B12 Deficiency Joint Pain: Does Low B12 Cause Your Aches?

As we age, we become more and more aware of our joints. After all, painful joints can affect mobility, our fitness, and eventually, our independence. [8]

But could joint pain be affected by B12 deficiency?

In this article, we'll explore what B12 deficiency is and whether it affects joint pain.

Continue reading as we cover everything you need to know.

Key Takeaways

• B12 is found in many foods that originate from animal sources.
• A B12 deficiency isn’t extremely common. [10] But due to the animal sources of B12, vegans and strict vegetarians are a group at risk of deficiency. [9]
• Older adults are another group at risk due to age related absorption problems. [11]
• Joint pain is linked to inflammation, which can have many causes not directly related to a B12 deficiency. While low B12 may potentially contribute to joint pain indirectly, more studies are needed to confirm this link. [12, 13, 14]
• There are many benefits to maintaining healthy vitamin B12 levels, including supporting red blood cell production, energy metabolism, and cognitive function. [10]
• If you are following a plant based-diet, or pregnant, then (with the advice of your healthcare provider) taking vitamin B12 is a smart move. [9]
• The best B12 supplements on the market today are Performance Lab® NutriGenesis® Multivitamin, which provides 24 premium research-backed nutrients in 4 daily capsules. For targeted B-vitamin support, Performance Lab® B-Vitamin Complex is stacked with choline and inositol to supply clean B vitamins in food-identical form.

What is Vitamin B12 and How Does It Support Red Blood Cells?

Vitamin B12 (also known as Cobalamin) is an essential (and water soluble) vitamin that plays an indispensable role in cell metabolism.

You need vitamin B12 to maintain a healthy nervous system, and it helps your body to produce red blood cells. Vitamin B12 cannot be produced by the human body and must be obtained from your diet or a vitamin supplement. [10]

• You can find vitamin B12 in many foods, particularly meat, fish, and dairy products such as cheese or milk.

Animal products are the primary sources of vitamin B12. Often, breakfast cereals are fortified with vitamin B12 too. Nutritional yeast is also a popular fortified food for those on plant-based diets. [10] 

• Vitamin B12 is absorbed in the small intestine, specifically the ileum. [4]

It is also possible to supplement with vitamin B12. It’s commonly found in multivitamins and nootropics.

It’s found in our Performance Lab® NutriGenesis® Multi,Caffeine 2™ and our nootropic Mind Lab Pro® formula. 

Some people choose to have B12 injections, but be sure to obtain medical advice before going ahead with this method of consuming this vitamin.

How Common is Vitamin B12 Deficiency and When is a Blood Test Needed?

Most people are not deficient in vitamin B12, as it is abundant in many foods. However, certain groups are in danger of deficiency and are at higher risk.

The groups affected are elderly people and those following a strict vegetarian or vegan diet. [9, 11]

Inadequate dietary intake, especially in vegetarians and vegans, leads to a deficiency in vitamin B12.

The reason for this is probably quite apparent when you look at the most common sources of B12 in the diet: meat, fish, and dairy.

Vegans consume none of these foods. Their only sources of vitamin B12 come from foods that are fortified with it. [10]

• Breakfast cereals, certain vegan milk-alternatives (soya etc.), and some types of bread are the only way to increase vitamin B12 through diet.

A vegetarian or vegan diet can provide some B12 through foods like algae and fortified nutritional yeast. But how well our body absorbs B12 from algae still needs more research before we can make solid conclusions. [15, 16]

Without supplementation, vitamin B12 deficiency can cause numerous issues and is a genuine possibility for vegans. Symptoms of deficiency can occur gradually and can be overlooked until they become severe. [9]

The other group at risk of vitamin B12 deficiency are older adults. Often due to age-related conditions that affect the body’s ability to absorb vitamin B12. [11]

Their diet doesn’t lack vitamin B12; their body is just not as efficient at extracting it from the food during the digestion process.

Those with diseases like Crohn's disease and celiac disease are also at risk, because these conditions hinder the body's ability to absorb B12. [6]

If you belong to any of these groups and experience symptoms of B12 deficiency, you may need to consult your doctor about taking a blood test.

Pernicious Anemia

Pernicious anemia is one of the causes of vitamin B12 deficiency. [17] It is an auto-immune disease that affects the stomach and leads to poor absorption of vitamin B12. It is typically treated with vitamin B12 injections rather than standard oral supplements. [49]

If you are elderly and are noticing some of the symptoms described below, it is a good idea to see a doctor to find out if you have pernicious anaemia.

Read on as we look at these symptoms in more detail in the next section.

Symptoms of B12 Deficiency: Fatigue, Neurological Symptoms, and More

There are many signs and symptoms of B12 deficiency, though unless you know what you are looking for, it can be difficult to spot. Cobalamin deficiency encompasses a wide spectrum of symptoms, making it challenging to diagnose.

