Nutrient deficiencies
Vitamin B12 Deficiency Symptoms in Women: Signs, Causes and When to See a Doctor
Quick answer
Common symptoms of vitamin B12 deficiency are tiredness, weakness, pale skin, breathlessness, pins and needles in the hands or feet, a sore red tongue, mouth ulcers, memory problems and low mood. Vegetarian and vegan diets are a common cause in India. A blood test can confirm it, and early treatment helps prevent nerve damage.
Last reviewed NariCareLife editorial team · 5 sources
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What is Vitamin B12 deficiency?
Vitamin B12 helps the body make healthy red blood cells and keeps the nervous system working well. When levels are low, the body makes fewer, larger red blood cells, which can lead to anaemia, and nerves can be affected too.
B12 is found naturally almost only in animal foods such as milk, curd, eggs, fish and meat. Many women in India follow vegetarian diets, and those who eat little dairy, or follow a vegan diet, are more likely to run low.
Symptoms usually develop slowly, sometimes over years, because the body stores B12. Some women have tiredness and anaemia, some have nerve symptoms such as tingling, and some have both. Nerve symptoms can occur even without anaemia.
Common symptoms of Vitamin B12 deficiency
Tiredness and weakness
Feeling tired, weak or low in energy, often the first sign people notice.
Pale or slightly yellow skin
Anaemia and the breakdown of fragile red blood cells can change skin colour.
Breathlessness and palpitations
Getting out of breath easily or noticing a fast heartbeat, especially with activity.
Pins and needles
Tingling, numbness or a burning feeling in the hands, feet or legs.
Sore, red tongue
The tongue may look smooth, red and swollen, and feel sore.
Mouth ulcers
Repeated mouth ulcers can occur with low B12.
Memory and concentration problems
Forgetfulness, confusion or difficulty thinking clearly.
Low mood and irritability
Changes in mood, including depression or irritability.
Balance and walking problems
Feeling unsteady on your feet or having trouble with coordination.
Vision changes
Blurred or disturbed vision is a less common sign that needs prompt attention.
What can cause Vitamin B12 deficiency?
- Vegetarian or vegan diets with little dairy or no fortified foods, since B12 comes mainly from animal foods.
- Pernicious anaemia, an autoimmune condition in which the stomach cannot absorb B12 properly.
- Stomach or bowel surgery, or conditions such as Crohn’s disease or coeliac disease that affect absorption.
- Long-term use of some medicines, such as metformin for diabetes or acid-reducing tablets.
- Older age, when the stomach may absorb B12 less well.
- Pregnancy and breastfeeding on a low-B12 diet, which can also affect the baby’s B12 levels.
How is Vitamin B12 deficiency diagnosed?
A doctor usually checks for vitamin B12 deficiency with a complete blood count, which can show anaemia and larger than normal red blood cells, and a blood test for B12 levels. Folate is often checked at the same time because the two deficiencies look similar. If needed, your doctor may order further tests, such as intrinsic factor antibodies to look for pernicious anaemia, and ask about your diet, medicines and digestive health.
When to see a doctor
See a doctor if you have ongoing tiredness, pins and needles, a sore tongue, mouth ulcers or memory problems, especially if you follow a vegetarian or vegan diet, take metformin or acid-reducing medicine, or are pregnant or breastfeeding. It is important to get diagnosed early, because nerve problems from low B12 may become permanent if left untreated. Your doctor will advise the right treatment and how often to recheck your levels.
Get medical help promptly if you notice:
- Numbness, weakness or tingling that is spreading or getting worse.
- Difficulty walking, frequent falls or loss of balance.
- Confusion, memory loss or sudden changes in behaviour.
- Changes in vision.
- Chest pain, severe breathlessness or fainting.
In an emergency, call 112 or go to the nearest hospital.
How nutrition and lifestyle may help
Food does not cure or treat Vitamin B12 deficiency, but everyday habits can support your overall wellbeing alongside the care your doctor recommends.
Include dairy every day
For vegetarians, milk, curd, buttermilk and paneer are the main natural sources of B12 and can be spread across the day.
Add eggs, fish or chicken if you eat them
Eggs, fish and meat are good natural sources of B12 and may help support your levels.
Check labels for fortified foods
Some breakfast cereals, plant-based milks and other packaged foods are fortified with B12. Read labels to find them.
Plan carefully if you are vegan
Vegan diets need a reliable B12 source. Discuss fortified foods and supplements with your doctor or dietitian.
Ask about checks if you take metformin
If you take metformin or acid-reducing tablets long term, ask your doctor whether your B12 should be checked.
Discuss supplements with your doctor
The right form and amount of B12 depends on the cause, so let your doctor guide any supplements or injections.
Indian foods to include
- Milk
- Curd (dahi)
- Buttermilk (chaas) and lassi
- Paneer
- Cheese
- Eggs
- Fish such as rohu, bangda and pomfret
- Chicken and mutton
- B12-fortified breakfast cereals or plant milks
Key takeaways
- Low B12 can cause both anaemia and nerve symptoms such as pins and needles.
- Vegetarian and vegan diets are a common cause in India, as B12 comes mainly from animal foods.
- A blood test can check your B12 and blood count.
- Dairy, eggs and fortified foods may help support B12 intake.
- Early diagnosis matters, as nerve damage may become permanent if untreated.
Vitamin B12 deficiency: frequently asked questions
The first sign of vitamin B12 deficiency is often tiredness or weakness, sometimes with pale skin or breathlessness. Some people first notice pins and needles in the hands or feet, a sore red tongue or mouth ulcers. Symptoms build slowly, so a blood test is the best way to check if low B12 is the cause.
Yes, vegetarians are at higher risk of B12 deficiency because B12 is found naturally almost only in animal foods. Lacto-vegetarians can get some B12 from milk, curd and paneer, but may still run low if they eat little dairy. Vegans need fortified foods or supplements, which is best discussed with a doctor.
Yes, vitamin B12 deficiency can cause numbness, tingling or a pins and needles feeling in the hands, feet and legs because B12 is needed for healthy nerves. These nerve symptoms can happen even when blood counts are normal. See a doctor promptly, as early treatment helps prevent lasting nerve damage.
Yes, low vitamin B12 can affect the brain and nerves, leading to memory problems, confusion, low mood or irritability. These symptoms have many possible causes, so a doctor should look at the full picture. If low B12 is found, treating it may help, particularly when it is diagnosed early.
The main Indian vegetarian sources of vitamin B12 are dairy foods such as milk, curd, buttermilk, lassi, paneer and cheese. Eggs are a good source for eggetarians. Pulses, vegetables, fruits and grains do not naturally provide reliable B12, so fortified foods may be useful. Ask your doctor whether you need a supplement.
Yes, long-term use of metformin, a common diabetes and PCOS medicine, can lower vitamin B12 levels in some people. This does not mean you should stop it. Ask your doctor whether your B12 should be checked from time to time, especially if you notice tiredness, tingling or numbness.
Sources & references
- Vitamin B12 or folate deficiency anaemia — NHS
- Vitamin B12 deficiency anemia — MedlinePlus, U.S. National Library of Medicine
- Vitamin B12 — MedlinePlus, U.S. National Library of Medicine
- Vitamin B12–Deficiency Anemia — National Heart, Lung, and Blood Institute (NHLBI)
- B vitamins and folic acid — NHS
