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Vitamin B12 deficiency: The warning sign when you wake up in the morning

Vitamin B12 performs a number of important functions in the body such as keeping the body’s nerve and blood cells healthy and helping to make DNA. Despite its essential role, some people are unable to absorb the vitamin due to an underlying condition called pernicious anaemia. This is an autoimmune disease that prevents the body from making intrinsic factor (a protein made by the stomach and needed to absorb vitamin B12 in the intestine).


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Pernicious anaemia is the leading cause of B12 deficiency in the UK.

B12 deficiency caused by pernicious anaemia can cause a number of disconcerting symptoms.

According to the Pernicious Anaemia Society (PAS), an international charity, one early warning sign is extreme fatigue.

This symptom is characterised by an overbearing tiredness that never really goes away, explains PAS.

One way to spot it is in the morning.

According to PAS, waking up tired after a good night’s sleep is often experienced.

Other early symptoms include:

  • Shortness of Breath
  • Extreme Fatigue
  • An overbearing tiredness that never really goes away. Waking up tired after a good night’s sleep is often experienced.
  • Brain Fogs
  • Clumsiness/Lack of coordination
  • Brittle, flaky nails & Dry Skin

How is pernicious anaemia identified?

According to the NHS, tests for pernicious anaemia are not always conclusive but your GP will run blood tests to identify the condition.

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How is it treated?

Vitamin B12 deficiency anaemia is usually treated with injections of vitamin B12.

There are two types of vitamin B12 injections:

  • Hydroxocobalamin
  • Cyanocobalamin

“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.

According to the health body, people who find it difficult to get enough vitamin B12 in their diets, such as those following a vegan diet, may need vitamin B12 tablets for life.

Why do vegan or vegetarians struggle to get enough B12 in their diet?

B12 is naturally found in animal and dairy products.


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Good sources of vitamin B12 include:

  • Meat
  • Salmon and cod
  • Milk and other dairy products
  • Eggs

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.

As the NHS points out, B12 can be found in yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products.

“Check the nutrition labels while food shopping to see how much vitamin B12 different foods contain,” the health body advises.

What happens once my treatment begins?

To ensure your treatment is working, you may need to have further blood tests, explains the NHS.

“A blood test is often carried out around 10 to 14 days after starting treatment to assess whether treatment is working,” says the health site.

Another blood test may also be carried out after approximately eight weeks to confirm your treatment has been successful.

“If your GP feels it’s necessary, you may have to return for an annual blood test to see whether your condition has returned,” adds the NHS.

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  • Posted on May 5, 2020