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Vitamin B12, also known as cobalamin, is a crucial nutrient for your body. It helps in making red blood cells, supports a healthy nervous system, and plays a role in creating DNA, the genetic material in your cells.

Sometimes, people can become deficient in vitamin B12. This means they don’t have enough of it in their bodies. There are a few reasons why this can happen. You might not get enough of it if you don’t eat foods like meat, dairy, and eggs, which are rich in B12. This is especially a concern for strict vegetarians and vegans. As you get older, your body’s ability to absorb B12 can decrease, putting you at risk for deficiency. There’s also a condition called pernicious anemia, where your immune system mistakenly attacks the cells that help your body absorb B12.

When you’re lacking in B12, it can lead to problems like feeling tired, weak, and even having difficulty breathing. Your skin may become pale, and you might experience a tingling sensation in your hands and feet. If this deficiency continues, it can even affect your brain, causing confusion and balance issues.

To find out if you have a B12 deficiency, doctors do blood tests. But sometimes, these tests may not show the full picture. The good news is that if you’re deficient, doctors can give you B12 through shots or pills, which usually helps you feel better. The key is to catch it early and treat it to avoid more significant problems down the road.

Now, let’s talk about why your blood test might show normal B12 levels even if you have a deficiency. The process of B12 metabolism is complex, and if any part of it is disrupted, it can lead to a deficiency. There are various causes, including problems with absorbing B12 from your food or conditions like pernicious anemia. Doctors often check the B12 levels in your blood to see if you’re deficient. However, these tests can sometimes give incorrect results due to certain antibodies in your blood, especially in cases of pernicious anemia. So, while these tests are the best we have for diagnosing B12 deficiency, they’re not always perfect. In some cases, even if your B12 levels seem fine, other factors need to be considered when diagnosing a deficiency.


Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician. 2003 Mar 1;67(5):979-86. PMID: 12643357.

Scarpa E, Candiotto L, Sartori R, Radossi P, Maschio N, Tagariello G. Undetected vitamin B12 deficiency due to false normal assay results. Blood Transfus. 2013 Oct;11(4):627-9. doi: 10.2450/2012.0183-12. Epub 2012 Dec 12. PMID: 23356970; PMCID: PMC3827408.

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