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Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Levels of B12 are exceptionally low in the UK, but the causes of deficiency are wide-ranging. The human body needs B12 to make red blood cells, nerves, DNA, and carry out other key functions. Complications linked to low levels are often concentrated in the body’s extremities – where nerves are more sensitive to touch. One disorientating symptom of B12 deficiency, known as position sense, dosage elavil may occur when the eyes are shut.

According to the NHS, vitamin B12 or folate deficiency anaemia can cause a wide range of symptoms.

The health body adds: “These usually develop gradually, but can worsen if the condition goes untreated.

“Anaemia is where you have fewer red blood cells than normal or you have an abnormally low amount of a substance called haemoglobin in each red blood cell.”

Symptoms associated with low B12 levels can be both physical or neurological, and typically involve a lack of energy, breathlessness, and feeling faint.

READ MORE: Vitamin D deficiency symptoms: The ‘vague’ symptom in adults to spot and how to treat it

Other common symptoms associated with low B12 levels can include strange sensations or tingling in the hands, legs and feet.

The website B12 deficiency lists impaired vibration and position sense as another possible complication of B12 deficiency.

In other words, it explains, this “affects awareness of joint position when eyes are closed.”

In clinical terms, joint position sense is defined as an individual ability to perceive the position of a joint with his/her vision occluded and minimal exteroceptive cues.

Clinically, joint position sense is often referred to as proprioception.

The condition is described in the case study of a 31-year-old who developed a B12 deficiency after undergoing surgery.

“On examination, she had profound loss of joint position and vibration sensation in all extremities and severely ataxic.”

Who is at risk of B12 deficiency?

Harvard Health explains: “The only foods that deliver [B12] are meat, eggs, poultry, dairy production and other foods from animals.”

Because B12 is found naturally in animal products, groups that exclude meat and fish from their diet are generally more vulnerable to deficiency.

The health body continues: “Strict vegetarians and vegans are at high risk for developing a B12 deficiency if they don’t eat grains that have been fortified with the vitamin or take a vitamin supplement.

“Conditions that interfere with nutrient absorption, such as celiac or Crohn’s disease, can cause B12 trouble.”

Those who undergo stomach surgery can also experience B12 deficiency, as this may deplete the concentration of intrinsic factor in the stomach.

Intrinsic factor is an acid produced in the stomach which the body needs to absorb vitamin B12.

Low levels of intrinsic factor therefore interfere with the body’s ability to extract vitamin B12 from food.

Patients who become severely deficient due to malabsorption of B12 may be recommended an injection.

Alternatively, B12 supplements are sometimes recommended for vegans and strict vegetarians.

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