People with a vitamin B12 deficiency are often fatigued and have pale skin. [6]

• Muscle weakness is another symptom, which has a link with fatigue. [20] B12 deficiency can also affect cognition, with impaired memory and focus reported, and in severe cases, memory loss. [18]

Confusion is another possible neurological symptom. It can also affect your vision, while depression can be a symptom too. [19]

Low vitamin B12 levels are associated with cognitive decline. [50]

Additionally, vitamin B12 is crucial for neurological functioning and can impact cognitive function, especially in older adults with mild deficiencies. [21]

Tingling Sensations from Vitamin B12 Deficiency

One of the most well-known symptoms of B12 deficiency is paraesthesia, which sounds a lot more terrifying than it actually is! Paraesthesia is the scientific term for pins and needles. [22]

• If you’ve ever had a pre-workout with beta-alanine in it, you may have experienced this. It’s an unpleasant experience and can make your skin feel itchy and prickly.

The diversity and severity of neurological symptoms related to B12 deficiency can vary, affecting both the central and peripheral nervous systems. [20]

Symptoms occur differently for each person, and can include trouble walking or moving in general. [23]

Other symptoms of Vitamin B12 deficiency:

As mentioned earlier, vitamin B12 deficiency can cause a wide range of symptoms, including but not limited to:

• a sore/red tongue [25]
• blurry vision
• loss of memory
• depression
• folate deficiency, which is often related to vitamin B12 deficiency. [24]

As mentioned previously, our Performance Lab® NutriGenesis® Multi delivers more than 100% RDA (Recommended Daily Allowance) of this nutrient.

This is great for those that don’t have the time to always plan each meal of the day and want a clean multivitamin that they can take on the go.

Can Vitamin B12 Deficiency Cause Joint Pain?

Joint pain has many causes and is quite common in the elderly. As such, it is difficult to work out if a B12 deficiency and joint pain are because of correlation or causation.

• A blood test is essential to confirm vitamin B12 deficiency and highlight the importance of early detection and treatment.

A 2012 case study published in the New England Journal of Medicine describes a 62-year-old man who came into hospital with suspected pernicious anemia and was found to have low levels of vitamin B12. [1]

Among his symptoms joint pain was mentioned. This was a profoundly severe case of vitamin B12 deficiency, and many of his symptoms were extreme. He had ataxia, which affects balance and how you walk, which could well have led to joint pain. 

Severe vitamin B12 deficiency can lead to other symptoms such as numbness and walking difficulties. Pain and numbness can also affect the legs as well as other parts of the body. [26]

Measuring active vitamin B12 (holoTC) levels may offer better diagnostic accuracy than total serum B12 levels when screening for deficiency.

B12 Deficiency, Joint Pain, and Inflammation: What You Need to Know

Severe joint pain directly stemming from B12 deficiency is rare. Only in severe deficiency cases, neurological complications can indirectly contribute to joint discomfort. [27]

Can Low B12 Cause Joint Inflammation and Muscle Aches?

There's limited evidence linking low B12 to localized joint and muscle pain. [28] However, research does suggest that B12 deficiency may contribute to increased systemic inflammation. [29]

For example, a 2012 study published in Nutrients found that people with B12 deficiency can have elevated levels of inflammatory markers like TNF-α and resistin. These findings indicate that B12 may play a role in reducing inflammation and supporting metabolic health.

Still, the researchers didn't find a direct link between low B12 and joint-specific inflammation and muscle soreness.

What vitamin B12 deficiency can cause, however, is nerve dysfunction. In severe cases, this can lead to muscle weakness, cramps, and even muscle pain, due to nerve damage from long-term deficiency.

How Does B12 Affect Inflammation?

B12 helps to regulate homocysteine metabolism, which can affect inflammation pathways. [2, 30, 31] Homocysteine is an amino acid found in your blood — it plays an important role in various bodily functions.

In normal conditions, B12 helps to keep homocysteine levels in check. But in the case of B12 deficiency, homocysteine may rise beyond normal levels, causing irritation to the cardiovascular system and increasing inflammation. [2, 5, 30]

How Long Does It Take to Recover from Vitamin B12 Deficiency?

The general timeline for recovering from B12 deficiency ranges from weeks to months, depending on severity.

Proper treatment with supplements or injections may relieve symptoms within several weeks. [32]

However, in more complex situations, such as nerves being damaged by severe B12 deficiency, full recovery can sometimes take up to a year. [32]

What Vitamin Deficiencies Can Cause Joint Pain and Knee Pain?

