy. They also contain omega-3 fatty acids, which have many 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 your eyes, lower LDL cholesterol and help prevent heart disease.

  7. Milk and yogurt. A cup of milk or yogurt a day can make for an excellent source of vitamin B12, and is also a reliable source of calcium and vitamin D. Yogurt 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 (DV) is the percentage of the recommended dietary allowance. One ounce of cheese is roughly equal to a slice of cheese that is large enough to cover the surface of a standard slice of bread.

  9. Non-dairy milks. Non-dairy milks like oat milk, almond milk, rice milk and soya milk are fortified with high amounts of B12, and are 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 grow and repair tissues and cells.

  11. Salmon. Salmon might be most known for containing high levels of omega-3 fatty acids, but it’s also a great source of B vitamins, including B12.

  12. Nutritional yeast. Nutritional yeast is a key ingredient of any vegan kitchen, and it’s a great plant-based source of many vitamins, including B12, as well as protein and minerals.

Should you take vitamin B12 supplements?

While it is possible to get all the vitamin B12 you need from the foods you eat, in certain cases a B12 supplement might be useful, particularly if you’re at greater risk of becoming deficient. The 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 the elderly, pregnant or breastfeeding women – as well as people who are taking antacids long-term, taking the diabetes drug metformin, have had bowel or stomach surgery, or are following a strict vegan diet.

However, while vegans are more at risk of B12 deficiency – because B12 is only naturally found in animal products – you don’t have to automatically take supplements if you follow a plant-based diet. Because the amount of B12 needed each day is so small, and because many plant-based foods are fortified with high levels of B12, it’s entirely possible that you can still get enough B12 from your diet. However, it’s still important for vegans to check that the foods that they eat do contain B12. If you’re unsure whether you’re getting enough, it’s best to visit your GP and ask for advice.

If you don’t have any health or lifestyle factors that prevent you from getting enough B12 in your diet, or that prevent your body from absorbing the amount of B12 that it needs, then you should be able to get all the nutrients you need from your food. If you want some ideas for recipes that are particularly rich in vitamin B12, then check out these ideas on Eat This Much. Alternatively, if you follow a plant-based diet, then have a look at these vegan recipes that are high in 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 factor – a protein required to absorb B12. Lack of intrinsic factor becomes more common as we get older, and is linked to pernicious anemia – an autoimmune condition that affects your stomach.

If you’re worried you’re not getting enough B12 from your diet, then it’s worth making an appointment with your GP to get a blood test and check that there isn’t another medical condition causing your symptoms. If a blood test confirms that you have low vitamin B12 levels, then you may be recommended to take a supplement. Vitamin B12 supplements come in many forms, including liquid form, pills that you swallow, chewable sweets, or even supplements that dissolve under your tongue. You can buy vitamin B12 supplements from Amazon in varying forms, as well as from pharmacies, supermarkets and health food stores, like Holland & Barrett. There are also plenty of vegan B12 supplements available on Amazon. If your levels are exceptionally low (which can be determined by a blood test), then your GP might offer you a vitamin B injection.

Final thoughts...

Vitamin B12 is a vital nutrient that your body needs for many different purposes, and being deficient can lead to health complications. 

Most people are able to get enough B12 from their diet alone, as it’s found in many animal products and fortified foods, but people at risk of B12 deficiency should have a chat with their GP or health practitioner about the possibility of taking supplements. Dosages will vary according to your individual needs, so it’s always best to speak to a professional if you’re unsure. 

Have you suffered from B12 deficiency? How have you taken steps to boost your vitamin B12 levels? We’d love to hear about your experiences. Join the health conversation on the community or leave us a comment below.

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