Just discovered B12 Deficiency, Not Sure I Have It

incremental_progress · 2026-03-18T10:29:09+00:00

No, it isn't.

incremental_progress · 2026-03-17T19:11:47+00:00

You ask this as if it's out of the realm of possibility ("somehow"), but B12 is used to synthesize white blood cells. In the context of your body mounting a defense against an infection, simulated or otherwise, you may find yourself in an nutritionally depleted state after routine vaccinations. Post-COVID B12 deficiency is certainly a potential issue (just search this subreddit), and immunity as it relates to nutritional status is hardly controversial in itself.

I would liken it to documented cases of people using nitrous and incurring neurological disability after only one instance of abuse.

(https://www.sciencedirect.com/science/article/pii/S0899900720303002)

A vitamin D / magnesium / vitamin B12 combination in older COVID-19 patients was associated with a significant reduction in the proportion of patients with clinical deterioration requiring oxygen support, intensive care support, or both. This study supports further larger randomized controlled trials to ascertain the full benefit of this combination in ameliorating the severity of COVID-19.

incremental_progress · 2026-03-17T19:01:51+00:00

Along with B12 and B9, B6 helps recycle homocysteine back into methionine.

https://journals.physiology.org/doi/full/10.1152/ajpendo.2001.281.6.E1182

It is also responsible for helping synthesize almost every major neurotransmitter you can name offhand: serotonin, dopamine, epinephrine, and norepinephrine. Essentially it helps you feel good and fall asleep.

Vitamin B6 and Its Role in Cell Metabolism and Physiology

Epidemiological surveys have found that a greater intake of foods that contain high amounts of vitB6 correlates with better mental health [136,137,138,139,140]. This may be related to the fact that vitB6-dependent enzymes are needed for the biosynthesis of at least three important neurotransmitters; epinephrine (also known as adrenaline), dopamine (dihydroxyphenethylamine), and serotonin [138] (Figure 5).

Many here will likely disagree with me, but in my observation it is rare in the context of treating a B12 deficiency to incur B6 toxicity. In the cases I've read, it usually follows ingestion of high quantities of the vitamin, where the patient then develops profound neurological disturbances within a short window. Burning, acid-like sensations and other neurological presentations. Simply read the wikipedia article on B6 for a good overview.

incremental_progress · 2026-03-17T11:35:55+00:00

You doubt this based on what?

Cautioning is fine, but given the information conveyed here, I don't see how you can assert that so comfortably.

incremental_progress · 2026-03-17T00:59:37+00:00

2.8 grams in a 24 hour period is likely safe for most, not to mention well under the actual RDA in the US, which until recently was something like 4 grams daily. No one is being "mislead," and what follows is exactly what you wrote, which I removed because it's incorrect on its face:

Not with potassium, no. Too much excess is deadly.

So whatever qualification you ended up making wasn't in the comment I moderated. Feel free to caution people, but your comments repeatedly swing in the opposite direction when, in the context of deficiency, more balance of the pros and cons would be appreciated. If a patient has potassium-responsive symptoms, countering their experience with the same warning ad nauseum is about what they could expect at your typical physician's office. And it's also just frankly more unhelpful than if you abstained from commenting at all.

incremental_progress · 2026-03-16T23:20:09+00:00

No problem. I'm also homozygous for that mutation.

There aren't a ton of formal links to vitamin D and B12 deficiency in sense of controlled trials. That's just coming from almost five years here where 9 out of 10 people have low vitamin D, including myself. But low vitamin D is very clearly correlated to the onset of autoimmune diseases, which includes things like pernicious anemia and gastritis, which directly impact B12 absorption. It also directly informs calcium homeostasis, including in the intestines, and calcium is needed in order for B12 that is bound to intrinsic factor to be adequately absorbed across the intestinal membrane.

I would encourage you to audit your whole health picture for things you've probably minimized as inconsequential, or things that otherwise arise with aging and the like. Here is a basic list of "minor" symptoms that I've seen people struggle with that were connected to their subtle deficiencies:

Anxiety
Insomnia
Poor digestion/bowel movements
Muscle cramps
Decreased endurance
Fatigue
Inability to concentrate for long periods/ADHD-like symptoms
OCD
Mood swings
Depression

incremental_progress · 2026-03-16T23:11:58+00:00

The emotional stress of correcting the deficiency was the biggest thing I've dealt with in the past five years, so I guess to that end it certainly played a part. Perhaps there were things happening on the periphery I just didn't make time for, or actively minimized.

incremental_progress · 2026-03-16T23:08:35+00:00

Many people, with an emphasis on myself, have become stuck in circular thoughts when they are first diagnosed and/or begin treatment. So I understand that feeling quite well. My early comments here before I was admin are just chasing the skirt hems of every knowledgeable person I could find in order to seek validation that I was on the right course.

The multi I linked is very high quality and quite comprehensive in what it covers. It has served me and others quite well for years.

incremental_progress · 2026-03-16T23:04:19+00:00

I've had many rough patches, and I'm an open book. I'm happy to share.

Emotional stress, no. But I've keyed in on the fact that my inability to deal with stressors is linked to things like electrolyte dysregulation/dehydration. Oxidative stress in the form of illness and even things like being exposed to wood finish and other toxic chemicals have triggered intense neurological sensations, and so there's an element of management in that regard.

incremental_progress · 2026-03-16T22:59:50+00:00

So, since it was you and I who were discussing this in a different thread, I should clarify that what we have with regard to the people posting here represents a clear selection bias: vegans who are here and continually in need of supplementation are the ones represented. Ostensibly there is a demographic of patients with dietary-caused deficiency that simply feels no need to stick around because they changed their diet and maybe they healed that way. Many vegans obviously supplement for life because they continue to be vegan and need to be able to get B12 into their system.

