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You may not have given much thought to vitamin B12, but it turns out this nutrient is important to help keep our body's nerve and blood cells healthy. It can also aid in preventing megaloblastic anemia which can make you feel tired and weak. Vitamin B12 is produced by certain microorganisms and is found almost exclusively in animal-based products: fish, meat, dairy and eggs. Normally, it is readily absorbed in the terminal ileum (the last part of the small intestine and first part of the colon). However, it also must combine with intrinsic factor, a protein produced in the stomach. 

For ileostomates who have all of their entire colon removed and part of their terminal ileum removed, the main concern is whether or not vitamin B12 is being adequately absorbed. In urostomates, roughly 6-8 inches of terminal ileum is removed and used as a conduit for urine when a urostomy is created. If a continent urostomy has been formed, even more of the small intestine and terminal ileum are used which could result in a vitamin deficiency. The ileum is usually not involved in colostomy surgery, however colostomates should confirm with their doctor exactly what portion of their colon was removed.

Some aren’t consuming enough, while others may not absorb it effectively – both issues can contribute to a deficiency. Here are nine signs of deficiency that all ostomates should look out for.

1. Extreme Fatigue

You need B12 to make red blood cells, which help carry oxygen through your body. Not having enough B12 can lead to anemia, which means your body does not have enough red blood cells to do its job. If your cells aren’t getting enough oxygen, you'll likely suffer from tiredness and exhaustion.

2. Pins & Needles Sensation

A condition called paresthesia is the sensation of uncomfortable tingling or prickling, usually felt in the arms, legs, hands or feet. Experts warn experiencing pins and needles could be a sign of Vitamin B12 or Vitamin B9 deficiency.

3. Forgetfulness

If left untreated, B12 deficiency can lead to symptoms such as confusion and poor memory. The good news is that this nutrient is one of the easiest vitamins to supplement (when you don’t forget to take it) in the right form and dosages.

4. Altered Taste

The tiny red bumps on your tongue are known as papillae, or what we commonly call the "taste buds." The loss of papillae could be from a B12 deficiency, causing your tongue to become smooth and red which in turn affects the taste of food.

5. Moodiness & Irritability

Serotonin is an important mood-regulating neurotransmitter that plays a vital role in good mental health. Certain nutritional factors can impact your brain's ability to produce serotonin, including a lack of vitamin B12.

6. Vision Problems

Not enough B12 in the body can affect the optic nerve and also block the blood vessels in the retina. Blurred vision, extreme sensitivity to light, and spotting are common problems experienced by those with vitamin B12 deficiency.

7. Appetite Loss

You might not get your regular hunger pangs or hardly want to eat anything at all. Lack of hunger or finding food tasteless is an important sign of vitamin B12 deficiency. 

8. Ears Ringing

Tinnitus is a condition where a person hears a ringing, buzzing or whistling sound in the ears. It’s believed that tinnitus is a result of a deficiency in the body and the use of vitamin B12 may be able to get to this root cause and eliminate it.

9. Mouth Ulcers

Mouth ulcers (also known as canker sores) are painful sores that appear in the mouth, often on the inside of the cheeks. It has been noted in several studies that canker sores are either caused (or triggered further) when there is a deficiency of B12 in the body.

FACT: Did you know there's a two-step process required for the body to absorb vitamin B12 from food?

The National Institutes of Health says that first, hydrochloric acid in the stomach separates B12 from the protein found in food. After this, vitamin B12 combines with a protein made by the stomach (intrinsic factor) which is needed in order for B12 to be absorbed in the large intestine.

Unfortunately, signs of a vitamin deficiency can take years to show up, and diagnosing it can be complex. If any of the symptoms above sound familiar, ask your doctor to run a blood test to check your B12 levels.

This article was made possible by a sponsorship from The Parthenon Company.

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