(Chronic) fatigue due to vitamin D or B12 deficiency

It’s just you, always tired. GPs often don’t know what to do with it and then quite easily say “just learn to live with it”. But sometimes the cause of the fatigue can be solved quite simply. This could simply be a low vitamin B12 status, which is estimated to occur in 10% of the Dutch population. Chronic fatigue can unfortunately have many different causes. And everyone experiences such fatigue differently. Some people can no longer do anything and lie in bed all day. Other people may even be able to work a few more hours. But it is certainly worthwhile to look further and look for the causes. Because some causes are demonstrable and also fairly easy to solve.

Possible causes of fatigue

A distinction can be made, among others:

  • Vitamin D3 deficiency
  • Vitamin B12 deficiency
  • Other deficiencies or causes

General practitioners in the Netherlands use a different, too high lower limit for both these vitamins when assessing the blood test. That is why these vitamins are often missed as the cause of (chronic) fatigue. The most common cause of a vitamin B12 deficiency is impaired absorption. This can occur, among other things, when taking antacids, because sufficient stomach acid is very important to absorb vitamin B12 from food.
A vitamin D deficiency often occurs in combination with thyroid and vitamin B12 deficiency. Thyroid disorders and iron deficiency anemia are causes of fatigue that are more likely to be diagnosed by the GP.

Vitamin D deficiency

Vitamin D is actually not a vitamin but a hormone. Vitamin D includes a group of five fat-soluble prehormones (hormone precursors), of which vitamin D2 and vitamin D3 are the most important. Vitamin B2 is involved in wound healing, because it fights inflammation and prevents sunburn. As we get older, less vitamin D is produced by the body. Vitamin D3 plays a role in bone and tooth development, among other things. This vitamin is also important for the white blood cells, which coordinate the defense against viruses and it also repairs certain cells in the body. Vitamin D3 absorbs the calcium present in the intestine from food. Vitamin D is produced in the body by the liver and then by the kidneys to produce the bioactive form calcitriol.

How much vitamin D does the body need per day?

Depending on his or her age or weight, an adult needs between 4,000 IU and 6,500 IU of vitamin D per day. You can get it by eating products containing vitamin D or by exposure to the sun. But with food you get at most 300 IU of vitamin D per day and unfortunately in the Netherlands we usually have more dark days than sunny ones. As a result, a shortage can sometimes increase considerably, especially in the winter months. Sunscreen with an SPF value of 15 or higher also prevents 99% of the absorption of vitamin D3 through the skin.

Symptoms of a vitamin D deficiency

And now it happens that a vitamin D deficiency causes, among other things, the following complaints:

  • frequent colds and flu
  • weak muscles and muscle cramps
  • chronic fatigue
  • bleeding gums
  • anxiety attacks
  • listlessness
  • disturbed sleep, waking up often and early (sleep insomnia)
  • hyperventilation
  • palpitations

These are all complaints that people with chronic fatigue often suffer from.

Unfortunately, many GPs have the idea that only older people can have a vitamin D deficiency and many GPs do not want to test for a vitamin D deficiency in the blood. In addition, many general practitioners also use a vitamin D value that is too low as a lower limit. They usually assume a value of 50 nmol/l, while a lower value of 80 nmol/l would be a much better lower limit. So if you have had blood tests done for the vitamin D value, always ask for the value, so that you can check for yourself how low or high this value is and whether it falls within the correct reference value.

GPs also often prescribe calci-chew if they detect a vitamin D deficiency. But this medicine is not intended for that at all. Colecalciferol in drink form is much better, especially for low vitamin D values (around 25 nmol/l). Fortunately, it is also possible to do something about your vitamin D deficiency yourself by buying vitamin D3 drops in the store. These drops are the best because oil has already been added to this product, so that vitamin D is better absorbed into the body. Vitamin D is a fat-soluble vitamin. Vitamin D is better absorbed if the body has sufficient magnesium.

Vitamin B12 deficiency

Vitamin B12 is a vitamin that is important, among other things, for blood production, for normal cell division, for the proper functioning of the entire (intestinal) metabolism and for the entire nervous system. And very important – for the proper functioning of the brain, because vitamin B12 and B11 are very important for good detoxification. In addition, both of these vitamins are necessary for proper cell function and cell division. For concentration, clarity, intelligence and zest for life. Because vitamin B12 is also essential for oxygen transport throughout the body and the brain. (1*). Vitamin B12 is also involved in the conversion of food energy into bioenergy. With a vitamin B12 deficiency, homocysteine, which is controlled by B12 and B11, can also build up. A homocysteine value above 9.5 is considered too high.

Symptoms of a vitamin B12 deficiency

  • (Severe) fatigue
  • Memory problems
  • Cramps, tingling in the feet and hands
  • Headache
  • Ataxia, coordination problems
  • Dizziness
  • Joint pain and muscle pain. The complaints are partly similar to those of Fibromyalgia
  • Having a strange feeling in your feet: the feeling of walking on cotton wool
  • Numbness in extremities
  • Weakening in legs, trunk or other part of the body (even the voice)

Please note , in addition to the above complaints, there are many more possible complaints!
Many GPs also underestimate a vitamin B12 deficiency as a possible cause of fatigue. Because GPs often do not use the correct reference values for vitamin B12 either. Values below 250 to 300 nmol/l can already be suspicious due to a possible vitamin B12 deficiency. However, GPs tend to use a lower limit of 100 nmol/l.

A correct determination of vitamin B12 in the blood and supplementation of the deficiency

The value of B12 in the blood cannot be measured correctly, also because there is only a fraction of active B12 in the blood. A better indicator of vitamin B12 deficiency is an elevated level of homocysteine. A low normal value (below 300 nmol/L) in combination with complaints consistent with a vitamin B12 deficiency should certainly be further investigated. A value above the lower reference value may still indicate a deficiency and in case of clear complaints, further testing for MMA (methylmalonic acid) and homocysteine should be performed.

A B12 deficiency can be supplemented by injections of B12 or sometimes by taking lozenges. Make sure that you buy the right form of B12 lozenges. Cyanocobalamin is the cheapest form of B12, but it often works less well. Adenosylcobalamin or methylcobalamin are better absorbable forms of B12 for the body, because they no longer need to be converted in the body. This plays a role in, among other things, too much nitric oxide stress.

Other deficiencies or causes of CFS

Of course, in addition to a deficiency of vitamin B12 or vitamin D, there are unfortunately many more causes of fatigue. Also consider adrenal fatigue, improperly functioning intestines or other organs such as the thyroid gland.

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