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Is Vitamin B12 Deficiency Misdiagnosed As Bipolar Disorder?

Updated on November 14, 2017
Vitamin B12 could be used to treat bipolar disorder.
Vitamin B12 could be used to treat bipolar disorder.

Vitamin B12 is an essential nutrient the human body needs. An estimated three million people have a vitamin B12 deficiency. In severe cases, many individuals with B12 deficiency experience both neurological and psychological symptoms that can resemble bipolar disorder. Many studies have found a connection with vitamin B12 deficiency and the diagnosis of bipolar disorder. However, the question remains whether low B12 is being misdiagnosed as bipolar disorder.

What are the Benefits of Vitamin B12?

B12 is water-soluble vitamin with a daily recommendation of 2.4 micrograms for adults under 50 years of age. Adults over the age of 50 are advised to reach the daily recommendation of 2.4 micrograms through fortified foods and B12 vitamin supplements. While B vitamins are often thought of as the energy and mood lifting vitamins, the purpose of B12 is actually more complex. Getting an adequate amount of daily vitamin B12 is essential for:

Heart Health

Vitamin B12 functions in the bloodstream to remove the dangerous buildup of the protein called homocysteine. Without an adequate amount of B12, inflammation of the arteries can occur, with the potential for future heart disease. B12 has the ability to keep homocysteine levels low, aiding to overall heart health.

Neurological Repair

Nerves throughout the human body have a covering of myelin sheaths to protect from toxins and free radicals. If B12 is low, the nerve coverings can become damaged and even die, ultimately disrupting nerve signals to the brain. Vitamin B12 repairs the nerve coverings to prevent against nerve-related conditions.

DNA Replication

Overtime, DNA cells do not replicate correctly due to age. Such facts as blood toxins, free radicals, high blood sugar and consuming foods high in omega-6 begin to slow down cellular replication. By receiving the recommended daily amount of B12, DNA cells begin to repair and replicate properly resulting in new cell growth.

Brain Health

Researchers found patients with Alzheimer's disease have lower levels of vitamin B12. To prevent memory loss, B12 repairs damaged nerve cells in the brain lacking the protective myelin sheaths covering.

Bone Health

Researchers have found a connection between osteoporosis and vitamin B12. Osteoporosis patients exhibit high levels of the protein homocysteine with low levels of vitamin B12. Adequate levels of B12 can help maintain strong bones reducing the risk of osteoporosis.

Who Develops B12 Deficiency?

Considered a very common vitamin deficiency, many people are unable to absorb enough B12 or do not consume enough B12 through their diet. Certain individuals are at risk for developing a B12 deficiency. Since B12 is not found in plants, vegetarians and vegans are at risk for developing a deficiency. Other individuals at risk also include:

  • Individuals who've had weight-loss surgery
  • Celiac disease (gluten-free diet)
  • Crohn's disease
  • Individuals prescribed heartburn medication

Individuals who are vegetarian, vegan and gluten-free are at risk of developing vitamin B12  deficiency.
Individuals who are vegetarian, vegan and gluten-free are at risk of developing vitamin B12 deficiency.

What are the Symptoms of B12 Deficiency?

When examining vitamin B12 deficiency it's important to look at both the neurological and psychiatric symptoms an individual may experience.

Neurological symptoms of B12 include:

  • Numbness or tingling in the hands, feet or legs
  • Balance issues (staggering or troubles walking)
  • Anemia
  • Swollen tongue
  • Jaundice
  • Weakness
  • Fatigue

Psychological symptoms caused by B12 Deficiency:

  • Mood changes
  • Irritability
  • Confusion
  • Depression
  • Poor Concentration
  • Sleep issues
  • Disorientation
  • Memory issues
  • Apathy or lack of interest
  • Hallucinations (rare)
  • Paranoia (rare)

While the symptoms of hallucinations and paranoia can occur, these symptoms are rare. Both hallucinations and paranoia are only found in extreme cases of individuals where B12 vitamin levels are severely low. All the above psychological symptoms often present themselves at the onset of a B12 deficiency. Many people actually exhibit psychological symptoms before developing neurological symptoms like anemia.

What is Bipolar Disorder?

Now that we fully understand the causes and symptoms of a B12 vitamin deficiency, let's look at the psychological disorder known as bipolar. Also known as bipolar depression and manic depression, the disorder is characterized by mood swings of depression and mania episodes lasting weeks to months. Bipolar disorder is considered a chronic, lifelong condition. Although the cause of bipolar disorder is still unknown, researchers believe brain structure and chemistry, environment and genetics are all factors attributed to the disorder.

Within the realm of bipolar disorder there are different types and features: Type I, Type II, cyclothymic, mixed features and rapid-cycling. Bipolar I and II are distinguished by the severity of mood episodes between mania and depression. Compared with type I and II, cyclothymic disorder is recognized by short periods of hypomanic and depression symptoms. Both mixed features and rapid-cycling bipolar exhibit unique hypomanic and depressive episodes. While individuals with mixed features experience hypomanic and depression symptoms simultaneously, rapid-cycling is recognized by four or more mood episodes within a year.

