6 symptoms of Vitamin B12 deficiency

We know about B12, but how much do we need to pursue it?

How do you know if you are suffering from vitamin B deficiency?

  1. Brain Fog

  2. Fatigue

  3. Thinning hair

  4. Low blood count or anaemia

  5. Reduced fertility

  6. Chronic pain

My blood tests are normal...
Normal is not normal.  Anything below 300ng/ml is low.  

Not deficient does not mean you do not need more, due to metabolic conditions that may mean you require a higher than normal maintainence dose.  This requires a thorough history and clinical exam, with an integrative medicine trained practitioner.

The ultimate blood test for B12

Methylmalonic acid (MMA) is produced in small amounts in the body, where it is converted into succinyl Coenzyme A. When there is not enough vitamin B12, there would be a relatively higher concentration of MMA in blood and urine.

This test is more expensive and I usually reserve this for those who are not responding to regular supplementation, or have high serum B12 levels in the presence of low B12 symptoms.  



Am I at risk of vitamin B deficiency?

  • Vegetarians and vegans are susceptible to it as vitamin B12 is mostly derived from animal products.

  • Regular consumption of alcohol depletes serum B12 levels

  • Previous gastric bypass, and reduced ability to absorb B12 from the gut

  • Autoimmune diseases like Crohn's or celiac prevents body from absorbing B12 effectively

  • Metformin which is used in the management of Diabetes, intereferes with B12 absorption and diabetics will benefit from B12 supplementation

  • Older adults, as ability to absorb B12 decreases with age


What treatments are available for me?

If your vitamin B deficiency is due to a low b12 diet, simply include foods with a high content of vitamin B12, such as meats, fish, dairy products and egg.

If you are vegetarian or adopt a vegan diet, yeast extract and soy products serve as alternatives to meat and dairy products. 

When you want to supplement, I find sublingual, sprays and liquid forms of Bs give the best outcomes.

Always ensure you target both folate and B12 at the same time as it is no good to be high in one and low in the other.  


Occasionally, you may need injections to replenish the low levels of vitamin B12 in your body.

While injecting vitamin B12 into your body is generally safe and is proven to be effective, as long as practiced by a doctor who is aware and able to help you avoid unwanted long term effects.  

As we all lead different lifestyles and have different eating habits, each of us have different dosage needs, hence it is best to seek a doctor on how to deal with vitamin B12 deficiency.

Which form of B12?

In essence,

  • AdenosylB12 is great for mitochondria and nerve cells

  • MethylB12 for DNA synthesis and methylation

  • HydroxyB12 is absorbed well

  • CyanocoB12 is the cheapest most available form, but absorption is the poorest compared to all of the above.

Each individual may have a different issue, so it's best to consult a trained integrative doctor to help you choose the best form for you.

Book now for a consult!


6 key nutrients for Chronic Fatigue

In this fast-paced world that we live in, we need all the energy that we can get in order to perform our tasks to the best of our ability.  Some of us may feel tired on certain days, due to the lack of sleep from over-working, or adapting to major changes in lifestyles.

However, if you have been feeling extremely tired for an extended period of time, you may be suffering from chronic fatigue.

What is chronic fatigue?

Chronic fatigue syndrome (CFS) is a condition of prolonged and severe tiredness or weariness. People with CFS find it difficult to carry out daily tasks at home or at work, and it occurs most often in people aged 30-50 years old, more often in women than in men, and sometimes in children and adolescents.


Other than feeling fatigued, people with CFS also experience headaches, sore throat, body aches and tender lymph nodes.

CFS is a mitochondrial disease

One of the established causes of chronic fatigue syndrome is due to a mitochondrial dysfunction in the body.

Mitochondria are little powerhouses found in the cells of our body, and their purpose is to convert nutrients into energy. They supply energy in the form of adenosine triphosphate (ATP), which is used as an energy currency in all bodily activities.

When there is a reduced supply of ATP as a result of mitochondrial dysfunction, cells will not have sufficient energy to perform optimally, resulting in slower bodily activities which we describe as “fatigue”.

Optimising mitochondrial function with nutrients, can do heaps in improving symptoms of CFS.


Magnesium is an important mineral that your mitochondria needs in order to perform optimally. In order to produce new mitochondria, it depends on enzymes that require magnesium as a cofactor. These same enzymes also play a part in the repair of mitochondria, in which it can be damaged due to oxidative stress during intense physical exercises. Without an adequate level of magnesium, your mitochondrial count may be low, and the rate of repair may be slow as well, leading to less energy being produced for your cells to function.



Coenzyme Q10, or CoQ10 for short, is crucial for keeping mitochondria healthy. It is the primary antioxidant that the human cell provides to protect mitochondria when they are producing energy. When there is a lack of CoQ10, the level of ATP that the mitochondria produce decreases. Certain exposures to chemicals like pesticides or environmental toxins causes an increased need or depletion of CoQ10, causing mitochondrial dysfunction. As we age, our body loses the ability to make important molecules such as CoQ10, hence it is best replenished by supplements.

Acetyl L-Carnitine

Acetyl L-carnitine is a natural derivative of L-carnitine, an amino acid found in red meat and dairy products and in all cells of the human body. L-Carnitine facilitates the transport of fatty acids into mitochondria, which they then convert it into energy.  Acetyl L-carnitine molecules function as a delivery system across cell membranes for their two principal components: L-carnitine molecules and acetyl groups; the latter are vital for chemical reactions involved in numerous cellular metabolic processes. Since it facilitates energy metabolism and acts as an antioxidant, it helps to feed and preserve our mitochondria, reducing the risk of mitochondria dysfunction.


D-ribose is a type of sugar that serves to produce cellular energy. It is involved in the production of ATP and muscle recovery, both of which are impaired in chronic fatigue syndrome. As D-ribose provides the necessary substrate for the production of ATP, it supports the synthesis of it, increasing energy levels in the cells, curbing fatigue due to low ATP levels. Furthermore, it is effective as it is readily absorbed by the body, and it is free from side effects as well.

Vitamin B3

Vitamin B3, or nicotinamide adenine dinucleotide (NAD), is a vital intermediary in energy production. Without sufficient NAD, energy production is slowed and every single cell in the body will go slow. Consuming more protein-rich foods help to supply the amount of vitamin B3 needed for optimum energy production.

Vitamin B12 injections

Another cause of chronic fatigue syndrome is the overproduction of nitric oxide and its oxidant product peroxynitrite, which are released in response to stress. Nitric oxide has a detrimental effect on brain function and pain sensitivity, resulting in muscle weakness, fatigue, and emotional changes. Vitamin B12 helps by removing the levels of nitric oxide in our bodies, reducing the effects of the symptoms in our body. If you have a low level of vitamin B12 in your body, seeking B12 injections can help to alleviate the problem that come with B12 deficiency.

With any intervention, you will need blood testing, and an experienced doctor to read your results accurately.

Book a consult to discuss your energy needs today.