Ask Dr. Etingin: B12 Deficiency Symptoms; Aerobic Exercise
Q. About two years ago, I became a vegan. My doctor said that, while a vegan diet is good in many ways, I should be aware of vitamin B12 deficiency symptoms. What are the signs that I might be low in B12?
A. Vitamin B12 is found in fish, meat, poultry, eggs, and dairy products—all foods you probably haven’t eaten for a while. Vitamin B12 is essential for healthy functioning of your brain, nervous system, and metabolism. Following a strict vegetarian or vegan diet is often done for health reasons, so it does seem unfair that one of the possible results is the onset of vitamin B12 deficiency symptoms. These may include fatigue and muscle weakness. You also may have more alarming symptoms, such as heart palpitations and shortness of breath. Another set of B12 deficiency symptoms involves nerve problems, such as numbness and tingling, especially in your hands and feet. It may even affect your ability to walk properly. Other symptoms may include changes in the way your tongue looks—it may become smoother, but swollen, and your skin may become paler or jaundiced. B12 deficiency symptoms may even affect your emotions and your thinking: People with low B12 levels often complain of memory problems and depressive symptoms. If left untreated, B12 deficiency can lead to serious brain and other neurological problems.
Without a blood test to confirm the problem, you probably won’t know that you have vitamin B12 deficiency. A doctor may recognize the possibility of B12 deficiency based on a physical exam and a review of your symptoms, and a simple blood test can reveal your actual B12 levels.
It’s a good idea to have your B12 levels checked when you have your annual blood work done. Very low levels may suggest you need monthly or bi-weekly B12 injections to restore and maintain healthy levels.
Q. I take a brisk walk every morning; is this really considered aerobic exercise? Do I need to do more?
A. The short answer is, “yes,” a brisk walk is excellent aerobic exercise. One way to make sure you’re keeping up a healthy pace is to take about 100 steps per minute. Brisk walking helps boost heart and lung function, and burns calories to help with weight control. If you can walk at a good pace for 30 to 40 minutes a day, you’ll be giving your cardiovascular system a nice workout and help keep your joints and leg muscles strong.
As to whether you should do more aerobic exercise, there is usually no harm in boosting your activity level if you are healthy enough to handle it. Swimming, bicycling, aerobics classes, dancing, and sports such as tennis all offer good aerobic workouts. Keep in mind that a well-rounded fitness routine includes more than just aerobic exercise. The other three “pillars” of fitness include strength training (with weights, exercise bands, or machines), stretching and flexibility exercises, and balance exercises, such as tai chi. Spending time each week working on these aspects of fitness will keep you strong and mobile for years to come.
–Orli R. Etingin, M.D., Editor-in-Chief
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