The hidden symptom of vitamin B deficiency you could be thinking is anxiety

The NHS has warned people about the often-overlooked symptoms of vitamin B deficiency, highlighting that signs may not be limited to fatigue or memory problems. In fact, what you think is anxiety could be a simple deficiency.

The medical experts say that vitamin B12 or B9 (commonly called folate) deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cannot function properly.

Red blood cells are responsible for transporting oxygen throughout the body, using a protein known as haemoglobin. Anaemia occurs when there's either a shortage of these vital cells or when the haemoglobin levels within them fall below normal - both of which can lead to reduced oxygen delivery to tissues and organs.

What are the symptoms of vitamin B12 or folate deficiency?

The signs and symptoms may "develop gradually, but can worsen if the condition goes untreated", says the NHS. One of these signs is heart palpitations and whilst commonly associated with stress and anxiety it could be a deficiency.

It notes that symptoms of vitamin B12 and folate deficiency anaemia include:

• rapid breathing or shortness of breath
• headaches
• indigestion
• loss of appetite
• palpitations
• problems with your vision
• feeling weak or tired (fatigue)
• diarrhoea
• a sore or red tongue, sometimes with mouth ulcers
• problems with memory, understanding and judgment (cognitive changes)

It adds: "Some of these symptoms can also happen in people who have a vitamin B12 or folate deficiency but have not developed anaemia.

"Vitamin B12 deficiency can also cause symptoms that affect your brain and nervous system (neurological symptoms)."

These symptoms include:

• numbness
• muscle weakness
• psychological problems, which can range from mild depression or anxiety, to confusion and dementia
• problems with balance and coordination
• pins and needles
• incontinence

Do I need to see a GP?

Yes, if you have any concerns, book an appointment as these conditions can often be diagnosed based on your symptoms and the results of a blood test.

The NHS stresses: "It's important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible. This is because although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible."

What causes this?

The NHS lists these as potential causes:

• pernicious anaemia - where your immune system attacks healthy cells in your stomach, preventing your body absorbing vitamin B12 from the food you eat; this is the most common cause of vitamin B12 deficiency in the UK
• a lack of these vitamins in your diet - this is uncommon, but can happen if you have a vegan diet and do not take vitamin B12 supplements or eat foods fortified with vitamin B12 , follow a restrictive diet or have a generally poor diet for a long time
• medicine - certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs

Vitamin B12 and folate deficiencies are significantly more common among older adults, with around 1 in 10 people over the age of 75 affected, and roughly 1 in 20 among those aged 65 to 74.

What foods have B12?

Vitamin B12 is found in:

• meat
• fish
• eggs
• dairy products
• specially fortified foods

Good sources of folate include:

• green vegetables such as broccoli, Brussels sprouts and peas