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Persistent fatigue, forgetfulness, numbness, or difficulty walking may sometimes be dismissed as normal signs of aging. However, these symptoms can also signal a vitamin B12 deficiency—a treatable condition that can damage the nervous system when overlooked.
Vitamin B12 helps the body produce healthy red blood cells and supports normal nerve function and DNA formation. Deficiency can cause weakness, pale skin, heart palpitations, weight loss, a painful tongue, and megaloblastic anemia. Neurological symptoms may include tingling or numbness in the hands and feet, balance problems, confusion, and memory difficulties.
Older adults face increased risk because aging can reduce stomach acid needed to release B12 from food. Pernicious anemia, gastrointestinal disorders, and weight-loss or stomach surgery can also interfere with absorption. People following vegan diets may be vulnerable because B12 occurs naturally primarily in animal-derived foods.
Long-term use of metformin for diabetes and acid-reducing medicines—including proton-pump inhibitors such as omeprazole—may also lower B12 levels. Patients should not discontinue prescribed medication, but they can ask whether testing is appropriate.
The National Institutes of Health reports that approximately 12% of adults 60 and older have B12 insufficiency under one commonly used laboratory threshold. Importantly, nerve-related symptoms can develop even without anemia, and untreated neurological damage may become permanent.
Food sources include fish, meat, poultry, eggs, milk, and other dairy products. Fortified cereals and nutritional yeast provide alternatives for people who avoid animal products.
A blood test can help identify deficiency, although additional testing may sometimes be necessary. Treatment may involve oral B12 or injections, depending on the cause and severity. Taking B12 without a deficiency, however, has not been shown to improve energy or memory.