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Tingling nerves and fatigue? You may need a vitamin B12 test. Recognise these signs, know diet treatment


Tingling sensations in the extremities, accompanied by persistent fatigue, can be distressing symptoms that impact daily life and while there could be various underlying causes, one potential culprit to consider is vitamin B12 deficiency. Vitamin B12, also known as cobalamin, plays a crucial role in nerve function, energy metabolism, and red blood cell production.

Tingling nerves and fatigue? You may need a vitamin B12 test. Recognise these signs, know diet treatment (Photo by Shutterstock)

In an interview with HT Lifestyle, Dr Ajay Shah, Managing Director at Neuberg Ajay Shah Laboratory, revealed why you might need a vitamin B12 test if you’re experiencing tingling nerves and fatigue –

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  1. Nerve Health and Tingling Sensations: Vitamin B12 is essential for maintaining the health of the nervous system, including the myelin sheath that insulates and protects nerves. A deficiency in vitamin B12 can lead to nerve damage, resulting in symptoms such as tingling, numbness, or burning sensations in the hands, feet, or other parts of the body. These sensations, known as paresthesia, are often described as “pins and needles” and may worsen over time if left untreated.
  2. Fatigue and Weakness: Vitamin B12 is involved in energy metabolism, helping convert food into usable energy for the body. Consequently, low levels of vitamin B12 can lead to fatigue, weakness, and decreased stamina. Individuals with vitamin B12 deficiency may feel chronically tired, even after adequate rest, and may experience muscle weakness or difficulty performing routine tasks.
  3. Risk Factors for Deficiency: Certain factors increase the risk of developing vitamin B12 deficiency, including –
  • Poor dietary intake: Vitamin B12 is primarily found in animal-based foods such as meat, fish, eggs, and dairy products. Vegans, vegetarians, and individuals with restricted diets may have difficulty obtaining sufficient vitamin B12 from food alone.
  • Malabsorption disorders: Conditions such as pernicious anemia, celiac disease, Crohn’s disease, or gastrointestinal surgery can impair the absorption of vitamin B12 from the digestive tract.
  • Ageing: As individuals age, their ability to absorb vitamin B12 from food sources may decline, increasing the risk of deficiency.
  • Certain medications: Long-term use of certain medications, such as proton pump inhibitors (PPIs), metformin, or antacids, can interfere with vitamin B12 absorption or metabolism.

4. Importance of Testing: Given the potential consequences of vitamin B12 deficiency on nerve health and energy levels, timely detection is crucial for appropriate management. A simple blood test can measure levels of vitamin B12 in the blood, helping healthcare providers assess whether supplementation or other interventions are necessary.

Dr Ajay Shah advised, “If you’re experiencing tingling nerves, persistent fatigue or other symptoms suggestive of vitamin B12 deficiency, don’t ignore them. Consulting with a healthcare professional and requesting a vitamin B12 test can provide valuable insights into your health status and guide appropriate treatment strategies. Addressing vitamin B12 deficiency early on can help alleviate symptoms, prevent complications, and restore overall well-being.”

Bringing her expertise to the same, Dr Farah Ingale, Director-Internal Medicine at Hiranandani Hospital in Vashi, shared, “Tingling nerves and fatigue can be symptoms of various conditions, ranging from vitamin deficiencies to neurological disorders. Vitamin B12 is a critical component in forming and maintaining your myelin sheath. Being deficient in Vitamin B12 can cause damage to your myelin sheath, which will disrupt nerve signals to and from your brain. One of the common symptoms of myelin damage related to vitamin B12 deficiency is numbness and tingling in the hands and feet.”

She highlighted, “Fatigue is one of the first signs of low levels of Vitamin B12 in your body. This is because Vitamin B12 helps red blood cells to carry oxygen throughout your body. Apart from fatigue, other symptoms of B12 deficiency can include rapid breathing or shortness of breath, headaches, indigestion, loss of appetite, palpitations, problems with vision, diarrhea, a sore or red tongue, feeling weak, problems with memory, judgment and understanding (cognitive changes).”

Adding that chronic fatigue often accompanies neurologic disorders, Dr Farah Ingale said, “Changes in brain chemistry, especially in neurotransmitters like melatonin, serotonin, and hypocretin, all impact wakefulness and contribute to chronic tiredness. In specific neurologic conditions, fatigue may manifest differently; for example, people with Multiple sclerosis often experience fatigue caused by nerve damage that prevents them from transmitting electrical signals properly. With small fiber neuropathy, fatigue occurs partly because the blood supply isn’t keeping up with muscle demand.”

To treat vitamin B12 deficiency with diet changes, Dr Farah Ingale suggested one can consume food like clams, liver, fortified cereal, trout, salmon, eggs, etc. If non-diet related, below steps can be taken:

  • Vitamin B12 oral medication or
  • Injection of Hydroxycobalamin every 2-3 months
  • If neurological symptoms affect the nervous system due to vitamin B12 deficiency, injection of vitamin b12 as per hematologist every two months might be required.
  • If a person is unable to tolerate oral medication has persistent vomiting and is suffering from severe vitamin B12 deficiency, an injection or even a nasal spray or sublingual preparations can be administered.



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