Several vitamin deficiencies can contribute to joint and knee discomfort. [33, 34]

The most well-known is vitamin D deficiency, which can cause bone and joint pain, as well as a host of other symptoms. [35]

It's estimated that about 1 billion people are deficient or insufficient in vitamin D. [36]

Low vitamin D levels are a possible contributing factor to osteoarthritis symptoms, including pain and loss of joint function. [38]

Other nutrient deficiencies that could contribute to increased joint discomfort include vitamin C, which supports collagen production, and zinc, which modulates inflammation and the immune system. [33, 37, 39]

Homocysteine and Vitamin B12

The reason people believe that vitamin B12 deficiency may lead to joint pain is that there appears to be a relationship between low vitamin B12 levels and high levels of homocysteine. This is because healthy levels of B12 can lower homocysteine. [30, 31]

Studies have found that people who have arthritis (a cause of joint pain) tend to have high levels of homocysteine. [2]

The idea is that vitamin B12 deficiency can lead to increased homocysteine levels, which would then cause oxidative stress, inflammation, and then joint pain. [2, 5, 6, 30, 31]

However, there is no evidence that vitamin B12 deficiency directly causes joint pain—just the study mentioned above.

That does not mean that we can say for sure that vitamin B12 deficiency doesn’t cause joint pain, just that the evidence is not there yet.

Common Causes of Joint Pain

There are many different causes of joint pain, but before looking for a cure, it is essential to get an idea of how joint pain is caused.

Age is a common factor, but not a specific cause. Gout is a common cause of joint pain, which is caused by high levels of uric acid in the body. [40]

Injury from exercise or a fall is another common cause of joint pain. Falling over, over-use injuries, or getting injured by say, a tackle in football can lead to joint pain down the line.

Inflammation that comes from arthritis, or in rare cases; medical conditions such as cancer can also cause joint pain. [41, 42]

As you can imagine, many of these causes have nothing to do with vitamin B12, which is why supplementation is not always a cure for joint pain. Though often, supplements can be helpful. Particularly for injury/exercise-related joint pain and arthritis. [43]

Should You Supplement with Vitamin B12?

If you are suffering from joint pain, then vitamin B12 supplementation should not be your first port of call. Other supplement ingredients can help.

If you are elderly and have concerns about some of the symptoms of vitamin B12 deficiency, then you should see your doctor. Poor absorption of vitamin B12 in older adults can be due to digestive problems, such as malabsorption or gastrointestinal disorders. [11] If you do have pernicious anemia, then supplementation may not be the answer.

If you are vegan, then supplementing with vitamin B12 is a sensible move. You are not going to get enough vitamin B12 from your diet unless you plan on eating a lot of cereal!

The Broader Benefits of Keeping Healthy B12 Levels

There are many benefits to maintaining healthy vitamin B12 levels. [10] Or perhaps a better way to phrase that would be that there are many downsides to not maintaining healthy levels of vitamin B12, as deficiency can lead to a range of health problems, including neurological and blood disorders.

While high levels of homocysteine may not cause joint pain, they can cause an increased risk of cardiovascular disease, an increased risk of cognitive disorders such as Alzheimer’s disease, and an increased risk of fractures. [3, 5, 7]

Taking vitamin B12 while pregnant is often deemed a good idea, as it may lower the risk of acute lymphoblastic leukaemia in children, which is why vitamin B12 is usually found in supplements for pregnant women alongside folate (vitamin B9). [44]

Maternal vitamin B12 deficiency during pregnancy can lead to neural tube defects, impaired brain development, preterm birth, and low birth weight. Additionally, adequate maternal B12 is crucial for both mother and child, supporting maternal health and reducing the risk of neurological and metabolic complications. [45, 46]

Final Thoughts on Joint Pain and B12 Deficiency

If you follow a vegan diet, then you should seriously consider taking a vitamin B12 supplement. However, if you are taking vitamin B12 because you think it will cure your joint pain, then you may not experience the results you're hoping for.

There does not appear to be enough evidence that vitamin B12 supplementation can reduce joint pain.

Also, if you are not vegan and are generally healthy, you are less likely to be deficient in vitamin B12, as your diet likely provides enough.

A more likely reason for deficiency would be low absorption in the gut, probably because of pernicious anemia or another condition. If this is the case, then oral vitamin B12 supplementation may not be enough. Make sure to see a doctor instead.

If homocysteine turns out to cause inflammation and therefore joint pain, then vitamin B12 supplementation would be a consideration. As things stand, that does not seem to be the case.

If you're looking to manage joint pain, especially related to osteoarthritis, other supplements may be worth looking into.

• Supplements such as glucosamine are more effective at helping with osteoarthritis symptoms and have the scientific evidence to back them up. [47]

Read more about the benefits of glucosamine.

Glucosamine is a natural compound found in cartilage, the tissue that cushions joints. Some clinical trials have shown that glucosamine can slow the progression of osteoarthritis, reduce pain, and improve mobility. [48]

Bottom Line: If you are vegan, take vitamin B12. If you are pregnant, then (with your doctor’s blessing) take vitamin B12. If you are not deficient in vitamin B12, then supplementation is unlikely to directly affect joint pain.