Woman, 41, suffered ‘burning sensation’ in mouth due to B12 deficiency

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

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Vitamin B12 is vital for our bodies to function. One of its main jobs is to help form red blood cells, which are needed to transport oxygen around the body. Therefore, a deficiency in B12 can lead to a type of anaemia and some serious side effects.

The vitamin is mainly found in animal products such as meat, fish, cheese and eggs.

Often people who don’t eat these foods can be at risk of a deficiency if they supplement it by taking vitamins or consuming other fortified foods.

This was the case for one woman whose story was published in the Journal of the Canadian Dental Association.

The 41-year-old was referred to the João de Barros Barreto University Hospital in Brazil by her dentist due to her symptoms.

“Her chief complaint was difficulty in eating certain types of food (mainly banana and tomato) because of a burning sensation and the presence of red stains on the inside of her cheeks and on her tongue,” the case study said.

“She had been a strict vegetarian for two and a half years and had not consumed milk, cheese, fish, meat or eggs during that time. She was not taking any medication.

“The current symptoms had been present for more than a year.”

Red patches in the mouth could be the result of glossitis, a common B12 deficiency symptom.

During an evaluation further symptoms were found.

These included:

• Paleness
• Dry lips
• Loss of taste of some fruit and vegetables
• Fatigue after “simple” daily activities
• Paresthesia – burning or prickling sensation in some limbs
• Memory problems such as forgetting facts, dates and appointments
• Difficulty answering questions.

Medical staff also detected further problems in her mouth.

The case study said: “Oral examination revealed pale oral mucosa (pale gums), glossitis with papillary atrophy (an inflamed tongue that is missing the usual bumps) and multiple areas of painful erythema (a skin reaction) on the dorsal surface and lateral borders of the tongue and buccal mucosa.

“The mucosa covering the lesions appeared atrophic, but no frank ulceration was evident.”

She was diagnosed with megaloblastic anaemia – a disorder where your blood cells are abnormally large, which is usually due to a B12 or B9 deficiency.

The patient was prescribed B12 injections and folic acid supplements for a month.

She was also asked to modify her diet and eat liver daily.

The oral lesions started to diminish within one week and after two weeks they had “completely disappeared” along with all other symptoms.

General symptoms of anaemia, which can be caused by a lack of B12 are:

• Extreme tiredness (fatigue)
• Lack of energy (lethargy)
• Breathlessness
• Feeling faint
• Headaches
• Pale skin
• Noticeable heartbeats (palpitations)
• Hearing sounds coming from inside the body, rather than from an outside source (tinnitus)
• Loss of appetite and weight loss.

The NHS lists specific symptoms of a B12 deficiency as:

• A pale yellow tinge to your skin
• A sore and red tongue (glossitis)
• Mouth ulcers
• Pins and needles (paraesthesia)
• Changes in the way that you walk and move around
• Disturbed vision
• Irritability
• Depression
• Changes in the way you think, feel and behave
• A decline in your mental abilities, such as memory, understanding and judgement.

Foods rich in B12 include meat, fish, milk, cheese, eggs, yeast extract like Marmite and some fortified cereals.

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