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Vitamin B12 Deficiency: Stages, Causes, Symptoms, and Treatment Vitamin B12 Deficiency: Stages, Causes, Symptoms, and Treatment
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Vitamin B12 Deficiency: Stages, Causes, Symptoms, and Treatment

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Today's fast-paced life has led to Vitamin B12 deficiency in many. Generally, it is a result of insufficient intake of foods containing Vitamin B12 or the body's inability to absorb it from the food you consume.

Vitamin B12 is an essential nutrient that helps the body make RBCs (Red Blood Cells) and your cells’ genetic material, DNA. It also helps the body keep red blood cells and nerve cells healthy. However, the human body is incapable of producing Vitamin B12, so it becomes crucial to eat or drink consumables rich in Vitamin B12.

Vitamin B12 deficiency can lead to neurological, physical, and psychological problems. To avoid such complications, take a Vitamin B12 Test in Ahmedabad at our lab and be assured. Let us now understand the deficiency a bit better.

What are the Stages of B12 Deficiency? 

The four stages of vitamin B12 deficiency are:

Stage 1: Early Serum Depletion

This stage is simply the beginning of deficiency, and you may not feel any symptoms. However, B12 serum blood levels start dropping, and most of it will be active B12 (holoTC).

Stage 2: Cellular Depletion

Yet again, you may not see any apparent symptoms at this stage. However, the deficiency continues, and cellular dysfunction begins.

Stage 3: Damaged Metabolism

By now, you might notice symptoms like abdominal discomfort, gastrointestinal issues, diarrhoea, indigestion, and bloating. There are noticeable changes in the blood, and homocysteine and methylmalonic acid levels continue to rise. Even though your body may not indicate full anaemia at this stage, you might see signs or symptoms like numbness, weakness, fatigue, tingling sensation, and more. The severity of symptoms varies from person to person; however, it often remains moderate during this stage. The doctor might recommend visiting a diagnostic centre in India and undergoing specific tests.

Stage 4: Clinical Damage

At this stage, the haemoglobin levels begin to decrease, and there are clear indications of anaemia. It might result in weakness, breathlessness, lethargy, and weakness. This is the most severe stage of deficiency, and if ignored, it increases the chances of permanent damage to the nervous system. In extreme cases, there is a chance that a certain body part might be paralyzed completely.

The early indication of this stage is myelopathy, and the condition is treatable only if diagnosed on time. In case the condition progresses and symptoms worsen, there can be permanent damage to the spine. Some more early indicators of the condition are depression, fatigue, hair loss, anxiety, poor memory, numbness, and cognition.

What are the Causes of Vitamin B12 Deficiency?

Vitamin B12 deficiency often occurs when the body does not get enough B12. Some reasons for vitamin B12 deficiency are:

  • Gastritis: It refers to stomach lining inflammation and is one of the most common causes of the condition. Gastritis leads to the lack of hydrochloric acid (Acid required in the B12 absorption process) in the stomach. Thus, the deficiency.

  • Lack of B12 in Your Food: Those who do not consume foods rich in B12 are bound to develop deficiency. Thus, it is essential to know those items and include them in your diet.

  • Digestive Issues: Diseases affecting the digestive system (like celiac and Crohn’s) might prevent the body from absorbing B12 completely, leading to deficiency.

  • Pernicious Anaemia: This is a rare medical condition; however, those affected by it are unable to make an intrinsic factor necessary for the body to absorb Vitamin B12. The intrinsic factor refers to a protein produced by the stomach, and a decrease in its production will increase the deficiency.

  • Alcohol Use Disorder: This condition is also known by the names alcohol addiction, alcohol dependence, and alcohol abuse. It can affect the digestive system, leading to Vitamin B12 deficiency.

  • Surgery: People who have undergone certain surgeries, such as gastric bypass or any other type of gastrointestinal surgery, might have difficulty absorbing B12, which can result in deficiency.

  • Transcobalamin II Deficiency: It is a genetic disorder that weakens the transportation of B12 or cobalamin in the body, resulting in vitamin deficiency.

What are the Symptoms of Vitamin B12 Deficiency?

Vitamin B12 deficiency can accompany several symptoms depending on its stage and the body’s overall condition. The low B12 symptoms are categorized into physical, psychological, and neurological symptoms and can worsen with time. They are:

General Physical Symptoms

  • Feeling extremely weak or tired
  • Weight loss
  • Sore tongue or mouth
  • Decrease in hunger
  • Vomiting, nausea, or diarrhoea
  • Yellowish skin

Neurological Symptoms

  • Vision problems
  • Tingling or numb sensation in the feet and hands
  • Difficult time remembering things
  • Difficulty in speaking and walking normally
  • Irreversible neurological problems

Psychological Symptoms

  • Irritation
  • Depression
  • Changes in mood and behaviour

How is Vitamin B12 Deficiency Diagnosed?

Diagnosing Vitamin b12 deficiency can be difficult due to the lack of noticeable symptoms in early or later stages. However, doctors will recommend blood tests and, at times, endoscopy to those at higher risk of developing the condition. In case the test reports identify the presence of red blood cells, doctors will suspect the condition. They might also suspect the condition in case of some nerve damage symptoms like loss of sensation or tingling. If your doctor recommends getting a blood test, consider a trusted diagnostic brand like ours to ensure a secure process and accurate results. Mostly, the vitamin b12 test price in Ahmedabad varies from 300 to 2100, depending on the parameters.

Learn more about the Vitamin B12 test details on our website.

If an elderly person is diagnosed with the condition, no additional tests are recommended since the root cause, such as low stomach acidity, is not serious. Doctors may recommend certain tests, like endoscopy and specific blood tests, to help them determine the exact cause of the condition.

People who cannot visit diagnostic centres or pathology labs can use our book home sample collection service to ensure that the tests and, ultimately, diagnosis are not delayed.

How is Vitamin B12 Deficiency Treated?

Vitamin B12 deficiency treatment can include a combination of oral medication, intramuscular injection, nasal gel, and nasal spray.

Older people suffering from deficiency are often recommended Vitamin B12 supplements since they are easy to consume and absorb. Oral medications are prescribed to people with the deficiency but no noticeable B12 deficiency signs/symptoms. In this case, blood tests are performed regularly to track their vitamin B12 levels and ensure they return to normal.

Vitamin B12 injections are often given to people with extremely low Vitamin B12 levels or those showing nerve damage symptoms. The injection dose may be daily, weekly, or for months until the B12 returns to a normal level. Further, doctors may continue to administer injections once every month unless the root cause of the deficiency is treatable.

Anaemia is often completely treated in about six weeks. However, if serious nerve damage symptoms persist for months and years, they might become permanent. It is often observed that mental functions in older people suffering from dementia and Vitamin B12 deficiency do not improve even after treatment.


Of the different minerals and nutrients your body demands to be healthy, one is Vitamin B12. It contributes significantly to keeping the blood and nerve cells healthy. However, B12 deficiency can lead to several problems, some concerning nerve damage that might become permanent. Therefore, if you are at risk of developing a deficiency or experiencing some symptoms, visiting the doctor and taking a blood test at Sterling Accuris Diagnostics to assess Vitamin B12 levels is necessary. The results will help doctors formulate effective treatment plans to cure the root cause and alleviate symptoms.

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