Tiredness and Deficiency in Vitamin B-12, Vitamin D, and Iron

As someone who has suffered from vitamin B-12 deficiency, vitamin D deficiency, and iron deficiency, I can share my experience with you and tell you how you can cope up with all these while on a vegan diet.

When We Recognize that Something is Abnormal …

Some of the earliest symptoms of illness we tend to notice would be “tiredness” and “pain”. All deficiencies can cause tiredness or fatigue (extreme tiredness) and lethargy (lack of energy), so how do we know what it is that we’re suffering from initially?

According to Mayo Clinic, “Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak. There are many forms of anemia, each with its own cause.”

The Experience when You Go to A Doctor:

Trust me, it’s great if your physician would consider the possibility of deficiency and help you diagnose it early on before it could lead to more serious complications or worse. Surprisingly, these three deficiencies are supposedly not uncommon, yet from my friends’ experiences and mine, many doctors, especially the specialists (not general physicians), either seem to overlook deficiencies and are more interested in other causes or recommend medicines without diagnosing the exact cause. Because we also lack the required knowledge to identify these deficiencies, we go by what the doctor says. There seems to be not enough awareness about the causes, presence, and consequences of these deficiencies among either the general public or even the professionals.

A photograph of a man wearing a blue shirt, lying down, seemingly tired and lethargic
Tired, lethargic, and weak? What could the cause be?

Symptoms and Diagnosis:

You can’t be sure that you have any of these deficiencies or a particular one unless you get yourself tested. You could also be deficient in more than one vitamin or mineral at once. I would suggest that if you seem to be experiencing a few of these symptoms for weeks or months at a stretch, that is certainly abnormal, then you better get your vitamin B-12, vitamin D and iron levels tested. In fact, even a physician can conclude what exactly the cause of your fatigue or tiredness could be only based on test results, not just a few symptoms.

If you self-diagnose wrongly or take medicines or supplements without knowing what your problem really is, you could end up wasting time and money, taking the wrong medicines and not taking what your body really needs. As you can guess, that would only worsen your condition. In my case, when I must have been taking medicines for vitamin B-12 deficiency, I was talking other medicines for weeks under the guidance of a physician but not the one supplement I needed. In that period, my vitamin B-12 level dropped down further.

Note that the symptoms or consequences of these three deficiencies could be pretty much similar, and that is one reason that it could all be quite confusing. You could be suffering from just one of these deficiencies or more; you might not know. to begin with, all these three issues cause tiredness or fatigue. You might feel worn out even when you think you are mostly leading a healthy lifestyle. You might feel unusually lethargic, unable to do things you’d be able to do easily otherwise. Do you think you’re affected both psychologically and physically when there really is no other reason you can blame it on, like sudden, hectic work, or periods, or other illnesses? The culprit could be one of these deficiencies.

A bar graph comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron
Comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron

Since these are deficiencies and not genetic or chronological illnesses, there is no specific age group for occurrence. Just about anyone could experience any one or more of these deficiencies depending on what you lack.

Notice that the initial or most commonly noticed signs often remain the same because any one of these deficiencies could be causing anemia. As mentioned earlier, there are different types of anemia, and common symptoms of anemia include lightheadedness or dizziness, tiredness or fatigue, lethargy, pains and aches, pale skin, etc. It’s when we experience these signs that we know that we are weak and we proceed to seek help.

Vitamin B-12 deficiency:

Vitamins B-12, folate, and D, and iron all of them, including other vitamins and minerals, help the body function smoothly and efficiently, keeping us healthy. They also aid similar causes and deficiencies in these would therefore show similar signs, but there are also noticeable differences. Tingling sensation in your feet, for example, is one of the key indicators of vitamin B-12 deficiency. When it gets worse, you could experience a severe pins and needles sensation in your feet, they say. I didn’t experience that, but I did experience numbness, signs related to the nervous system. As vitamin B-12 deficiency continues for a long while, you could experience significant cognitive impairment, affecting your thinking, understanding, memory, and judgment because this vitamin is necessary for healthy brain functioning.

Part 2 of the bar chart comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron
Comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron — part 2

Look for signs like these along with general signs of anemia; can you relate? If so, it might be vitamin B-12 that your body lacks. Don’t let this one pass because this is a serious condition. In the long run, when unattended, it could lead to problems like dementia and paralysis. vegetarians and vegans are even more prone to vitamin B-12 deficiency because this is often found more abundantly in animal products.

Vitamin D deficiency:

When it comes to vitamin D deficiency, apart from the generic anemia symptoms, one key indicator would be severe, unexplained, sudden hair loss. This is unique to vitamin D deficiency if I’m not wrong. Everyday, several times, you’d notice that you’re losing more hair than you ever have lost. Apart from this, you could also notice multiple problems with respect to muscles and bones, like pain, cramps, etc. Along with these, you could also be experiencing depression. Vitamin D deficiency and depression are closely linked, as many studies have proven so far.

Part 3 of the bar chart comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron
Comparing symptoms of deficiencies of vitamin B-12, vitamin D, and iron — Part 3

Iron deficiency:

If all the common symptoms of anemia are present and you do not see signs that are more specifically caused by either of the above conditions, then check your iron levels if you have not. Overall weakness combined with a poor appetite, cold hands and feet, trouble sleeping, and strange cravings (?) might be warning signs of iron deficiency.

Prevention & Treatment:

The good news is that deficiencies can generally be prevented easily with a healthy diet, unless you have rare problems like an inability to absorb nutrients. Even though most of the commonly found sources of vitamin B-12 include animal products, there are many vegan products that are fortified with vitamin B-12. Look for processed foods, flours, and nut milks fortified with vitamin B-12. Usually, tofu, fortified flours, and other soy products come with this option. The same applies to vitamin D, too. You can find vitamin D in vegan foods like mushrooms and spinach, and don’t forget, the most natural (and free! 😉) source of vitamin D is sunlight, so expose yourself to sunlight regularly.

Regarding iron, there are so many vegan foods that can help us get enough iron. For example, spinach, lentils, nuts, and seeds are all some of the iron-rich foods we can easily get.

But if you’re already suffering from severe deficiency, then as your physician might suggest, you should take supplements. It could take anywhere between one month and several months to get your levels back to normal even when you are taking supplements everyday. As long as the problem has not reached an extreme level, you are protected with natural foods and supplements.

As always, prevention is better than cure! Unfortunately, we don’t take our health as seriously as we should do. Get yourself tested once in a year or twice a year, while leading a healthy lifestyle, and that’s how you can stay healthy and self-aware.

*Note: The information regarding the symptoms comes from several sources, and none of this can be promisingly accurate, plus conditions can vary from person to person, so let the tests and your physician (knowing your medical history, existing issues, and family history) guide you on the right path. The purpose of this post is to raise awareness and to help identify vitamin B-12, vitamin D, and iron deficiencies in the early stages. If you can offer valuable, evidence-based information or consider yourself a subject matter expert, feel free to share what you know.



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Lakshmi Prakash

Lakshmi Prakash

A conversation designer and writer interested in technology, mental health, gender equality, behavioral sciences, and more.