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What You Need To Know About Vitamin B12 Deficiency

It seems like vitamin B12 is all the buzz right now – but what is it exactly, why is it so important and how do we know if we’re not getting enough?

Women’s Health asked Dr Fiona O’Leary, Accredited Practising Dietitian and Senior lecturer in Dietetics at The University of Sydney, to fill us in.

Why is vitamin B12 so important to have in our diet?

We can’t make vitamin B12 so we need to have it in our diet. We need it to maintain healthy cells and DNA, prevent a type of anemia called megaloblastic anemia (this is different to iron deficiency anemia) and keep nerves and the brain cells healthy.

Is it hard to obtain and why?

Vitamin B12 is easy to get and most people get enough vitamin B12 in their diets.

Vitamin B12 is only found in foods of animal origin for example dairy foods, meats, poultry, fish and seafood. Some foods that do not naturally contain vitamin B12 are fortified with vitamin B12 (so it’s added to the food) e.g. some soy milks, specialty vegetarian products. You can check the label of these types of foods to see if they have vitamin B12 added.

The bacteria in our intestines also produce some vitamin B12, but it’s not known how much of this is absorbed. Also, some people think foods like mushrooms and seaweed contain vitamin B12 but this type of vitamin B12 is different to the type we need, so it’s best to make sure you have enough in your diet from animal source foods, use fortified foods or take a supplement. Most multivitamins also contain vitamin B12.

Are many people lacking it?

Most people have enough B12 in their diet as they eat a variety of foods, and deficiency rates in Australia are low.

Who is most at risk of not getting enough?

Most at risk are vegans, particularly vegan women who are planning to fall pregnant or who are pregnant or breastfeeding. The babies of vegan mothers are also at risk. The developing baby in the uterus, relies solely on the mother for vitamin B12 and if the mother has low levels and/or inadequate diet then both the mother and particularly the baby are affected. Babies of vegan mothers who are breast fed should have a vitamin B12 supplement. Talk to your dietitian or doctor.

It is critical that vegan mothers and women in the childbearing ages, who may fall pregnant, get enough vitamin B12. This can be from fortified foods or from supplements. It is recommended that anyone in this group sees an Accredited Practising Dietitian (APD), who can assess the diet and give expert advice. You can use the ‘Find an APD’ and ‘Smart Eating for a Healthier You’ sections of the Dietitians Association of Australia website or ask your GP for a referral to a dietitian.

Patients with diseases of the bowel such as Crohn’s Disease or other chronic bowel inflammatory conditions, or who have had operations to remove part of the stomach or bowel may also be at risk as they may not absorb the vitamin B12. As people get older the absorption of vitamin B12 can reduce, but because the body stores and conserves vitamin B12 it takes time for symptoms to develop. Talk to your GP if you think you have low vitamin B12 levels.

How can we ensure we are getting the right amount of vitamin B12?

If you already eat a varied diet that contains dairy foods, fish, chicken or meat then you are likely getting enough.

Older people can develop a problem absorbing vitamin B12 from the foods we eat, but a deficiency takes a number of years to develop. Some medications may interfere with the absorption e.g. medicines taken for reflux and Metformin for diabetes. It’s very important to discuss this with your doctor and not to stop medications without medical advice. The doctor can perform a blood test to test your vitamin B12 levels. Deficiency takes several years to develop as the body is very good at conserving vitamin B12.

Signs of vitamin B12 deficiency to look out for: 

Strange sensations or “prickles”


Loss of memory

Pale skin

Heart palpitations and shortness of breath

A smooth, red tongue

Changes in mental health like depression

If you’ve noticed these symptoms speak to a medical professional. 

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