A vitamin B12 deficiency can persist for years before the first symptoms become noticeable. If you suffer from mood swings, difficulty concentrating, and persistent fatigue, a deficiency could already be the underlying cause. Vegans are particularly affected, as vitamin B12 is found almost exclusively in animal products.
Table of contents
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1. Function of vitamin B12
Every single cell in the body needs a small amount of vitamin B12 to function normally. B12, also known as cobalamin or coenzyme B12 , is a vital vitamin that is involved in the following processes , among others:
- Cell division
- Energy metabolism
- Blood formation
- Synthesis of DNA
- Synthesis of hormones and neurotransmitters
- Lipid metabolism, protection of nerves in the CNS and brain
- Detoxification, reduction of homocysteine
If vitamin B12 is not sufficiently absorbed through food (meat, especially offal, fish, eggs, and dairy products), serious damage can occur . However, this often only becomes apparent years later, after all the body's reserves have been depleted.
Take-home message #1: Vitamin B12 is necessary for almost all processes in the body, so stores should always be full.
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2. What are the causes of a vitamin B12 deficiency?
If you've previously thought only vegans can suffer from vitamin B12 deficiency, you're not entirely correct. Just like with vitamin D deficiency, everyone can have too little B12 in their blood, for example, if they don't get enough from their diet or their needs are elevated.
1. Insufficient vitamin B12 intake
A vitamin B12 deficiency in the cells can occur if
- you eat too one-sidedly or vegan,
- you have an increased need, e.g. during stressful times or when doing a lot of sport,
- or the absorption capacity of the gastrointestinal tract is impaired.
Since vitamin B12 can only be absorbed by the body through the oral mucosa or the lower part of the small intestine , a healthy intestinal flora is essential for optimal absorption. Intrinsic factor, a protein to which vitamin B12 binds, is produced in the gastric mucosa, allowing it to be transported to the small intestine.
According to recent studies, even a slight impairment of the gastrointestinal tract can lead to B12 no longer being fully utilized – resulting in an increased need.
Although the body produces vitamin B12 through intestinal bacteria in the large intestine, it cannot be metabolized there. The vitamin B12 produced by the body is excreted unused in the stool.
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2. Increased vitamin B12 requirement
Normally, an adult needs about 3 micrograms of vitamin B12 daily —a small amount with a significant impact on all bodily functions. However, in certain situations and circumstances, they may need more vitamin B12 than usual:
- During pregnancy and breastfeeding: If a vitamin B12 deficiency already exists during pregnancy, it can negatively impact the development of the embryo. Infants can also only absorb this essential vitamin B12 through breast milk.
- with increasing age: From the age of 50 onwards, it is advisable to replenish the B12 stores, because the absorption capacity decreases with increasing age.
- In case of stress: There is no question that stress is one of the biggest B12 killers, both psychological stress due to high mental pressure to perform and physical stress due to competitive sports and heavy physical exertion.
- For athletes: If you constantly train your body for peak performance, you also put it under stress. The result is an increased need for vitamin B12.
- Regarding alcohol consumption: Sure, too much alcohol is never good. But even small amounts can put a strain on the stomach, intestines, and liver and impair B12 absorption.
- for smokers: Nicotine consumption weakens your performance in every respect and also prevents the optimal utilization of vitamin B12.
- Medications: Regularly taking medications usually affects the mucous membranes in the gastrointestinal tract. This can increase the need for B12.
Take-Home Message #2: A vitamin B12 deficiency occurs in the body when too little B12 is absorbed or the need is increased.
3. Which foods are rich in vitamin B12?
Did a blood test reveal that you have a B12 deficiency? Or are you feeling weak? Then you can compensate for this with an optimal diet .
As already mentioned, animal products are particularly rich in vitamin B12. These include meat, fish, dairy products, and eggs. The following table lists foods that contain high levels of vitamin B12.
