Vitamin B12 deficiency: Night-time twitching in toes could be warning that levels are low

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 carries out a number of biological processes, from the maintenance of the nervous system to the production of red blood cells. It becomes increasingly harder to absorb as we age, however, because levels of stomach acids become depleted. This can prevent absorption of B12 in the liver, which may cause symptoms to appear progressively.

When twitching occurs in the toes, it may reflect an underlying health condition or temporary interruptions in the circulatory system, muscles and joints.

The National Institutes of Health cites muscle spasms as a symptom of low B12 levels, alongside tingling, soreness, weakness and numbness.

While many complain of spasms in their toes, low levels can cause twitching in muscles throughout the body.

The B12 Deficiency website explains: “Even if you only suffer from a handful of symptoms […], particularly neurological symptoms, it is advisable to get yourself tested and educate yourself about this deficiency.

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“While B12 deficiency may not always be the culprit (these signs and symptoms can stem from other causes) it is essential that your doctor rules this condition out due to the potential for misdiagnosis.”

Twitching and spasms are common manifestations of low B12 levels, as are cramping and tingling.

These symptoms occur because vitamin B12 plays a critical role in the nervous system.

Its absence can cause people to develop nerve conduction problems, which causes involuntary muscular contractions.

Psychology Today states: “The occasional twitching at night is nothing to worry about, but chronic muscle spasms may point to different health conditions.

“At the very least, experiencing twitching indoor sleep can cause an increase in nighttime wakefulness and a decline in sleep quality.”

The longer a deficiency is left unmanaged, however, the more damage nerves become subject to.

Medical intervention at this stage is imperative, as nerve damage can eventually lead to peripheral neuropathy.

This is because B12 is needed for the production of the myelin sheath around the nerve endings, which protects them.

According to the peripheral neuropathy centre: “Without this protection, nerves cease to function properly and conditions such as peripheral neuropathy occur.

“Even B12 deficiency that is relatively mild may affect the nervous system and the proper functioning of the brain.”

Where to find vitamin B12Levels of B12 can in most cases be increased by making the right dietary additions.

Sources include red meat, poultry and eggs, dairy products, and fish, but it is also available as an injection or supplement.

Oral therapy of B12, injections and supplements are usually reserved for patients with a confirmed deficiency or older patients who are unable to absorb the nutrient naturally.

Other risk factors for the condition include gastric surgery, which can disrupt the production of intrinsic factors, which the body needs to take up B12.

When vitamin B12 is absorbed into the liver, levels can sustain the body for years, so symptoms tend to develop in a gradual manner.

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