Vitamin B12 deficiency can be attributed to a number of causes but the two most common are dietary-related and pernicious anaemia. The latter is an autoimmune disease that prevents the body from making intrinsic factor - a protein made by the stomach that is needed to absorb vitamin B12 in the intestine. The former is because B12 is found naturally in a wide variety of animal and dairy products.
Consequently, those adhering to strict vegan or vegetarian diets are at a disproportionately higher risk of B12 deficiency.
The causes may differ but the symptoms are often the same and a number involve the tongue.
According to the National Heart Lung and Blood Institute (NIH), a smooth, thick, red tongue is also a sign of vitamin B12 deficiency.
Case reports suggest tongue-related symptoms are a common characteristic of B12 deficiency.When to see a GP
According to the NHS, you should see a GP if you're experiencing symptoms of vitamin B12 deficiency.
These conditions can often be diagnosed based on your symptoms and the results of a blood test, the health body points out.
It is also imperative that you seek a medical opinion soon rather than later.
"Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated," the NHS warns.
How is B12 deficiency treated?
The treatment for vitamin B12 or folate deficiency anaemia depends on what's causing the condition.
Vitamin B12 deficiency anaemia is usually treated with injections of vitamin B12.
There are two types of vitamin B12 injections:HydroxocobalaminCyanocobalamin
"If your vitamin B12 deficiency is caused by a lack of the vitamin in your diet, you may be prescribed vitamin B12 tablets to take every day between meals," explains the NHS.
What foods contain B12?
Good sources of vitamin B12 include:MeatSalmon and codMilk and other dairy productsEggs
If you're a vegetarian or vegan, or are looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, however.
B12 alternatives include yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products, says the NHS.
It adds: "Check the nutrition labels while food shopping to see how much vitamin B12 different foods contain."