Foods high in vitamin B12
| Groceries |
in μg / 100g |
% of an adult's recommended daily intake |
vegetarian |
vegan |
| Beef liver | 65 | 2167% | ||
| veal liver | 60 | 2000% | ||
| Lamb liver | 35 | 1169% | ||
| caviar | 16 | 533% | ||
| oysters | 14.5 | 483% | ||
| Liver sausage, fine | 13.5 | 450% | ||
| Liver dumplings | 10 | 333% | ||
| mackerel | 9 | 300% | ||
| herring | 8.5 | 283% | ||
| mussel | 8.5 | 283% | ||
| lean beef | 5 | 167% | ||
| wild boar | 5 | 167% | ||
| trout | 4.5 | 150% | ||
| tuna | 4.3 | 143% | ||
| goose | 4 | 133% | ||
| Redfish | 3.8 | 126% | ||
| pollock | 3.5 | 116% | ||
| Camembert | 3.1 | 103% | x | |
| Emmental cheese | 3.1 | 103% | x | |
| lamb | 3 | 100% | ||
| duck | 3 | 100% |
Foods with medium vitamin B12 content
| Groceries | in µg / 100g |
% of an adult's recommended daily intake |
vegetarian |
vegan |
| Salmon | 2.9 | 97% | ||
| squid | 2.5 | 83% | ||
| Pork schnitzel | 2.1 | 70% | ||
| Edam | 2 | 67% | x | |
| Parmesan | 2 | 67% | x | |
| lean veal | 2 | 67% | ||
| pike | 2 | 67% | ||
| Chicken egg yolk | 2 | 67% | x | |
| Gouda | 1.9 | 63% | x | |
| chicken egg | 1.8 | 60% | ||
| Gyros | 1.6 | 53% | ||
| plaice | 1.5 | 50% | ||
| minced meat | 1.5 | 50% | ||
| Mortadella | 1.4 | 46% | x | |
| salami | 1.4 | 46% | ||
| Bratwurst | 1.3 | 43% | ||
| Mozzarella | 1.3 | 43% | x | |
| Frankfurter sausages | 1.1 | 36% | ||
| lean pork | 1 | 33% | ||
| Cream cheese (at least 10% fat) | 1 | 33% | x | |
| quark | 0.9 | 30% | x | |
| Fish fingers | 0.8 | 26% | ||
| cottage cheese | 0.7 | 23% | x | |
| anchovy | 0.6 | 20% | ||
| sheep's milk | 0.5 | 17% | x | |
| cow's milk | 0.4 | 13% | x | |
| yogurt | 0.4 | 13% | x | |
| Goat's milk | 0.1 | 3% | x | |
| Wheat/white beer | 0.1 | 3% | x |
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4. Symptoms of a vitamin B12 deficiency
The list of symptoms of vitamin B12 deficiency is long, as they affect all bodily functions. The first signs can occur individually or in combination with other symptoms:
- fatigue
- Mood swings
- Difficulty concentrating
- Sleep problems
- physical and mental exhaustion
Since the symptoms are quite diffuse and can also be an indication of completely different diseases , the diagnosis of vitamin B12 deficiency is not always clear.
The first symptoms of deficiency often only appear after the body has been undersupplied with the nutrient for several years . Therefore, vitamin B12 deficiency is often only detected very late.
If vitamin B12 absorption decreases, the body draws on the B12 stores in the liver and muscles. However, when the last reserves in the body's cells are depleted, the first symptoms appear.
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5. Testing and treatment of vitamin B12 deficiency
If you suspect a deficiency might be the cause of your fatigue and lack of energy , it's best to consult your doctor for a urine test . This can quickly determine whether you are actually suffering from a vitamin B12 deficiency.
In cases of severe deficiency, it is possible to replenish stores through injections. Alternatively, there are B12 supplements that can be taken continuously.
Since only a limited amount of vitamin B12 can be transported via the intrinsic factor, an overdose is impossible.
That's why B12 supplements often contain up to 1,000 micrograms. Any unused vitamin B12 is simply excreted from the body in the urine .
Take-Home Message #3: The symptoms manifest themselves in a wide variety of mental and physical areas and are often not clearly attributed to a vitamin B12 deficiency. A urine test, for example, can provide information.
Vitamin B12 deficiency is widespread
Recent studies have shown that latent vitamin B12 deficiency is more widespread in the population than previously thought [1]. However, due to the diffuse nature of the symptoms, the deficiency is rarely recognized as the cause of the symptoms.
