Hypochlorhydria is a natural result of ageing, but certain factors can increase the risk of this occurring in later life. Examples include chronic stress, stomach surgery, bacterial infection, and some medications. The NHS pointed out that a “pale, yellow tinge” to the skin is a warning sign of a vitamin B12 deficiency. Other symptoms of a vitamin B12 deficiency to look out for include:
- A sore and red tongue
- Mouth ulcers
- Pins and needles
- Disturbed vision
Megaloblastic anaemia is “a hallmark of vitamin B12 deficiency”, added the National Institutes of Health (NIH).
This presents its own symptoms too, said the NHS, such as:
- Extreme tiredness (fatigue)
- Lack of energy (lethargy)
- Breathlessness
- Feeling faint
- Headaches
- Pale skin
- Noticeable heartbeats (palpitations)
- Hearing sounds coming from inside the body, rather than from an outside source (tinnitus)
- Loss of appetite and weight loss
A vitamin B12 deficiency can be diagnosed following a targeted blood test.
This is usually in combination with a discussion of symptoms, as there is a limitation to only relying on the blood test.
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The NHS explained: “A particular drawback of testing vitamin B12 levels is that the current widely-used blood test only measures the total amount of vitamin B12 in your blood.
“This means it measures forms of vitamin B12 that are ‘active’ and can be used by your body, as well as the ‘inactive’ forms, which cannot.
“If a significant amount of the vitamin B12 in your blood is inactive, a blood test may show that you have normal B12 levels, even though your body cannot use much of it.”
Should signs of a vitamin B12 deficiency not be seen to, complications can develop.
Neurological damage can occur, which may lead to difficulty walking or speaking.
It can also lead to a loss of physical coordination, which can affect your whole body.
If neurological problems do develop, they may be irreversible, highlighting the importance of speaking to a GP.
Treatment typically involves vitamin B12 injections, which will either be:
- Hydroxocobalamin
- Cyanocobalamin
“Hydroxocobalamin is usually the recommended option as it stays in the body for longer,” said the NHS.
Injections are typically administered by a GP or nurse every other day, for two weeks, until symptoms improve.
After this initial period, you might need to have an injection every two to three months “for the rest of your life”.
If the deficiency was left long enough in the first place to cause numbness and tingling in the hands and feet, you’ll be referred to a haematologist.
To ensure treatments are effective, you might need to have further blood tests.