Category: Nutrition

vitamin B12 deficiency

Vitamin B12: Are you deficient?

Would you be surprised to learn that 92% of the U.S. population suffers from a vitamin or mineral deficiency? It sounds crazy, but it’s true. And vitamin B12 is one of the deficiencies most overlooked.

If you are over 50 and reading this, about 20% of you are deficient in vitamin B12 – but it’s not just older adults that are impacted. In general, there is a lack of knowledge of the warning signs of a deficiency and late detection…so folks of all ages may be overlooking a deficiency in this important vitamin.

Why should you care about B12?

For starters, the human body doesn’t make vitamin B12 – so all of us must get this nutrient from our diet. We also can’t store it up, thus we need to consume foods that contain it on a regular basis. Adults need around 2.4 micrograms (mcg) of vitamin B12 each day.

But what does B12 do for us? Plenty!

It is crucial for making DNA and red blood cells and carrying out other functions, such as helping to support the nervous system. And while the optimal situation is to get B12 from our diet, the reality is that many of us don’t eat enough of the correct foods to get the amount of this vitamin we need each day. The chart below shows some of the best food sources for vitamin B12, but if we don’t eat enough of these food categories regularly, a supplement may be needed.


Vitamin B12 deficiency


Am I at risk of not having enough vitamin B12?

To know for certain, you should ask your medical provider to run a test to see if you are indeed deficient in B12. In general, there are some individuals at a higher risk for a B12 deficiency.

  • Vegetarians, older adults, pregnant or breastfeeding women*
  • Individuals who have recently had weight loss stomach surgery
  • Sufferers of Crohn’s or celiac disease
  • Individuals with pernicious anemia
  • Individuals on prescribed heartburn medications, which impact vitamin absorption
  • Alcoholics or recovering alcoholics – alcoholism causes damage to the gastrointestinal lining, where the vitamin is absorbed and distributed

*If you fall under one of these categories, consider getting your levels checked for an early diagnosis.

Why vegetarians? Well, since animal proteins are one of the best sources of B12, vegetarians are automatically missing out on a regular source of B12. The reality is that non-meat eaters have to work harder than the general public to get enough food sources of B12 and avoid the need for a supplement.


What are the signs of a possible B12 deficiency?

There are many signs of a possible deficiency, but keep in mind that these signs could also signal other conditions. A check of your B12 levels, once some of these signs appear, is the best way to know if your symptoms are related to this deficiency or some other cause.

Be on the lookout for the following symptoms:

  • Tingling hands/feet or “pins and needles” sensation (People who are vitamin B-12 deficient may not produce enough myelin to coat their nerves. Without this coating, nerves can become damaged.)
  • Trouble walking due to numbness
  • Jaundice (yellowish, pale skin)
  • Fatigue or weakness due to not enough red blood cell production
  • Fast heart rate and shortness of breath (making up for reduced number of red blood cells
  • Mouth ulcers, swollen tongue, burning sensation in the mouth
  • Cognitive impairment, perhaps due to reduced oxygen getting to brain
  • Irritability
  • Nausea, vomiting, diarrhea (not enough oxygen reaching the gut)
  • Decreased appetite


How could B12 benefit me?

The benefits are many when your levels are low. If you are not deficient in B12, you may not experience these benefits .


Taking vitamin B12 during pregnancy has been proven to mitigate birth defects.


Supports healthy skin, hair, nails
Since low vitamin B12 levels can cause various dermatologic symptoms, adding B12 can improve those conditions. Hyperpigmentation, nail discoloration, hair changes, vitiligo (the loss of skin color in patches) and angular stomatitis (inflamed and cracked mouth corners) are all common with B12 deficiencies.


Better sleep/energy
Vitamin B12 assists in melatonin production, a hormone responsible for sleep regulation. It also aids in glucose metabolism, which can boost your energy levels.


Improvement to brain function/mood
One of the vitamins essential in the production of serotonin, the brain chemical responsible for mood regulation, is B12. Supplementing B12 may help in lessening the effects of depression, but I always recommend that you consult with a health practitioner to help you deal with depression symptoms.

Studies show that patients who have lower levels of B12 have an increased risk for brain volume loss, particularly as they age. Adding a B12 supplement can boost the production of neurotransmitters, which help our cognitive functioning and memory.


Aid to digestion
If you struggle with digestion issues, you’ve likely learned about the importance of “gut” bacteria. Vitamin B12 helps the production of necessary digestion enzymes, fostering healthy bacteria production needed to break down foods and support a healthy metabolism.


Other benefits
Many folks boosting their vitamin B12 levels – either through foods or supplements – have experienced other benefits. While there is still a lot of research around these benefits, it’s worth noting that if you are deficient, B12 may:

  • Support bone health and prevent osteoporosis
  • Assist in maintaining heart health
  • Reduce macular degeneration


So what are your best ways to get B12?

First, I always recommend getting your levels checked. If you are deficient, you can always increase your intake of foods high in B12. However, a serious vitamin B12 deficiency can be corrected two ways: weekly shots of B12 or a daily high-dose B12 supplement. A mild deficiency can be corrected with a standard multivitamin.


Final thoughts

If you fall into a high-risk category for a deficiency in vitamin B12 or any other vitamin (vitamin D is another one where folks are often deficient), talk to your health provider and get your levels checked. If you aren’t high risk but you are having some of the deficiency symptoms noted, you should also talk with your health provider. Deficiencies are so common…and often overlooked. A level check is easy – and could be a huge difference maker in your health! Call our office to schedule one and a vitamin consultation with me.

