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What Are The Symptoms Of Vitamin B12 Deficiency In Older Adults?

Updated: Oct 20, 2021

Vitamin B12 deficiency is often mistaken for old age. The signs are subtle and progress slowly.

The common symptoms of vitamin B12 deficiency in the elderly include:

  • Depression or mood impairment

  • Irritability

  • Cognitive slowing

  • Weakness, which may progress to paraplegia

  • Forgetfulness

  • Impaired position sense and vibration sense

  • Extrapyramidal signs

  • Dementia

  • Psychosis

  • Peripheral sensory deficits

  • Visual disturbances

  • Lhermitte’s signs

  • Ataxia

  • Abnormal deep tendon reflexes

If these signs persist for more than six months without any other clear cause or if you have anemia, then it may be time to get a vitamin B12 deficiency test.

The most common cause of vitamin B12 deficiency in older adults is pernicious anemia, which affects the stomach and reduces its ability to absorb vitamin B12.

However, you may develop vitamin B12 deficiency as a result of a poor diet.

Vitamin B12 is almost exclusively found in meat and dairy products, with the exception of some fortified processed foods. Vegans can find it challenging to meet the daily recommended intake of this nutrient.

Vitamin B12 deficiency can lead to many health issues, including brain fog, fatigue, and depression.

Vitamin B12 plays a crucial role in maintaining healthy nerve cells and red blood cells. Knowing what the early warning signs are can help with the prevention of these symptoms.

This article discusses the most common signs of low levels of vitamin B12.

Let’s get started!

Depression or mood impairment

You need vitamin B12 to synthesize serotonin and norepinephrine. Serotonin or norepinephrine are the neurotransmitters that stabilize mood. Having low levels can lead to depression and mood impairment.

Depression is one of the overlooked signs of vitamin B12 deficiency. Yet up to 20% of people over 65-years old have depression.

Studies find that vitamin B12 can improve symptoms of depression and anxiety when taken with antidepressant medications compared to taking antidepressants alone.


Low vitamin B12 can lead to various neurological symptoms, including mood impairment, dementia, memory loss, and more, which can lead to irritability.

Studies show that about 40% of people with irritability and anxiety have low levels of vitamin B12.

​If you or your loved one has irritability, it's important to consult with a medical professional and get tested for any vitamin deficiencies.

Irritability can sometimes be a sign of more severe health complications.

Cognitive slowing, forgetfulness, and dementia

Vitamin B12 is needed for the synthesis of neurotransmitters and nerve cells. This nutrient plays a role in maintaining healthy nerve cells, which control our cognitive function.

Studies show that people with low vitamin B12 have experienced some kind of cognitive impairment, including problems concentrating and recalling information.

Cognitive slowing may also lead to dementia, which typically affects people over the age of 65 and is caused by a decline in brain function due to aging or disease.

Dementia develops after abnormal changes in blood vessels that lead to reduced oxygen supply to the brain. Dementia can also be caused by chronic stress, depression, and anxiety.


Vitamin B12 plays a key role in the normal function of nerve cells. Deficiency can lead to cognitive impairment and psychotic symptoms such as paranoia or delirium.

Psychosis can make you act in a delusional manner, with impaired judgment and even aggression.

The condition is characterized by the loss of contact with reality, including delusions and hallucinations.

Visual disturbances

Vitamin B12 deficiency is also linked with visual disturbances, including double vision or blurry vision.

You may experience intermittent eye pain and even lose sight if vitamin B12 deficiency is left untreated. It occurs due to a damaged nervous system which ultimately damages the optic nerve. When the optic nerve is damaged, the nervous signals are compromised, which impairs your vision.

Please consult a doctor before the vision problems worsen. Visual disturbances like these can be a sign of nerve damage, which may lead to permanent vision loss.

Peripheral sensory deficits

Damage to the nerves causes a loss in sensation and motor function below the point of injury.

With peripheral sensory deficits, you may experience numbness or tingling sensation on one side of your face or body because these sensations are controlled by the damaged nerve cells.

The numbness can spread to the arms and legs, which can lead to weakness in these areas.

