Can B12 Deficiency Cause Balance Problems?

Can B12 deficiency cause balance problems? Can it cause issues like dizziness or what's known as ataxia?  Yes B12 is important for a lot of different neurological functions.  It's important specifically in the nervous system for myelin sheath production which allows for nerve impulses to be conducted through out the nervous system.  In this article we will look at a specific case report of B12 deficiency that caused some of these symptoms.  We will also look at the findings on MRI and physical exam and how B12 deficiency was responsible for those findings.  Case Report: https://www.ncbi.nlm.nih.gov/pmc/arti... Yes b12 deficiency can cause balance issues because of its role in the nervous system. B12 is a vital nutrient critical for many functions.  It is needed for the production of red blood cells but B12 is needed for production of any cell.  B12 is also a critical nutrient for gastrointestinal function and the absorption of nutrients.  It also plays a role in neurological and psychiatric aspects of our body.  Therefore when there is a B12 deficiency, it can cause problems in any of these areas.  When it comes to balance, of course, B12 deficiency is involved because of its role in the nervous system. Of all the possibilities of where B12 deficiency shows up, many times the initial presenting symptom is neurological in nature.  When you are deficient in B12 for long enough the body doesn't have enough B12 to go around for all of these different functions in the body. This is when symptoms start to manifest.  When it comes to the nerves and nervous system, B12 is needed for the production of myelin sheath.  Myelin sheath is like an outer coating of the nerve that allows for proper conduction of the nerve impulses.  You can think of it like a wire with an outer plastic coating.  If there is no plastic coating, you might get more short circuits.  Similarly if you have B12 deficiency this can lead to a decrease in the nerve conduction, weird sensations, or sensations that are out of place.  The myelin allows for conduction of signals from any part of your body to your brain and vice versa.  So the odd sensations can happen in your legs and your arms or even more centrally in the spinal cord itself.  Let's look at some case examples so we can better understand how B12 deficiency balance problems might manifest. The information on this case of B12 deficiency and balance problems is coming from a case report that was published and you can find here.  This case report describes five different neurological manifestations of B12 deficiency.  In all five cases the laboratory, imaging, and clinical history were compatible with the diagnosis of cobalamin deficiency.  As a side note, cobalamin is another way to say B12. So B12 deficiency and cobalamin deficiency are synonymous.  In all five cases the B12 deficiency symptoms resolved with administration of B12 injections.  Now let's look at some specific cases related to B12 deficiency and balance problems.  Two of the patients in this case report presented with what the authors describe as posterior-lateral cord syndrome causing gait ataxia.  One of the two had a more acute case with  sensory gait.  First let's look at what is ataxia.  Ataxia is an impairment in coordination.  This impairment can happen for many reasons like a lack of proper impulses from the brain to the hand.  Imagine if you are not be able to hold a cup because you can't quite feel it.  In this case the nerves that transmit the feelings when you touch it aren't getting transmitted up to the brain.  This is similar to what can happen with B12 deficiency.  So let's look closer at one of these cases to better understand how B12 deficiency causes coordination and balance problems.  This case is a year old patient with difficulty walking.  The authors  describe a slippage of foot wearing without knowledge. The patient's shoes are slipping off without her  recognizing it.  Her physical exam also shows that the patient has impaired joint position in the lower limbs. She had nothing neurological wrong in the upper limbs.  So she didn't know the positioning of her joints in space.  She also had positive Romberg sign.  The Romberg test is used to evaluate the causes of motor coordination loss also known as ataxia