Dr. Sharman

how to eat a Mediterranean diet

How to Eat a Mediterranean Diet

The Mediterranean diet – you’ve likely heard of it but may not know why it’s popular, how it would benefit you or what to do to get started. The good news is that it’s not a fad diet – one that you try for a while and drop after reaching your goal (weight loss, cholesterol level reduction, etc.). What I love about it is that the Mediterranean diet is more of a lifestyle plan for eating and achieving wellness. Best of all, you can incorporate parts of it into your meals and still get some great benefits for your overall health and specific health conditions.

So let’s learn more about this lifestyle approach to eating.


The Diet Defined

how to eat a Mediterranean dietThe Mediterranean diet gets its name from the traditional cooking and eating style of the countries bordering the Mediterranean Sea – Greece, Turkey, Israel and Spain…to name just a few. The diet incorporates the basics of healthy eating with fruits, vegetables, fish and whole grains. Specifically, the tenants of Mediterranean diet include:

  • Eating primarily plant-based foods, including legumes and nuts
  • Replacing butter with extra-virgin olive oil
  • Flavoring foods with herbs and spices over salt
  • Only eating red meat a few times a month
  • Eating fish and poultry at least twice a week
  • Avoiding sugar-sweetened beverages, processed foods, refined grains and refined oils

As well, a part of this diet/lifestyle of eating includes enjoying meals with family and friends. I love this! Eating is pleasurable and it’s important to not eat in a hurry and grab things quickly. The emphasis on sharing meals helps us to focus on taking time to enjoy the food we eat. The diet also advocates drinking red wine in moderation and getting plenty of exercise. Many of the people in the countries from where this diet hails spend a lot of time walking each day rather than driving in a car.


Benefits of the Mediterranean Diet

As with most diets that focus on plant-based foods and steer clear of processed foods and unhealthy fats, you will likely lose weight. For those of us looking to trim back our weight, this eating lifestyle will help you do it while still enjoying many delicious foods.

Studies have shown that the traditional Mediterranean diet reduces the risk of heart disease – so anyone with a preexisting heart condition or the genetics to develop a heart condition should consider this diet. As well, it’s been shown to help reduce the level of oxidized low-density lipoprotein (LDL) cholesterol – what we often refer to as “bad” cholesterol – that can build up and eventually cause blocked arteries.

The Mediterranean diet is associated with a reduced risk of cardiovascular mortality, incidence of cancer and occurrence of Parkinson’s and Alzheimer’s diseases. It may even reduce breast cancer in women, due to the emphasis on extra-virgin olive oil and mixed nuts. The bottom line is that most scientific organizations encourage this eating lifestyle as a preventive for many major diseases and to improve overall health and wellness.

There’s just not much to NOT love about it!


Getting Started with the Diet

It’s really not complicated to get started once you learn a little about the foods to include and exclude from this eating lifestyle.

What to eat

  • Generous helpings for various fruits and vegetables
  • Nuts and seeds – go beyond peanuts; think about almonds, walnuts, Macadamia nuts, hazelnuts, cashews, sunflower seeds, pumpkin seeds
  • Legumes– seed or pod foods like beans, peas, lentils, chickpeas
  • Tubers – foods grown underground such as potatoes, sweet potatoes, turnips
  • Whole grains
  • All kinds of seafood and fish at least twice a week
  • Poultry
  • Dairy – Greek yogurt, cheese
  • Extra-virgin olive oil plus other healthy fats like avocados
  • Herbs and spices –  garlic, basil, mint, rosemary, sage, nutmeg, cinnamon, pepper

Stick with whole, single-ingredient foods.


What not to eat

In general, processed and multi-ingredient foods are to be avoided. To know what to avoid, you’ll likely want to get in the habit of reading labels more carefully. Specifically, steer clear of:

  • Table sugar
  • Anything with added sugar – ice cream, sodas, candy
  • Refined grains – non-whole grain breads, cereal, pasta
  • Anything containing trans fats, especially margarine
  • Refined oils – canola, vegetable, soybean
  • Processed meats – hot dogs, lunch meats
  • Highly processed foods – made in a factory or labeled “diet”


A Word About Beverages

how to eat a Mediterranean dietYes, red wine is a staple in the diet of these Mediterranean countries. However, it’s meant to be consumed in moderation. Studies have connected wine with a reduced risk of heart disease in some research studies. So how much should you drink?

A moderate amount of wine means no more than 5 ounces of wine daily for women (or men over age 65), and no more than 10 ounces daily for men under age 65. This is about one glass per day.

Water is actually the main beverage in the Mediterranean diet. Coffee and tea are OK (both are made from water) but avoid any sugar-sweetened beverages and fruit juices.



Sample diets abound online – so if you’re not ready to invest in a cookbook, start here with some ideas for crafting your own Mediterranean meal plan. Some websites have downloadable cookbooks with recipe and meal planning ideas.

There are tons of cookbooks available – one of the best rated ones I came across is The Complete Mediterranean Cookbook. It contains over 500 recipes that have been kitchen-tested. And if you want to read more about this eating lifestyle and others from around the world, I highly encourage you to check out a fun website called Oldways. You will learn a great deal and come to appreciate how cultural food traditions can impact our health and wellness.

Eating healthy doesn’t have to be a chore….it can still be a very positive experience with significant benefits to your wellness.  If you switch to this eating lifestyle, be sure to let me know about your experience!


Dr. Sharman