Vitamine B12 tekort? Zo herken je de symptomen

Vitamin B12 deficiency? Here's how to recognize the symptoms.

Geschreven door: Ebrina van der Bijl

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Gepubliceerd op:

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Leesduur: 4 min

Vitamin B12 is a remarkable vitamin. Your body can store it for months, sometimes even years. As a result, a deficiency develops slowly and often unnoticed. It's only when symptoms like tingling, memory problems, or fatigue occur that alarm bells ring.

I often see people struggling with vague symptoms for years until they finally get their B12 tested. In this article, I explain how to recognize a vitamin B12 deficiency, what the causes are, and how you can quickly replenish it.

A vitamin B12 deficiency develops slowly and can lead to symptoms such as fatigue, tingling, loss of concentration and muscle weakness.

Possible causes include insufficient animal nutrition, old age, stomach or intestinal problems and long-term use of medication, such as antacids or metformin.

Supplementation can be achieved with supplements or a B12-rich diet; if absorption problems arise, injections are often necessary to deliver the vitamin directly into the bloodstream.

Table of contents
Symptoms of a Vitamin B12 Deficiency Main Causes of a B12 Deficiency Step-by-step Plan: Quickly Resolve a B12 Deficiency When Are B12 Injections Necessary? How Much Do You Need? My Personal Advice

Symptoms of a vitamin B12 deficiency

A vitamin B12 deficiency often develops gradually.

The most common symptoms are:

  • Fatigue and low energy
  • Dizziness and palpitations
  • Tingling in hands or feet
  • Memory problems or loss of concentration
  • Tinnitus
  • Muscle weakness or coordination problems

These complaints are related to the role of B12 in the production of red blood cells and the functioning of the nervous system. (1) (2)

Main causes of B12 deficiency

A deficiency can have various causes:

  • Nutrition - Vegans and vegetarians are at particular risk because B12 is only found in animal products. The B12 from plant foods (pseudo vitamin B12) cannot be utilized by the body.
  • Age - In the elderly, absorption from the stomach often decreases.
  • Health - Stomach or intestinal problems, such as celiac disease or Crohn's disease, hinder absorption.
  • Medications - Long-term use of antacids or metformin reduces B12 status.

Step-by-step plan: quickly resolve B12 deficiency

Fortunately, you can easily supplement your B12 deficiency yourself with the following actions:

  1. Supplementing with supplements - Start with a highly absorbable B12 in melt-in or lozenge form. These are absorbed directly through the oral mucosa, bypassing the intestines.
  2. Nutrition - Add B12-rich foods like liver, mussels, herring, dairy, and eggs. For vegans, fortified products or supplements are essential.
  3. Lifestyle and monitoring - Have your B12 levels tested if symptoms persist and repeat the checkup after a few months. This way, you can see if the changes in your diet and supplements are having sufficient effect.

When are B12 injections necessary?

Vitamin B12 injections are usually only necessary when supplements aren't effective enough. This is especially true if there are problems with absorption in the stomach or intestines.

The most common situations are:

  • Pernicious anemia – An autoimmune disease in which the body no longer produces intrinsic factor. Without this substance, B12 can hardly be absorbed.
  • Stomach or intestinal diseases – Such as Crohn's disease, celiac disease or after gastric reduction surgery.
  • Elderly people with significantly reduced stomach acid production – Stomach acid is needed to release B12 from food. As you age, your stomach often produces less acid.
  • Long-term use of certain medications – For example, antacids (PPIs) or metformin, one of the most commonly used medications for type 2 diabetes, which disrupts the transport of B12 through the intestinal wall. This results in less B12 entering the bloodstream.

In these cases, your body simply can't absorb enough B12 orally. An injection bypasses this problem and delivers the vitamin directly into the bloodstream.

Good to know : In cases of severe deficiency, doctors often start with a series of injections to quickly replenish the supply, followed by maintenance with tablets or booster injections.

How much do you need?

The Health Council recommends 2.8 micrograms per day for adults. Slightly higher values ​​apply for children, pregnant women, and breastfeeding women.

However, in case of a deficiency, higher doses are often necessary: ​​Between 500 and 1000 mcg per day in supplement form is effective and safe. (3)

Good to know : Because B12 is water-soluble, you pee out any excess. Therefore, no safe upper limit has been established.

My personal advice

I always choose a melting tablet with the active forms methylcobalamin and adenosylcobalamin . The advantage of this is that I know my body can use the vitamin immediately.

Because I regularly work with people who have stomach or intestinal complaints, I see every day how important this form is.

I advise you not to wait until your symptoms worsen, but to preventively maintain your B12 status.

Ebrina van der Bijl - Natural Performance

Ebrina van der Bijl

Ebrina is a nutritionist with a deep commitment to healthy eating and a sustainable lifestyle, based in beautiful Portugal. Her passion for natural and organic products is at the heart of her work. With a background in Nutrition & Dietetics and experience in product development and writing, she translates complex scientific information into practical advice for a balanced lifestyle.

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Sources used

  1. Bensky, M.J., Ayalon-Dangur, I., Ayalon-Dangur, R., Naamany, E., Gafter-Gvili, A., Koren, G., & Shiber, S. (2019). Comparison of sublingual vs. intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency. Drug Delivery And Translational Research, 9 (3), 625–630. https://doi.org/10.1007/s13346-018-00613-y
  2. Tuğba-Kartal, A., & Çağla-Mutlu, Z. (2020). Comparison of Sublingual and Intramuscular Administration of Vitamin B12 for the Treatment of Vitamin B12 Deficiency in Children. Revista de Investigacion Clinica, 72 (6). https://doi.org/10.24875/ric.20000208
  3. Abdelwahab, O.A., Abdelaziz, A., Diab, S., Khazragy, A., Elboraay, T., Fayad, T., Diab, R.A., & Negida, A. (2024). Efficacy of different routes of vitamin B12 supplementation for the treatment of patients with vitamin B12 deficiency: A systematic review and network meta-analysis. Irish Journal Of Medical Science (1971 -), 193 (3), 1621–1639. https://doi.org/10.1007/s11845-023-03602-4
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