Vitamin B Deficiency, Symptoms, and Testing

B vitamin deficiencies can affect your overall health and well-being. B vitamins are essential for many bodily processes, including the metabolism of proteins and fats, energy production, cell division, and the formation of red blood cells. The body needs B vitamins to make hormones and enzymes that help regulate everything from digestion to immunity. A lack of B vitamins in your system can result in many symptoms such as fatigue, depression, poor concentration, hair loss, skin problems, numbness or tingling, constipation, and joint pain. Symptoms relate to the B vitamin(s) you are deficient in.

B vitamin deficiency can result in fatigue, headaches, depression as well as many other symptoms

B vitamin deficiencies can be caused by several factors, including poor diet and absorption problems. Certain medical conditions, such as Crohn’s disease or celiac disease, can lead to malabsorption which affects the body’s ability to absorb B vitamins. Alcoholism is another cause of B vitamin deficiency since alcohol consumption interferes with how your body absorbs and utilizes B vitamins. Additionally, certain medications, such as antacids or antibiotics, can interfere with the body’s ability to absorb essential B vitamins.

Proper eating habits and balanced diets are key for preventing any nutrient-related deficiencies from occurring. Not getting enough B vitamins in your diet can also contribute to a deficiency. Some individuals have methylation issues which can contribute to B vitamin deficiency and when requiring supplementation, may need methylated forms of B supplements.

Since B vitamins are mainly found in animal products such as meat, fish, and dairy products, those on vegetarian or vegan diets may not be able to get enough B vitamins and are at higher risk of developing a deficiency. A lack of exposure to sunlight can also lead to B vitamin deficiencies, as some B vitamins such as Vitamin D are synthesized in the skin when exposed to UV radiation.

For those with chronic joint pain, it’s important to note that not all B vitamin deficiencies cause joint pain. However, studies have shown that Vitamin B3 (niacin), Vitamin B5 (pantothenic acid), and Vitamin B6 (pyridoxine) may help reduce joint pain associated with arthritis.1 Vitamin B3 helps to reduce inflammation and also assists with energy production, while Vitamin B5 helps promote healthy cartilage growth in the joints. Lastly, Vitamin B6 may improve nerve function and can help relieve stiff muscles in the legs and feet. B vitamins have also been used in combination with medication to reduce the negative side effects.2–4

If you suspect that you’re deficient in any of these vitamins, it’s important to talk to your healthcare provider so they can perform a blood test to determine if there is indeed a deficiency present. Functional lab tests are essential for detecting vitamin B deficiencies. The commonly used tests to assess a person’s vitamin B levels include urine organic acids test, red blood cell folate, and homocysteine levels.

The urine organic acid test is used to see how well the body metabolizes certain nutrients. It measures the level of metabolites in the urine that usually indicate either too much or too little of vitamins like B1, B3, B6, and B12. This test can identify if there is an imbalance between these vitamins, which could be indicative of deficiency.

Red blood cell folate and homocysteine levels are two other common tests used to check for vitamin B deficiencies. These tests measure the amount of folate and homocysteine present in the red blood cells and can help diagnose deficiencies. Low levels of folate and high levels of homocysteine indicate a vitamin B deficiency, as folate helps to break down homocysteine.

A methylmalonic acid (MMA) test measures the amount of MMA in your blood or urine. MMA is made in small amounts during metabolism as your body processes food into energy. Vitamin B12 is needed for metabolism, and when there is not enough, more MMA is made, so high MMA levels can be a sign of a vitamin B12 deficiency. Vitamin B12 deficiency can result in health issues, including lower red blood cell counts, also called anemia.

If you do have a vitamin deficiency, there are several ways to address it: eating a balanced diet rich in fruits, vegetables, whole grains, and lean protein; increasing your intake of food sources high in B vitamins such as leafy greens, legumes, and nuts; or taking a multivitamin supplement.

Regardless of the method you choose to address any vitamin deficiencies, it’s essential that you consult with your healthcare provider before embarking on any form of supplementation. Overall, functional lab tests are essential for detecting vitamin B deficiencies accurately. With these tests, healthcare professionals can assess an individual’s levels of certain vitamins and determine if they have a deficiency, allowing them to tailor treatments accordingly. Knowing which tests to use is key, so it’s important to speak with your healthcare provider before making any decisions about testing or supplementation. By monitoring your levels of B vitamins and ensuring they are at healthy levels, you can help reduce joint pain and improve overall health.


1.          Jonas WB, Rapoza CP, Blair WF. The effect of niacinamide on osteoarthritis: A pilot study. Inflammation Research. 1996;45(7). doi:10.1007/BF02252945

2.          Shea B, Swinden M v., Ghogomu ET, et al. Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Journal of Rheumatology. 2014;41(6). doi:10.3899/jrheum.130738

3.          Golovacheva VA, Golovacheva AA. B vitamins and nonsteroidal anti-inflammatory drugs: The efficacy of the combination for nonspecific back pain. Sovremennaya Revmatologiya. 2020;12(5). doi:10.14412/2074-2711-2020-5-117-122

4.          Juturu V, Kremer J. Dietary Approaches and Alternative Therapies for Rheumatoid Arthritis. Curr Nutr Food Sci. 2010;6(4). doi:10.2174/157340110793663662

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    […] is important to recognize if you have symptoms of B vitamin deficiencies. By adding niacin to your diet or supplement regimen you can potentially reduce the symptoms […]

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