Yes—vitamin B12 deficiency can be easy to overlook, particularly in older adults, and untreated deficiency can cause anemia and potentially permanent nerve damage
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Warning signs to know
- Persistent tiredness or weakness — especially with pale skin or shortness of breath.
- Tingling or numbness — often in the hands or feet.
- Balance or walking problems — feeling unsteady or having difficulty coordinating your movements.
- Muscle weakness.
- A sore, red, or unusually smooth tongue or mouth ulcers.
- Memory, concentration, or thinking difficulties.
- Mood changes, such as irritability or depression.
- Vision problems in more advanced cases.
Importantly, you can have neurological symptoms without having obvious anemia, so don’t assume B12 is adequate just because a routine blood count is normal.
Who is more likely to become deficient?
Risk is higher with vegan diets without B12 supplementation, conditions affecting absorption, certain stomach or intestinal surgeries, and some medications (including long-term metformin and acid-suppressing medicines).
What to do
If you have several of these symptoms—particularly new numbness, balance problems, or unexplained weakness—ask a healthcare professional about testing rather than simply taking high-dose supplements. Blood tests can help establish whether B12 deficiency is actually present and identify the underlying cause.
Sudden weakness, numbness, trouble speaking, facial drooping, or difficulty walking is different: seek emergency care because these can be signs of a stroke.
If you want, I can also explain the best B12-rich foods, daily requirements after age 60, and when a B12 supplement is actually necessary.