Weakness, which may progress to paraplegia

Weakness in your legs can be a sign of vitamin B12 deficiency and even lead to paraplegia, a spinal cord injury that can cause paralysis of the lower limbs. This occurs when your body cannot produce red blood cells that are responsible for transporting oxygen throughout the body. As a result, you feel tired.

You may experience mild weakness that gets worse over time, which is known as chronic progressive neuropathy.

Eventually, this condition may become so severe that you can no longer control your lower body muscles or sensation below the waist.

Impaired position sense and vibration sense

Nerve damage can result in impaired position sense, also known as proprioception. It occurs when the peripheral nerves, which are responsible for transmitting information about position and movement to your brain, become damaged.

You may have difficulty knowing where your arms or legs are without looking at them because you can’t properly feel them.

Impaired vibration sensation can also lead to losing a sense of where your limbs are in space, which may cause you to bump into objects or fall because your body cannot correctly orient itself.

Lhermitte’s sign

Lhermitte’s sign is associated with vitamin B12 deficiency and multiple sclerosis (MS), a disorder that affects the central nervous system.

Lhermitte’s sign occurs when patches of myelin in the brain and spinal cord are damaged by inflammation. The inflammation interrupts communication between your brain and body, resulting in loss of sensation or movement below the point of injury.

Lhermitte’s signs may feel like getting an electric shock in your arms or legs, which can be followed by weakness and even paralysis.


Ataxia is often a sign of vitamin B12 deficiency. It causes loss of coordination due to peripheral neuropathy that results from low levels of vitamin B12.

Ataxia is a condition that causes loss of control over your muscles, resulting in slow and uncoordinated movements. Other symptoms include difficulty focusing on an object when moving or keeping your balance when standing still.

Abnormal deep tendon reflexes

An abnormal tendon reflex is a sign of damage to the nervous system caused by vitamin B12 deficiency. This causes an exaggerated response from the part of your brain that sends signals for your muscles to respond to outside stimuli with movement or tension.

You may experience clumsiness and weakness because your nerves cannot properly transmit information between the body and brain.

Extrapyramidal signs

Vitamin B12 deficiency can cause extrapyramidal symptoms that hinder motor movements control. This can result in involuntary muscle contractions and rigidity of muscles that may affect your face or limbs.

These problems are typically caused by damage to one side of the cerebellum, which is located at the base of your brain. The cerebellum controls movement coordination.

Symptoms often include slow body movements with a loss of balance because you cannot correctly orient yourself when moving around objects or people.

How does B12 deficiency make you feel?

Depending on the severity of your vitamin B12 deficiency, you may experience fatigue or shortness of breath when exercising because your body cannot produce enough red blood cells to carry oxygen through your tissues.

In extreme cases where there is nerve damage, it can result in paralysis that affects all four extremities and other parts of the body, such as the face and bladder control.

If left untreated over time, these conditions will only worsen, leaving you with irreversible physical handicaps.

Taking vitamin B12 supplements can help prevent and reverse these deficiency symptoms.

Raising vitamin B12 fast

A straightforward way to increase vitamin B12 is by adding vitamin B12-rich foods into your diet. Natural vitamin B12 supplements that you should include in your daily diet are:

  • Eggs

  • Low-fat milk, yogurt, and cheese

  • Fortified breakfast cereal

  • Fish and shellfish such as clams, tuna, salmon, and trout

  • Beef, liver, and chicken

  • Fortified nutritional yeast

If you are vegan or want to save yourself from the hassle of preparing a dish, you can take the Why Not Natural Organic Vitamin B12 Liquid to take care of your daily recommended intake of vitamin B12.

Consult your doctor before taking any over-the-counter vitamins as they could interfere with other medications you may be taking now or have taken recently for more severe conditions like cancer treatment or heart surgery procedures.


If you are experiencing some signs of vitamin B12 deficiency like irritability, depression, weakness, or memory loss, talk with your doctor about appropriate treatment options.

You can supplement vitamin B12 with eggs, low-fat milk, yogurt, and cheese. Alternatively, you can take the vegan Why Not Natural vitamin B12 supplement to reverse the deficiency symptoms.

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