When it Comes to Vitamin B12, How Much is too Much?

Recent research has pointed out that men are more likely to be deficient in Vitamin B than women.

One of the big preoccupations of the nutrition space is Vitamin B12. It’s a water-soluble vitamin which is essential for the smooth functioning of the body. However how much of it is too much, what are the symptoms of its deficiency, what are the dietary sources, are oral supplements alright - the list of questions regarding this vitamin are endless.

Here’s an attempt to understand it better with the help of health and medical experts.

How Important is B12 Really?

Preeti Rao, Health and Wellness Expert, Max Multi Speciality Centre, Panchsheel Park, affirms that Vitamin B12 truly is the “latest buzz” in the nutrition world. But how important is it truly?

Vitamin B12 essentially is required for nerve tissue health, brain function and the production of red blood cells. More importantly the metabolism of every cell in the body depends on vitamin B12 as it plays a part in the synthesis of fatty acids and energy production.

Preeti Rao

The nutrition expert further adds that the vitamin is essential for both men and women. However, recent research has pointed out that men are more likely to be deficient in Vitamin B12 than women even in the healthy population zone, she adds. Interestingly, this can neither be explained by diet habits nor estrogen effects.

Dr Vaibhav Mishra, Additional Director, Cardiac Surgery, Fortis Hospital Noida, too emphasises the importance of B12.

B12 is the most important vitamin that is essential for the healthy functioning of the brain and the nervous system. While it is required for both men and women, the latter require it in excess during pregnancy and lactation.

Dr Vaibhav Mishra

What Functions Does B12 Serve in the Body?

There are several functions it serves in the body which are listed in the following manner by Rao:

• Essential for physical and mental health
• Creates and regulates DNA
• Essential In the formation and division of red blood cells
• Protects the brain and the nervous system
• Synthesizes a person's DNA to provide the body with energy
• Enables the release of energy by helping the human body absorb folic acid
• Protects against anemia

The importance of Vitamin B12 for the healthy functioning of the nervous system as well as in the production of red blood cells cannot be stressed enough, according to Dr Mishra.

It is important for a healthy nervous system and production of the red blood cells. If deficiency continues for a long period of time, it leads to changes in the brain chemistry. This could be permanent in nature. Additionally, it can lead red blood cell production to drop significantly, resulting in anaemia. The body will feel lethargic and slow, a person’s ability to exercise and function will become low.

Dr Vaibhav Mishra

Too Much B12 and Hip Injuries, Especially in Women

A study that was published in the journal Jama Network Open concluded that an excess of Vitamin B12 can lead to hip injuries in women. The question the study asked was if high intake of B6 and B12 can cause hip fractures.

The analysis included 76,000 female nurses in the US that were followed for an average of 21 years. It was seen that about 2,300 women out of the total suffered hip fractures during the study, and half of them experienced them before the age of 76 years.

When women with the highest daily intake of B6 and B12 were compared with women with the lowest intake, it was further concluded that the former were more likely to have hip fractures during the study by 47 percent.

Rao agrees with this study and lists down hip fractures as a negative outcome of increased B12 levels in the body. She mentions more side-effects in the form of diabetes and kidney disease, acne, greater risk of heart attack, stroke. When it comes to pregnant women, it leads to an increased risk of autism spectrum disorder in their offspring.

Dr Mishra comments on the same and says:

There’s no association as such with hips and bones, I have mainly seen a D3 vitamin deficiency linked to it.

Dr Vaibhav Mishra

What is the Role of Supplements When it Comes to B12?

It’s important to note that no supplements should be taken without advise from a medical expert. Rao further mentions that supplementation cannot replace healthy eating, but it can support it in today’s times.

The nutritional value of fruits, vegetables and meat today has greatly declined in the last 50 years. With lack of standards for organic produce in India, one cannot be certain of the nutrient value derived from the foods we are consuming. Moreover with the aggressive agriculture on the Indian land, the soil does not get the required rest to recuperate from the heavy lighting it has been doing to feed the increasing Indian population.

Preeti Rao

She adds that research has pointed out that approximately 39 percent of the general population may have possible B12 deficiencies or difficulty with the absorption of this nutrient. Supplementation therefore is recommended to fill the nutritional gap and bring Vitamin B12 to normal range, yet it cannot replace the importance of a balanced diet, and regular guidance by a medical practitioner.

Symptoms of a B12 Deficiency

Dr Mishra says that a B12 deficiency tends to be sub-clinical in nature which means it’s only after a prolonged period of deficiency that symptoms begin to appear.

The only way to pick up on the same is through a blood test. This is because the symptoms are non-specific in nature.

Dr Vaibav Mishra

Here are some symptoms to watch out for:

• Fatigue/low energy
• Irritability
• Memory loss
• Decline in judgment, understanding
• Mental cloudiness
• Mood swings
• Anxiety
• Depression
• Slow reflex
• Difficulty in walking
• Sore mouth or tongue
• Weight loss/loss of appetite
• Pale and yellowing skin
• Menstrual problems
• Muscle cramps
• Tingling in the hands and feet
• Numbness in palms and soles
• Breathlessness

Sources of B12 and Why Vegans, Vegetarians Need to Pay Extra Attention

A large number of people in India are deficient in this particular vitamin, according to this study. As India struggles with malnutrition, the deficiency is also tied with several other factors including lifestyle, poor dietary choices and lack of information.

The deficiency is more pronounced among the vegetarians as well as vegans. This is because B12 is primarily found in meat and poultry.

Since the source of Vitamin B are beef, pork, ham, poultry, lamb, fish, and India being largely a vegetarian nation, this deficiency will hit the nation more.

Preeti Rao

Vegetarians who are looking to increase their B12 intake should pay attention to consuming dairy products, such as milk, cheese, and yogurt, soya milk, eggs fortified breakfast cereals, he adds.

An important point to note is that Vitamin B12 deficiency may occur in between 40 to 80 percent of the vegetarian population who are not also consuming a vitamin B12 supplement.

Preeti Rao

Dr Mishra agrees with her and affirms:

Vitamin B12 is not present in a plant based diet i.e. a vegetarian diet in India which is why the most vulnerable of all communities are the vegetarians and the vegans; 30 to 40 percent of them have a sub-clinical deficiency.

Dr Vaibhav Mishra