Vitamin B12: foods, deficiency symptoms and who needs tablets
Vitamin B12 comes only from animal foods: kaleji, meat, fish, eggs, milk and dahi. Adults need about 2.4 micrograms a day. Deficiency causes tiredness, tingling in the hands and feet, a sore tongue and anaemia. Vegetarians, older adults and people on metformin or acid-reducing medicines are most at risk.
Vitamin B12 in common foods
| Food | Portion | B12 (micrograms, approx.) |
|---|---|---|
| Kaleji (liver), cooked | 100 g | 20 to 70 |
| Beef or mutton, cooked | 100 g | 2 to 3 |
| Fish (rohu, surmai, tinned tuna) | 100 g | 2 to 9 |
| Chicken, cooked | 100 g | 0.3 to 0.5 |
| Egg | 1 whole | 0.5 |
| Milk | 1 glass (250 ml) | 1.1 to 1.3 |
| Dahi | 1 katori | 0.8 to 1.0 |
| Paneer or cheese | 50 g | 0.4 to 0.8 |
| Daal, sabzi, fruit, roti | Any amount | 0 (plants have none) |
Kaleji once a week covers a lot of B12, but it is very high in vitamin A, so pregnant women should avoid it.
A day that covers B12 without meat
- 1 glass of milk with nashta (1.2 mcg)
- 1 egg (0.5 mcg)
- 1 katori of dahi or raita with lunch (0.9 mcg)
- A small piece of paneer or a glass of lassi in the evening (0.5 mcg)
That is roughly 3 mcg, above the daily need. Strict vegetarians who avoid dairy and eggs cannot reach it from food and need a supplement.
Metformin, omeprazole and B12
Long-term metformin for diabetes lowers B12 absorption in a noticeable number of people, and long-term acid-reducing medicines do the same by lowering stomach acid. If you have taken either for years, ask your doctor whether your B12 should be checked, especially if you feel tingling or unusual tiredness. See also the diabetic diet chart.
See a doctor first if
- You have tingling, numbness or weakness in the hands or feet
- You have a sore, smooth or burning tongue
- You are a strict vegetarian, or had stomach or weight-loss surgery
- You have taken metformin or omeprazole for years
- You are pregnant or breastfeeding and eat little animal food
Common questions
Which foods contain vitamin B12?
Only animal foods: liver (kaleji), meat, fish, eggs, milk, dahi and cheese. Plants contain no reliable B12, so vegetarians depend on dairy and eggs, and strict vegetarians need a supplement.
How much vitamin B12 do adults need?
About 2.4 micrograms a day, slightly more in pregnancy (2.6) and breastfeeding (2.8). A glass of milk, a katori of dahi and an egg together already cover most of it.
What are the symptoms of B12 deficiency?
Tiredness and weakness, tingling or numbness in the hands and feet, a sore or smooth tongue, mouth ulcers, poor memory or low mood, and anaemia on a blood test. Nerve symptoms can become permanent if deficiency is left untreated, so do not ignore tingling.
Who is at risk of B12 deficiency in Pakistan?
Strict vegetarians, people who eat very little meat or dairy, older adults, people on metformin or long-term acid-reducing medicines (omeprazole and similar), people after stomach or weight-loss surgery, and those with pernicious anaemia or gut disease.
Should I take B12 tablets or injections?
That is for your doctor to decide after a blood test. Mild deficiency is often treated with tablets; injections are used for poor absorption, pernicious anaemia or nerve symptoms. Do not start injections on your own.
Can B12 give me energy or help weight loss?
Only if you are actually deficient. In people with normal levels, extra B12 does not add energy and does not help weight loss, whatever the injection is marketed as.
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Sources
- NIH Office of Dietary Supplements. Vitamin B12: fact sheet for health professionals
- Devalia V et al. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. British Society for Haematology. Br J Haematol, 2014
- Aroda VR et al. Long-term metformin use and vitamin B12 deficiency (DPPOS). J Clin Endocrinol Metab, 2016
- USDA FoodData Central (B12 content of foods)