What are the symptoms of Vitamin B (Vit B) deficiency?

Symptoms of Vitamin B Deficiency

Vitamin B deficiency presents with a wide range of symptoms affecting multiple body systems, primarily including neurological symptoms (numbness, tingling, impaired coordination), cognitive difficulties, fatigue, and hematological abnormalities such as anemia. 1

Common Symptoms by Body System

Neurological Symptoms

• Pins and needles or numbness (paraesthesia) 1
• Balance issues and falls due to impaired proprioception 1
• Impaired gait and coordination 1
• Peripheral neuropathy (particularly in B12 deficiency) 1
• Sensory ataxia related to spinal cord damage 1
• In severe cases, paralysis (B12 deficiency) 1

Cognitive and Psychological Symptoms

• Difficulty concentrating 1
• Short-term memory loss (sometimes described as "brain fog") 1
• Symptoms that may mimic dementia or delirium 1

Visual Symptoms

• Blurred vision 1
• Optic atrophy 1
• Visual field loss (scotoma) 1

Hematological Manifestations

• Anemia (particularly macrocytic/megaloblastic in B12 and folate deficiency) 1
• Abnormal findings on blood count, including macrocytosis 1

Oral Symptoms

• Glossitis (inflammation of the tongue) 1

General Symptoms

• Unexplained fatigue 1
• Weakness 1

Specific Vitamin B Deficiency Presentations

Vitamin B12 (Cobalamin) Deficiency

• Neurological symptoms often precede hematological abnormalities 2, 3
• Numbness and tingling of limbs and skin 1
• Disrupted coordination 1
• Paralysis in severe cases 1
• Permanent degenerative lesions of the spinal cord if deficiency persists longer than 3 months 3

Thiamin (B1) Deficiency

• Neurological damage (dry beriberi) 1
• Cardiovascular manifestations (wet beriberi) 1
• Metabolic acidosis 1

Folate (B9) Deficiency

• Megaloblastic anemia 1
• Neural tube defects in fetuses of deficient pregnant women 1
• Growth retardation 1
• Neurological complications 1

Riboflavin (B2) and B6 Deficiency

• Associated with increased risk of depression 1
• B6 deficiency specifically linked to increased anxiety 1

Risk Factors for Vitamin B Deficiency

• Diet low in vitamin B (vegan/vegetarian diets, restricted diets) 1
• Malabsorption conditions (atrophic gastritis, celiac disease) 1, 2
• Medications (metformin, proton pump inhibitors, H2 blockers) 1, 2
• Bariatric surgery 1, 2
• Advanced age (particularly those over 75) 2, 4
• Family history of vitamin B deficiency 1
• Autoimmune conditions 1

Important Clinical Considerations

1. Neurological symptoms of B12 deficiency may become irreversible if not treated promptly 2, 3

2. Never administer folic acid alone before treating B12 deficiency, as this may mask hematological symptoms while allowing neurological damage to progress 2, 3

3. B12 deficiency often presents with neurological symptoms before hematological abnormalities appear 2

4. For B12 deficiency, serum levels may be normal despite tissue deficiency; additional testing with methylmalonic acid and homocysteine may be necessary 2, 5

5. Vitamin B deficiencies often coexist and may have overlapping symptoms 1

By recognizing these symptoms early and addressing the underlying deficiency, significant morbidity can be prevented, especially the potentially irreversible neurological damage associated with prolonged B12 deficiency.