What are the symptoms of vitamin B12, iron and folate deficiency, and can they be linked?
I have previously shared with you 9 Reasons Why You Might Be So Tired. In this post we look further into nutrient deficiencies and pay close attention to Iron, Vitamin B12 and Folate.
Iron is a vital mineral needed every second of the day, as it transports oxygen around the body.
The best sources of iron (‘haeme’ iron) are lean meat and seafood. Dietary sources of non-haeme iron are plant foods such as nuts, beans, vegetables and fortified grain products. Haeme iron sources are considered the best because the body absorbs these much easier. Some foods and drinks can enhance or inhibit iron absorption too. For example, vitamin C enhances it, whereas the tannins found in tea can inhibit absorption. Over-the-counter iron supplements often cause constipation, because they are poorly absorbed by the body and have a binding effect when unabsorbed.
When you are low in iron, you may notice symptoms of general fatigue and weakness. Headaches, pale skin, shortness of breath and dizziness can also occur. Several other symptoms can include: cold hands and feet, tongue swelling or soreness, brittle nails and a tingling or crawling sensation in the legs. Some individuals experience cravings to eat ice, dirt or clay.
Iron deficiency is common and can affect anyone. Individuals at higher risk include: menstruating, pregnant and lactating women; teenage girls; athletes; infants and toddlers. Those on diets that are low in iron, such as veganism and vegetarianism, are also at higher risk. Periods of rapid growth, pregnancy, breastfeeding and high intensity exercise all increase the body’s iron requirements. Blood donation and chronic disorders that involve bleeding, such as peptic ulcers, can deplete iron. Conditions that damage the digestive system, for example coeliac disease, also greatly reduce iron absorption.
We need Vitamin B12 to make red blood cells, and it plays a key role in our brain and nervous system function.
B12 is naturally found in animal products, including meat, fish, poultry, eggs and milk products. It is typically bound to proteins in food. Absorption of B12 requires a healthy digestive system. Stomach acid and protein-digesting enzymes in the stomach are first needed to ‘free’ vitamin B12 from the proteins. Then, Intrinsic Factor, which is also produced by the stomach, must bind to the free B12 so it can be absorbed by the intestines into the blood. Therefore, any digestive issues can affect the absorption of vitamin B12, such as low stomach acid, low Intrinsic Factor production, H. pylori infection (the bacteria that causes stomach ulcers) or a weakened stomach lining. A vegan diet can also lead to low levels of Intrinsic Factor, impairing the absorption of an often already reduced amount of vitamin B12.
Vitamin B12 deficiency often presents with fatigue and weakness. Deficiency can also cause constipation, loss of appetite, and weight loss. Other deficiency signs can also include balance disturbances, confusion, poor memory, depression, mouth or tongue soreness and numbness and tingling in the hands and feet.
An interesting symptom of Vitamin B12 deficiency is the desire to eat ice and non-food materials, like dirt and paper! This is technically known as ‘pica’
Like vitamin B12, we also need folate to make red and white blood cells, as well as to keep our brains and nervous systems functioning correctly.
Unlike vitamin B12, most of the sources of folate are plant foods, such as green vegetables like spinach and broccoli, peanuts and other legumes, as well as citrus fruits. Folate can be damaged by heat, so it is best to eat some of these raw.
The symptoms of folate deficiency, especially if it is severe, include anaemia, fatigue and poor immunity. Because of its role in nervous system health, other symptoms can include depression, confusion, insomnia and neuropathy. You may have heard of a substance known as ‘homocysteine’, which can be harmful to cardiovascular and nervous system health in high levels. Folate, along with vitamins B12 and B6, help to keep it in check.
The need for folate is higher in pregnant and breastfeeding women, in order to meet the needs of the baby’s rapidly developing nervous system. Alcohol, the oral contraceptive pill and some other pharmaceuticals can also deplete or reduce absorption of folate. Some people carry a gene different to the one required for correct folate activation, so folinic acid supplementation is required. Folinic acid is the active form of folate.
How do I find out if I am deficient?
A blood test is the best way to identify any of these deficiencies. A supplements is generally recommended but some, in particular iron supplements, can leave you feeling bloated, unconformable and constipated. These supplements may help but it won’t fix the underlying cause of the deficiency.
Let me help you get to the bottom of any of your health concerns and start to fix them from there. I know you don’t want to be on supplements for ever, so lets have a chat about what’s possibly causing the problem, how we can fix it and ways to get your energy up.