“I’ve read lots recently about vitamin B12 deficiency and seem to have many of the symptoms described. However, I’m not vegetarian (they seem to be more at risk) and I have a good diet. I was diagnosed with type 2 diabetes last year though, and am taking the prescription drug metformin. Have you any advice? I’m 49 years old.“
Clinical nutritionist Suzie Sawyer replies.
Animal products such as meat, fish, eggs and dairy are the main sources of B12 rather than plants, hence vegetarians and vegans are at risk of deficiency. Symptoms can be vague and varied but include tiredness, low mood, irritability and ‘brain fog’. A severe deficiency of B12 can lead to pernicious anaemia, which usually requires B12 injections to raise levels quickly. It can also mask a deficiency of folate or folic acid, as these two nutrients work together in a number of body systems.
However, one of the main reasons for deficiency is a lack of something called intrinsic factor within the gut which is needed for the absorption of vitamin B12. Alternatively, people may have sufficient intrinsic factor but antibodies are produced which inhibit production. Either way, it leads to the possibility of deficiency.
Additionally, good gut bacteria is needed to metabolise vitamin B12; foods that feed the friendly gut flora include Jerusalem artichokes, asparagus, onions, leeks, bananas, fermented foods (nori, tempeh, miso and tofu), plus green tea.
You also mention taking metformin for diabetes. Unfortunately, this drug is known to deplete levels of vitamin B12, hence many diabetics are tired all the time and don’t realise why. It’s important you get a blood test from your GP to see if you’re deficient and ask them to check your folate levels at the same time. They can then advise on the next steps as appropriate.
Meanwhile, taking a daily high potency multivitamin and mineral supplement that contains vitamin B12 and folic acid will help plug any nutrient deficiencies. This in itself may help boost your energy levels quite quickly.