What are the Symptoms of Bipolar Disorder?

To identify bipolar disorder in an individual, the frequency, length and symptoms of mood episodes are examined. Each of the different types of bipolar exists an array of symptoms for both mania episodes and depressive episodes.

Mania Symptoms:

  • Racing thoughts
  • Feelings of euphoria
  • Increased energy
  • Talking fast
  • Risk taking
  • Decreased need for sleep
  • Intense sensations of touch and smell
  • Feeling irritable or distracted

Depression Symptoms:

  • Lack of interest
  • Lack of energy
  • Appetite changes
  • Troubles concentrating or recalling information
  • Troubles making decisions
  • Sleep changes (too much or no sleep at all)
  • Thoughts of death
  • Thoughts of suicide

Thoughts of death or suicide happen during depressive episodes of bipolar.
Thoughts of death or suicide happen during depressive episodes of bipolar.

Are People Being Misdiagnosed with Bipolar Disorder?

By examining both B12 vitamin deficiency and bipolar disorder, we can see that both share common symptoms. Symptoms that are shared between B12 deficiency and bipolar disorder include:

  • Mood changes
  • Irritability
  • Depression
  • Confusion
  • Memory problems
  • Troubles concentrating
  • Sleeping difficulties
  • Lack of interest (apathy)
  • Hallucinations and paranoia (rare)

Since each of these symptoms are present in both B12 vitamin deficiency and bipolar disorder, is it possible that many individual's are being misdiagnosed with bipolar disorder? To prove the existence of a B12 deficiency a blood test is needed. In order to treat B12 deficiency, doctor's often prescribe B12 shots for a better absorption rate to return B12 levels to normal. Along with B12 shots individuals may also need to make dietary changes to include more foods with amounts of B12.

Considering the symptoms that are shared between B12 deficiency and bipolar disorder, it is easy to see how someone could be misdiagnosed when based off symptoms alone. However, what has research stated in the connection between B12 vitamin deficiency and bipolar disorder? A study published in 1905 from the Journal of the American Medical Association found B12 deficiency caused psychiatric and neurologic symptoms before worsening to anemia. Recent research in 2009 found that B12 deficiency "partially" caused psychosis symptoms. This study from the Medical University of South Carolina further found with B12 supplementation that psychosis symptoms improved significantly.

Both B12 vitamin deficiency and bipolar disorder are complex in nature. Although both exhibit many of the same features or symptoms, more research needs to be conducted. For now, the debate over misdiagnosis rages on in the scientific community and individuals impacted by the diagnosis of bipolar disorder. While there's not one specific cause of bipolar disorder, science has found many individuals diagnosed with bipolar disorder have severely low levels of vitamin B12.

From medical research finding a connection between the diagnosis of bipolar and B12 deficiency, B12 supplementation is now considered a recommended treatment for bipolar. Many individuals with bipolar often spend longer periods in a depressive state. With a B12 supplementation, individuals with bipolar disorder are finding significant relief from depression symptoms. B12 deficiency may just be the key to not only treating bipolar disorder, but also the cause.

Do you think vitamin B12 deficiency is misdiagnosed as bipolar disorder?

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    • KatWin profile image

      Kathy Burton 2 months ago from Florida

      I always thought you ruled out organic causes of symptoms before moving on to psychiatric treatment. Once again caught making an assumption. Good article.

    • beckieland profile image

      Rebecca Mayglothling 6 months ago from Binghamton NY

      I feel like this article could have solved a lot of familial issues for me growing up! I take D for my lack of sunlight here in the Northeast, but I wonder if some extra B12 would help with my seasonal affective disorder! Great food for thought here.

    • Liztalton profile image

      Liztalton 6 months ago from Washington

      Thank you Nitika!

    • Nitika Mehra profile image

      Nitika Mehra 6 months ago from Delhi

      Great Article! Very useful for mental health professionals.

    • Ginny Stone profile image

      Ginny Stone 6 months ago from Pretoria, South Africa

      That is horrendous. So sorry. Glad that you got sorted eventually.

    • Liztalton profile image

      Liztalton 6 months ago from Washington

      Ginny stone the reason I wrote this article is because I was having the same symptoms and I was diagnosed with bipolar. Finally after two yrs of a psychiatrist prescribing meds that didn't work (and even made symptoms worse) he finally ordered vitamin tests. Guess what! I was severely low on b12. After that I did b12 injections for a year to get my b12 levels better. Now I'm on no meds for bipolar and doing great just taking supplements. Sometimes to help someone all that's needed is a few simple tests instead of just prescribing pills. Thank you for commenting and sharing! I hope your sister in law starts feeling better!

    • Ginny Stone profile image

      Ginny Stone 6 months ago from Pretoria, South Africa

      Gosh! Scary. My sister in law is currently undergoing tests (in hospital) because she has been experiencing some of those symptoms - do you think it is something that they routinely test for? Going to share this with her anyway. Thanks for the interesting article.


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