B12 deficiency: A growing health concern in the UK

A growing number of Britons are affected by vitamin B12 deficiency, a condition that often goes undiagnosed due to its vague symptoms and unreliable tests.

The story of Zita Wells, a 45-year-old pet carer from Sussex, highlights a growing health concern in the UK: vitamin B12 deficiency. What began as unusual fatigue and breathlessness during dog walks culminated in a sudden episode of weakness while shopping, leading to her diagnosis.

Zita’s experience is not unique; experts warn of a silent epidemic affecting millions, often going unnoticed due to its non-specific symptoms and diagnostic challenges.

Vitamin B12, or cobalamin is crucial for producing red blood cells, repairing DNA, and maintaining a healthy brain and nervous system.

Found primarily in animal products, it’s essential for everyone, but particularly for older adults and those with restrictive diets. Despite its importance, deficiency cases are on the rise, with hospitalizations tripling since 1999. Yet, many remain undiagnosed, risking severe complications like nerve damage, heart failure, and even death.

The rising tide of B12 deficiency

Current estimates suggest that about one in 20 Britons are affected by B12 deficiency, with the risk increasing to one in five for adults over 50. The condition’s insidious onset and common symptoms—such as fatigue, brain fog, and tingling in extremities—often lead to misdiagnosis or delayed treatment. Experts attribute the rise in cases to several factors, including aging populations, increased adoption of vegetarian and vegan diets, and the consumption of ultra-processed foods.

Professor Martin Warren, a synthetic biologist at the Quadram Institute, notes that nutrition levels in developed countries are still a concern. ‘More and more Britons are struggling with B12 deficiency,’ he says. ‘And the older you get, the more prevalent it is. Yet we still don’t have adequate testing—or enough awareness about the condition. People are slipping through the net.’

The challenges of diagnosis

Diagnosing B12 deficiency is fraught with challenges. The most common NHS test measures the total amount of B12 in blood serum, but this method is remarkably unreliable with a less than 50% accuracy rate. Better tests exist, but they are more expensive and less accessible. As a result, many patients with borderline test results are turned away without treatment, despite experiencing symptoms.

Lucy Smith, a 54-year-old mum from Devon, thought her symptoms were due to menopause before discovering her severe B12 deficiency. ‘I had been struggling with tiredness, irritability, bleeding gums, and not being able to sleep very well for years,’ she says. After receiving B12 injections, her symptoms improved dramatically. Her story underscores the importance of awareness and better diagnostic tools.

The impact on older adults

Older adults face a perfect storm of risk factors for B12 deficiency. As we age, our bodies produce less stomach acid, which is essential for absorbing B12. Additionally, older adults are more likely to be on medications that block B12 absorption, such as proton-pump inhibitors and metformin. Research from Cornell University and the University of Alabama highlights the role of B12 in muscle function and aging, revealing that deficiencies can accelerate muscle wastage and loss of strength.

Professor Warren emphasizes the importance of maintaining adequate B12 levels as we age. ‘Older adults are more likely to be on medications that block B12 absorption, as well as naturally producing less stomach acid,’ he says. ‘It’s much more common than people realise. In a room of 20 people, one person, statistically, will have B12 deficiency. If it’s a room of over-50s, that shrinks to one in five.’

Raising awareness and seeking solutions

Despite its prevalence, B12 deficiency remains underdiagnosed and undertreated. Experts advocate for raising awareness, particularly among older adults and those with restrictive diets. They recommend that anyone experiencing symptoms should raise them with their doctor and ask for a B12 test. For those concerned about their B12 levels, simple dietary adjustments and supplements can help, especially when taken with meals to enhance absorption.

Dr. Ali Niklewicz, a nutrition scientist at the University of Surrey, stresses the importance of awareness. ‘It’s important that people are aware of B12 and nutritional deficiencies in general,’ she says. ‘But the good thing about it is that, once found, it’s very treatable.’