Most people have the experience of momentarily forgetting someone’s name, or a street address, or to have a word on the “tip of their tongue.” But when we know what we want to say, and the words aren’t there, or we experience confusion about simple things, it can be truly upsetting. Not being able to find the words you want to use is called “expressive aphasia,” or “anomic aphasia” and can happen after a person suffers a stroke. It can happen for other reasons too.
I experienced expressive aphasia and anomic aphasia when I was vitamin B12 deficient. I was diagnosed with Postural Orthostatic Tachycardia Syndrome, or POTS, in 2008. But this was not the full story.
My POTS symptoms came from being vitamin B12 deficient for, most likely, decades. I finally got a diagnosis of pernicious anemia in February of 2012. Pernicious anemia prevents absorption of vitamin B12. My memory problems, aphasia, and “foggy head” still come back when my vitamin B12 level drops. Before my pernicious anemia diagnosis, I often opened my mouth to speak, and was unable to find the words I wanted.
My memory issues were once so severe, I found myself standing outside of my apartment building looking at my keys, trying to remember what I was supposed to do with them, and trying to remember what they were called. It invoked a feeling of terror in me; I felt like I was losing my mind. It became commonplace for me to search for a word, and to have to substitute another word besides the one I wanted was not there. At the time, I was in my early 40s and wondered if I had early-onset Alzheimer’s Disease, or some other type of dementia. Of all of my myriad symptoms, “losing my mind” was one of the scariest. I feared there might be a grain of truth to what some doctors were telling me– doctors who diagnosed me with “somatoform disorder” (“it’s all in your head”), depression, anxiety, and “dysthymia.” The truth was that I had bone-deep fatigue, and other symptoms, the cause of which eluded doctor after doctor. However, there are psychological changes that can occur with vitamin B12 deficiency.
In their book, Could It Be B12?: An Epidemic of Misdiagnoses, authors Sally Pacholok, RN, and Jeffrey Stuart, DO, have an entire chapter devoted to troublesome symptoms that can mimic the symptoms of “normal” aging, including memory loss, forgetfulness, and signs of dementia.
According to Could It Be B12?: An Epidemic of Misdiagnoses, (pg 32) “between fifteen and forty percent of people over sixty have low serum B12 levels. This means that at least one in seven people over sixty—and possibly as many as four in ten—are at risk of suffering from nerve, brain, heart, and blood vessel damage caused by an often ‘silent’ deficiency.” The authors state there is a critical window of time in which low vitamin B12 needs to be treated, before permanent cognitive changes and damage result.
Some symptoms of low vitamin B12 which sometimes are attributed to old age include: leg pains; difficulty walking; falls; confusion; memory loss; and neuropathy. Pacholok and Stuart make a solid case that low levels of vitamin B12 lead to brain atrophy. They reference studies that show that low vitamin B12 levels precede Alzheimer onset, and so can be a factor in (contribute to) the development of Alzheimer’s Disease. They state, “In 2008, an article in the [periodical] Neurology reported that low B12 causes brain atrophy (shrinkage) and is linked to the cognitive impairment in the elderly.” Brain atrophy is associated with confirmed Alzheimer’s Disease, and so is vitamin B12 deficiency.
If you or your loved one have memory loss, depression, dementia symptoms, or any of these signs, consider that it may be an easily reversible case of vitamin B12 deficiency–easily reversible if caught in time, so do not delay in asking your doctor for a serum (blood) vitamin B12 level. Keep in mind, the US parameters for this lab have a “gray zone”, which is discussed in Could It Be B12?: An Epidemic of Misdiagnoses. Any reading below 400 pg/mL, if the patient is symptomatic, warrants follow up testing. The video by the same name covers this, as well as other important information about vitamin B12 deficiency. Vitamin B12 deficiency and pernicious anemia are far too often misdiagnosed.
Be Well & B12!