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If you’ve been living with multiple sclerosis (MS), you may recognize common symptoms such as numbness, imbalance, and fatigue. Many features of MS overlap with those of vitamin B12 deficiency, making it sometimes difficult to tell the two apart.
In addition to other conditions that can mimic MS, research suggests there may be a link between MS and vitamin B12 deficiency. While your healthcare team is best equipped to make an accurate diagnosis and give medical advice, understanding how these conditions relate can be helpful.
Learn how MS and vitamin B12 deficiency share symptoms, how they may be connected, and what sets them apart.
Vitamin B12 deficiency happens when your body doesn’t get enough B12 from food or supplements, or can’t absorb it effectively. It’s also called cobalamin deficiency.
Vitamin B12 is a B vitamin that’s important for keeping your central nervous system (CNS) healthy and supports the production of DNA and red blood cells. Over time, lower levels of vitamin B12 can lead to mental or physical health problems.
Your body can’t make vitamin B12 on its own, so you need to get it from food, drinks, or supplements. This vitamin is found in animal-based foods such as eggs, milk, or meat. It’s also added to some plant foods through a process called fortification.
Most healthy adults need about 2.4 micrograms per day to prevent deficiency. Since vitamin B12 deficiency plays a role in nerve function, lower levels may resemble neurological conditions, including MS.
Certain conditions, such as MS, genetic conditions, or digestive disorders, can increase the risk of a vitamin B12 deficiency. Research has identified a possible link between MS and lower levels of vitamin B12.
Although researchers are still studying this link, both MS and low vitamin B12 can affect the brain and spinal cord and cause neurological problems. This includes:
MS and vitamin B12 deficiency may share similar symptoms, but their underlying causes differ. MS is an autoimmune condition in which your immune system attacks the myelin sheath, or protective layer that covers your nerve fibers.
This happens when your immune system becomes too active and mistakes the myelin as a threat. It’s not clear why this happens, but some possible contributors may be:
Vitamin B12 deficiency differs from MS because it’s caused by a lack of nutrients. When vitamin B12 is low, it can affect nerve health and may damage the myelin sheath. Low vitamin B12 also interferes with body processes, potentially leading to a buildup of a chemical called homocysteine, which may damage your brain and nerve cells.
Vitamin B12 levels have also been thought to correlate with MS, but the relationship is not fully understood. One possible link is that both conditions harm the myelin sheath.
Scientists have found that some proteins that carry vitamin B12 in the body (called TCN2 and CD320) may work with the same pathways involved in supporting nerve
function. Vitamin B12 is in the brain and also helps protect our nerves.
One MyMSTeam member shared how they experienced symptoms when their vitamin B12 was low, saying, “I’m having a good day. And I’m starting my B12 because I was very low on the B12 and was causing me to have symptoms.”
A B12 deficiency doesn’t cause MS, but it can be treated and may make nerve-related recovery harder if it’s missed. Your MS healthcare provider can help figure out whether your symptoms are from MS or a vitamin B12 deficiency. This can be done through lab work, blood tests, and imaging.
Vitamin B12 deficiency is checked with blood tests such as:
MS can be checked with imaging tests, such as MRI scans. These scans can show areas of damage in the brain and spinal cord. MS often causes plaques, or scars, on the myelin sheath.
Treatment options for MS and vitamin B12 vary because the causes are not the same.
MS treatment plans focus on slowing the rate of disease progression. This includes reducing flare-ups and decreasing symptoms.
Steroid medications may be used to reduce the flares and inflammation. Other medications, such as disease-modifying therapies (DMTs), may also be recommended for slowing the rate of disease progression. Treatment may involve physical, speech, or occupational therapy to help people regain strength, speech, movement, or daily living skills.
MS treatment may also change over time, as a MyMSTeam member commented, “Once I reached my sixties, after 29 years of dealing with this ‘lovely’ disease, my MS is stable. I’m no longer on DMT. I just take oral medications for symptoms like spasms. Yeah for my sixties!”
If B12 is low or borderline, treatment is needed. Vitamin B12 deficiency is treated by increasing your vitamin B12 levels. The method may vary depending on how severe the deficiency is and how effectively your body absorbs it. Your doctor may prescribe B12 injections, oral medications, or nasal sprays.
You can also get vitamin B12 in foods such as:
Vitamin B12 deficiency and MS have similar symptoms, but they are different conditions with different causes and treatments. Vitamin B12 deficiency is sometimes treatable and reversible through diet or B12 supplementation, making it important to assess on an ongoing basis.
If you have any neurologic symptoms or are unsure which are related to your MS, contact your healthcare team. They can ensure you get the right diagnosis and treatment plan.
On MyMSTeam, members share their experiences with MS, get advice, and find support from others who understand.
Have you had symptoms of MS or vitamin B12 deficiency? Do you want to connect with others living with MS? Let others know in the comments below.
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