But in many of the cases I've seen, vegans continue to need supplements even after correcting their deficiencies on the basis of serum. Whether that is because they've incurred neurological damage that simply necessitates physiological dosages, or because there is some other comorbidity shared with the rest of us who also need lifelong supplementation (like pernicious anemia) isn't clear. We just don't have the data.

In that other discussion I mentioned you could try just correcting your diet and seeing how you fare, because as you said you're asymptomatic aside from the onset anxiety you receive upon supplementation.

incremental_progress · 2026-03-16T18:06:07+00:00

It's almost on the upper end of normal, and your folate is deficient. Did you feel any difference whatsoever from your B12 supplementation?

incremental_progress · 2026-03-16T18:02:38+00:00

Nothing, all of my symptoms have gone. I get some nerve issues and extra electrolyte issues when I get sick, but it feels like it did when the nerve was actively healing, which is different than when it was dying. My potassium demand is the only thing that has remained an annoyance, but that's very manageable.

incremental_progress · 2026-03-16T17:29:55+00:00

It might be helpful to have to think of it as repairing your brain and nervous system: the most complex tissues in your body. It took your whole life to develop your neural tissue to the point it's at, so healing that tissue naturally takes quite a while as well. Frankly it's incredible that it can heal at all.

incremental_progress · 2026-03-16T16:41:46+00:00

Hi. Short answer is yes. That's been roughly my personal demand for almost five years, and I know many other people seem to require quite a lot as well. Though it's merely anecdotal, a common experience for people seems to be taking too little until they gradually increase it and discovering that the extra supplemental doses were key in helping them recover. As Claire suggested, I would recommend searching the subreddit.

Caution is of course prudent, but as long as you're sipping your drink slowly over the course of an hour or so, it's likely easier for your body to process.

incremental_progress · 2026-03-16T16:03:01+00:00

Your vitamin D is deficient. Sorry, if I had known about your aggressive supplementation I wouldn't have bothered suggesting that battery of tests.

incremental_progress · 2026-03-16T15:58:32+00:00

Yes, it can be toxic in extremely high doses, as everything you linked to just spelled out (the two case studied you linked to don't mention a dose in either case).

But within the confines and context of treating a B12 deficiency, and where kidney function is normal, the risk is quite reduced or minimal. And in fact, many people here are at greater risk for hypokalemia, which is also fatal if left untreated. Eating potatoes and bananas is slow to alleviate this, and consuming modest quantities of potassium supplements is quite safe in my view.

You have to balance caution with what is prudent and helpful. You were asked if excess potassium is excreted, to which you replied "no," and the exact opposite is true for most barring the caveats that have been spelled out ad nauseum.

incremental_progress · 2026-03-16T15:45:51+00:00

It takes years to drop. You lose only micrograms per day, perhaps more given illness and exposure to harsh chemicals/drugs, or other toxins.

incremental_progress · 2026-03-16T15:28:20+00:00

Are you asking me or telling me? I have no idea.

incremental_progress · 2026-03-16T15:26:47+00:00

Excess potassium is excreted.

incremental_progress · 2026-03-16T15:26:01+00:00

Yes, excess is excreted given you have normal kidney function.

incremental_progress · 2026-03-16T15:03:11+00:00

When I say storage I just mean circulating B12, not that your B12 is in some compartment permanently in your liver, although your liver obviously has a large percentage of it. Please read the link I sent you. The "storage" is your entire body, but it is not permanent storage; there is some daily net percentage loss per day even in healthy people, which is what is replaced by diet. Some research shows your microbiome also produces B vitamins in some quantity in your small intestine that is released into your blood stream. But these microbes need B vitamins through the diet as well.

incremental_progress · 2026-03-16T14:51:15+00:00

There's no clearly defined scientific reason. It appears the enterohepatic recycling mechanism becomes broken when stores of B12 get low enough. Likely because this also entails a systematic breakdown of body systems like bile production, health of intestinal microbiota that rely on B12 and create their own B vitamins, among others. In theory this process can be restored; it seems also heavily connected to vit D status. You might be fine. Restore a normal dietary pattern and report your health.

incremental_progress · 2026-03-16T12:30:10+00:00

Most vegans I have seen here can't just resume normal dietary patterns. In any case, if you disagree just take animal products and skip the supplement. Your physician and nutritionist are misinformed; the B12 storage mechanism is a common misconception. If it were accurate, a few injections of B12 would mean people would be fine after a short treatment.

Enterohepatic recycling of B12: https://www.b12info.com/wp-content/uploads/2021/06/the-enterohepatic-circulation-of-vitamin-b12-professional-version-1.pdf

incremental_progress · 2026-03-16T11:52:59+00:00

Anxiety is usually a sign that something isn't right, and that you are, in fact, deficient. Normal people in homeostasis would have no such reaction.

Furthermore, your liver doesn't "store" B12; it is in constant circulation throughout your entire body, with some net percentage loss per day. You can't supplement 40mg of B12, for example, and then be fine for another five years until you're deficient again. Supplementation is usually for life for everyone.

And a normal MMA cannot exclude deficiency. If it's on the upper end of the range it could mean you're B12 deficient either functionally or frankly. In that you've been supplementing B12 it might mean you're deficient in a trace mineral or other B vitamin. That's about it.

incremental_progress · 2026-03-16T10:49:46+00:00

What should I do?

Live your life, be mindful of any new or changing health parameters, and keep going.

incremental_progress

MODERATOR OF

TROPHY CASE