Vitamin B Deficiency Symptoms You Shouldn’t Ignore

All sorts of nutrients contribute to your energy levels, but one group holds a special claim to fame for increasing your oomph: B vitamins. From B1 to B12, these water-soluble micronutrients act as coenzymes in energy metabolism, which is why they’re often linked to sustained energy.

B vitamins are also involved in processes related to mood, brain function, and hormone regulation. It’s not great news, then, that research shows many adults—especially women, vegetarians, and those under chronic stress—are deficient in key Bs like B6, B12, and folate.

Ahead, experts share the most common vitamin B deficiency symptoms, plus the easiest ways to restore balance.

• ABOUT OUR EXPERTS: Jenna Volpe, R.D.N., L.D., C.L.T., is a registered dietitian with Whole-istic Living. Jennifer Bianchini, M.S., R.D.N., I.F.N.C.P., is a registered dietitian and the founder of Body to Soul Health.

The Most Common vitamin B deficiency symptoms

“There are eight primary types of B vitamins, which are chemically diverse and thus have unique and distinct roles in the body,” says functional registered dietitian Jenna Volpe, R.D.N., L.D., C.L.T., of Whole-istic Living. For this reason, signs and symptoms of low B vitamins will vary, depending on the type of B vitamin deficiency and the underlying cause.

Read More: The 6 Most Common Nutrient Deficiencies

That said, all B vitamins are involved in energy metabolism to a certain extent—so fatigue is a common indicator of a deficiency.

In addition, neurological symptoms like mood swings and brain fog can get in the mix. Volpe specifically points to irritability, depression, and/or restlessness as indicative of various types of B vitamin deficiencies.

Why Certain Groups Are More at Risk

As with most nutrient deficiencies, people in certain demographics are more susceptible to getting low on B vitamins. Women of childbearing age are one hefty chunk of the population that’s often affected. “Women are at risk for low B vitamin levels because they have increased physiological needs throughout the reproductive cycle, especially during pregnancy and lactation,” says Jennifer Bianchini, M.S., R.D.N., I.F.N.C.P., founder of Body to Soul Health. “During their reproductive years, hormonal fluctuations throughout the menstrual cycle increase the need for certain B vitamins.”

Vegetarians (especially vegans) are another group at high risk. “B12 is naturally found almost exclusively in animal-based foods,” Bianchini explains. “Vegetarians who consume dairy and eggs (lacto-ovo vegetarians) have a lower risk than vegans but may still fall short without fortified foods or supplements.”

People with digestive conditions, a history of gastric surgery, or those on certain medications may have absorption problems that impact B vitamin uptake, Bianchini notes. And if you’re in your later years, your levels may start to dip. “As we age, the stomach produces less intrinsic factor—a protein required for B12 absorption—and less stomach acid, both of which impair B12 absorption,” she says.

Don’t forget the effects of lifestyle, either. According to Bianchini, chronic stress can deplete several B vitamins, especially B5 (pantothenic acid) and B6, which are used in energy metabolism and adrenal hormone production. (Just one more unwelcome gift from stress.)

Read More: 5 Ways Stress Can Impact Your Health

How to Restore Balance With Food

Both Bianchini and Volpe say that a varied eating pattern rich in fruit, vegetables, whole grains, legumes, healthy fats, and high-quality proteins is a food-first way to restore B vitamin levels.

A few examples of foods to focus on include:

• Oatmeal. “Oatmeal provides thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), and pantothenic acid (vitamin B5),” says Volpe. Try some with a sprinkle of pumpkin seeds, which are a good source of niacin, folate, and vitamin B6.
• Nutritional yeast. Bianchini says people on a plant-based diet can include nutritional yeast not only for its cheesy flavor, but for its added vitamin B12 content. However, Volpe notes that this form of B12 is synthetic and may not be absorbed as efficiently as forms found in animal products.
• Leafy greens and legumes. Need to bring up folate levels? Turn to beans and greens. They’re an excellent food source of this B vitamin.
• Milk and meat. These animal foods are naturally abundant in vitamin B2, also known as riboflavin. For an even greater B boost, try liver. “Beef and chicken liver are very nutrient-dense foods, naturally containing a significant amount of almost all types of B vitamins,” Volpe says. She suggests making them into a pâté or blending them into meatloaf to make them more palatable. 
• Peanuts and peanut butter. In a PBJ, nutty parfait, or trail mix, peanuts and their butter are a great way to raise your niacin, vitamin B6, and folate intake.

When to Consider a Supplement

Cultivating a varied diet is always a smart move, but in some cases, dietary changes alone may not resolve a B vitamin deficiency. Bianchini says certain health conditions and long-term stressors can make supplementation necessary. 

The only way to know where your levels fall is to undergo a blood test. “If you’re experiencing symptoms like fatigue, brain fog, mood swings, tingling hands or feet, or poor digestion, it may be time to check your B vitamin levels and supplement,” Bianchini says. Once you’ve got the go-ahead from your healthcare team, look for a product that’s third-party tested by an organization like NSF, USP, or ConsumerLabs.

Read More: How To Tell If That Supplement You Bought Online Is Fake

You can also ask your doctor about whether an activated form of vitamin B is right for you. “An ‘activated’ B vitamin refers to its methylated or coenzyme form—the form that is most readily absorbed and used by the body,” explains Bianchini. “This includes methylcobalamin (B12), methylfolate (B9), and pyridoxal-5-phosphate (P5P, the active form of B6).” These forms might be particularly useful for the quarter or so of the population with a genetic variation called the MTHFR gene. People with a MTHFR gene variant may have a reduced ability to metabolize certain forms of B vitamins, and may benefit from methylated forms—but should speak with a healthcare provider first,” Volpe says.

Just note that, even though vitamin B is water-soluble—meaning any excess amounts will get flushed out through your urine—side effects are still possible. Stick to your healthcare provider’s guidance for dosing to help ensure safety and effectiveness.