Since psychological symptoms such as depression, mood swings and lack of motivation usually become noticeable long before physical impairments, a connection with the deficiency is often ignored.
This makes it all the more important to regularly replenish stores to give the body what it needs for normal functioning. A balanced diet with meat, fish, eggs, and dairy products is the best way to prevent this.
Those who do not consume sufficient animal products should cover their needs by taking B12 supplements in order to maintain long-term performance .
The supplement should ideally contain the natural forms of vitamin B12, hydroxocobalamin, adenosylcobalamin, and methylcobalamin. The synthetic form, cyanocobalamin, is less effective.
Vitamin B12 deficiency impairs mental performance
Maybe you know this feeling: You actually feel alert and fit, but you still can't concentrate properly. You simply lack the focus for the mental challenges that await you every day.
This could be an early sign of a vitamin B12 deficiency. The symptoms initially manifest themselves on a psychological level , with cognitive performance gradually declining .
Researchers have confirmed in a study of elderly people that a cobalamin deficiency damages the brain. A deficiency in cobalamin leads to impaired memory performance and reaction speed . [2] You can counteract this with an improved diet.
Take-Home Message #4: Vitamin B12 deficiency is more common than you think and can be corrected through diet or supplementation.
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6. Vitamin B12 deficiency in vegetarians and vegans
Since vitamin B12 is found almost exclusively in animal products and rarely in plant products, a deficiency in vegetarians and vegans is often unavoidable. The only way to ensure adequate intake of this vital nutrient is to take B12 supplements (e.g., VEGAN BASICS , FOCUS , MOOD ).
However, there are actually some vitamin B12 power plants that have very low levels of vitamin B12. These include barley and spinach , for example. However, cobalamin is not produced in the plants themselves; in organically grown plants, it can be absorbed through the roots as a nutrient from the fertilized soil.
Among algae, chlorella has now emerged as the only source of B12 . While other algae species contain vitamin B12 with very poor bioavailability, only the cobalamin in chlorella has been shown to have a certain bioavailability for the human organism [3].
However, vegans would have to consume very large quantities of algae to even begin to compensate for a vitamin B12 deficiency .
How to prevent vitamin B12 deficiency:
-
Through diet: A balanced diet is always best, as it provides the body with all the necessary nutrients, which can also be easily absorbed when combined. Offal is particularly rich in vitamin B12.
Since even passionate meat eaters don't like to consume liver, kidneys, and the like, fish, seafood, and dairy products should be regularly included in the diet. Important information for all athletes: In eggs , B12 is primarily found in the unpopular egg yolk . However, studies show that vitamin B12 is better absorbed from meat, fish, and especially dairy products than from eggs [4].
- Through supplements: Those who consciously follow a vegetarian or vegan diet should prevent deficiencies by taking dietary supplements. There are now a number of vegan tablets and capsules that can be taken with a clear conscience even by strict vegans (e.g., VEGAN BASICS , FOCUS , MOOD ).
- Reduce stress: It's perfectly fine to expect optimal performance from your body and mind. But to achieve the desired performance, you need sufficient sleep and relaxation phases. After all, people who lead a more relaxed lifestyle consume less vitamin B12.
- Eliminating gastrointestinal problems: Anyone who frequently suffers from stomach pain, heartburn, or digestive problems should get to the root of the problem. Restoring the intestinal flora usually helps. Only a healthy intestine can optimally absorb nutrients and make them available to the body.
Take-Home Message #5: The best way to prevent vitamin B12 deficiency is through a balanced diet, minimal stress, and a healthy gut flora. Supplements are available for vegetarians and vegans.
7. Conclusion
Vitamin B12 is involved in many different processes in your body. A deficiency usually only becomes noticeable very slowly and can manifest itself through a wide variety of symptoms.
The easiest way to get vitamin B12 is through a meat-based diet and other animal products. Algae are almost the only plant-based source of B12. However, the levels here are also very low, which is why supplementation makes more sense in this case.
8. Sources
[1] http://www.ars.usda.gov/is/pr/2000/000802.htm
[2] http://www.neurology.org/content/77/13/1276.abstract
[3] https://www.ncbi.nlm.nih.gov/pubmed/18247530
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586559/
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