Posted March 12, 2026 by Anupreet Kaur, MD, FAAFP, Medical Director, Care Management and Population Health
Vitamin B12 is a vital nutrient that supports the production of red blood cells and the proper functioning of the nervous system. Despite its importance, B12 deficiency is surprisingly common, particularly among older adults, vegetarians and individuals with certain medical conditions. In the United States and United Kingdom, the prevalence of B12 deficiency is approximately 6% in persons younger than 60 years, and nearly 20% in those older than 60 years (AAFP, September 2017).
The symptoms of B12 deficiency are often subtle, making early detection challenging. Common symptoms include:
Neurological symptoms may progress over time, so addressing concerns early is important. Because these signs overlap with many other conditions, diagnosis can be challenging.
Laboratory tests are the standard method for identifying B12 deficiency, yet results are not always straightforward. A patient may present with normal serum B12 levels while still experiencing clinical symptoms. In such cases, additional markers like elevated homocysteine or methylmalonic acid can provide crucial diagnostic insight. Regular bloodwork and maintaining a detailed medical history are key.
Treatment is typically straightforward. Dietary sources of B12 include meat, fish, eggs, dairy, nutritional yeast, fortified plant or dairy milk, fortified cereals and more. Individuals who have difficulty absorbing B12, including older adults and those with gastrointestinal disorders, may require supplementation in the form of oral tablets or injections. The choice of treatment depends on the severity of deficiency and the underlying cause. Consistent monitoring ensures that treatment is effective and prevents long-term complications.
Beyond treatment, awareness and prevention play an important role. Some people are at higher risk for deficiency. Risk factors for suspecting B12 deficiency: decreased small intestinal absorption (for example in Crohn’s disease), decreased stomach intrinsic factor (for example in gastritis, anemia), genetic alcohol abuse, vegetarian diet, prolonged use of acid suppressants and Metformin use.
Recognizing the deficiency early and intervening with treatment can often improve energy levels, cognitive function and your overall quality of life quickly while also reducing the risk of irreversible neurological damage.
It’s important to take action quickly if you notice any of the following symptoms:
Start by scheduling an appointment with your healthcare provider. Bring a clear record of your symptoms, diet, medications and any medical conditions, as this information can help guide testing.
Your provider may order blood tests to measure B12 levels and other related markers, such as homocysteine or methylmalonic acid. Based on the results, they can recommend the most appropriate form of supplementation, whether through diet, oral tablets or injections. Follow up testing is often necessary to ensure levels return to a healthy range and that symptoms improve.
Prevention is equally important. If you belong to a higher-risk group including vegetarians, older adults or are a person with certain digestive conditions, it may be wise to discuss long-term supplementation with your provider. Regular monitoring and patient education can be key to maintaining adequate B12 levels and avoiding additional complications.
By taking these steps, individuals can actively protect their energy, cognitive function and overall neurological health. Early awareness and intervention can make a significant difference in both short-term well-being and long-term outcomes.
Visit https://www.summacare.com/find-your-doctor-or-hospital to schedule a visit with a provider near you.