The importance of a balanced diet cannot be overstated. It’s not just about keeping cardiovascular disease and weight gain at bay, but also about ensuring that your body gets all the essential vitamins and minerals it needs to function optimally. One of these essential vitamins is vitamin B—especially B12, which is commonly found in meat, fish, seafood, eggs, and dairy. However, it’s not uncommon to fall short of your recommended intake.

According to Samantha Turner, MPH, RDN, a registered dietitian and owner of Forks and Grace, “Vitamin B12 deficiency is relatively common, especially among older adults, vegetarians, and vegans.” She further explains that “[Vitamin B12] plays an important role in supporting nerve and brain health and energy metabolism, and is crucial for nerve development, DNA synthesis, and red blood cell formation.”

While a doctor’s visit can reveal a deficiency, there are other warning signs to be aware of. Here are some signs that you might not be getting enough vitamin B12, as per doctors and nutritionists.

Feeling constantly tired, rundown, or low on energy can be a symptom of various health problems, but it can also indicate a deficiency of this vital nutrient. Leann Poston, MD, a licensed physician and health advisor for Invigor Medical, explains, “Vitamin B12 is essential to make healthy red blood cells. Low B12 levels can decrease red blood cell production and make it difficult for them to deliver oxygen to body cells, which can cause fatigue.”

If you’re planning on conceiving, a lack of vitamin B12 could become a problem. Qianzhi Jiang, PhD, RDN, a family dietitian and owner of The Nutrition Changer, shares, “Vitamin B12 deficiency has been linked to infertility as vitamin B12 improves the number of healthy eggs and embryo quality.” She adds that a low level of vitamin B12 is also associated with increased homocysteine, an amino acid that can increase the risks of many diseases when in excess. “Elevated homocysteine levels can damage the lining of the uterus, causing infertility,” Jiang explains.

Experiencing a pins-and-needles sensation in your extremities could be a sign that your body is low on vitamin B12. Poston elaborates, “Vitamin B12 deficiencies can cause changes in how your nerves send messages throughout your body. As the rate at which nerve impulses decreases, your body interprets this with numbness and tingling.”

But that’s not all. Jiang adds, “People with vitamin B12 deficiency can experience irritability, abnormal gait, an impaired sense of smell, and absences of neurologic reflexes such as the knee-jerk reaction.” In severe cases, psychiatric symptoms that resemble the symptoms of dementia can also occur.

If you notice some tenderness in your mouth that’s not related to a burn or toothache, it could be a sign you’re lacking in vitamin B12. Poston explains, “Vitamin B12 deficiency can cause glossitis. This appears as a smooth appearance of the tongue that can be painful.”

A vitamin B12 deficiency can also lead to misshapen red blood cells, says Poston. “These cells get caught in the spleen, decreasing the number of red blood cells circulating. This condition, called anemia, can cause pale skin color.”

However, there are also internal signs of this condition. Jiang notes, “Some people may see no or very mild symptoms caused by pernicious anemia for years while others may experience fatigue, muscle weakness, or palpitations (which is a feeling that your heart is pounding or skipping a beat). However, pernicious anemia may not be seen in cases of mild vitamin B12 deficiency.”

While this information is up-to-date and provided by top experts, it’s not intended to replace professional guidance. Always consult your healthcare provider directly for any questions about your medication or health.

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A recent study has raised concerns about the potential exposure to harmful chemicals, specifically PFAS, from frequent seafood consumption. These toxins, often referred to as “forever chemicals,” persist in the body indefinitely once ingested.

The study, published in Exposure and Health, suggests that regular seafood eaters may be at a higher risk of exposure to these chemicals, which have been linked to a range of health issues, including cancer, fetal abnormalities, high cholesterol, and thyroid, liver, and reproductive disorders.

The research team conducted a detailed analysis of PFAS concentrations in fresh seafood and surveyed eating habits in New Hampshire, a state known for its high seafood consumption. They tested 26 types of PFAS in the most commonly consumed fish: cod, haddock, lobster, salmon, scallop, shrimp, and tuna. The results revealed that shrimp and lobster contained the highest levels of PFAS compounds.

“The scientific community is working hard to understand more about the overall risk-benefit tradeoff of consuming seafood,” said Megan Romano, PhD, an associate professor of epidemiology at Dartmouth’s Geisel School of Medicine. “Part of the current challenge for consumers is that some of the traditionally safer seafood choices in terms of mercury content may have higher concentrations of other pollutants, like PFAS.”

The study’s findings have underscored the need for more stringent public health guidelines regarding seafood intake, particularly in coastal areas with PFAS pollution. Kathryn Crawford, the first study author and an assistant professor of environmental studies at Middlebury College, emphasized that exposure to PFAS via seafood is a function of both the amount of seafood people eat and the concentrations of PFAS in seafood.

“We found that people in NH consume more seafood on average than other parts of the U.S. Also, the region has been home to PFAS-related industries, which can release PFAS into the environment that can ultimately bioaccumulate in organisms like fish and shellfish,” Crawford added.

The study’s findings suggest that people in areas with PFAS pollution and high seafood consumption may be exposed to more PFAS than elsewhere. This has led to calls for the development of public health guidance for seafood consumption that takes these findings into account.

“There needs to be more awareness and strict guidelines on what is considered safe with these chemicals,” said Julia Zumpano, a registered dietitian with the Cleveland Clinic center for human nutrition. “People should limit known sources or PFAS in non-stick cookware, personal care products, cleaning products, grease resistant products, water resistant fabrics, stain resistant products.”

Pregnant individuals and children are particularly vulnerable to excessive seafood consumption. “Pregnancy and early childhood are periods of rapid development with a person’s life, which makes them susceptible to chemical exposures that might interfere with these normal developmental processes,” Crawford said.

David Love, PhD, an expert in food systems and sustainability and associate professor at John Hopkins Bloomberg School of Public Health, explained that pregnant and nursing individuals and young children cannot tolerate chemicals found in certain types of seafood, especially when consumed in large amounts.

Experts agree that the findings of the new study add to our understanding about the risks of PFAS exposure. David Love said, “PFAS is an emerging risk that we should be aware and continue to monitor and evaluate, but we are not yet able to set national guidance for seafood.”

For the general public, seafood should be limited to about 12oz per week, but fish high in mercury should be consumed less frequently, according to Zumpano. She also recommended choosing fish from the ‘best choices’ list most often, limit fish from the ‘good choices’ list and avoid fish in the high mercury list.

“Choose low mercury canned tuna, ideally that has been tested for mercury content,” Zumpano said. This study highlights the importance of a balanced diet and the need for consumer-friendly recommendations about seafood consumption.

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In the initial stages of your weight loss journey, you may notice a rapid drop in your weight. However, this pace is not sustainable and eventually, your weight loss will slow down and may even seem to halt altogether. This is a common occurrence regardless of the weight loss method you choose, be it medication like Ozempic, weight-loss surgery, or traditional methods like diet and exercise. The timing of this weight-loss plateau, however, can be influenced by the method you choose. Recent research provides insight into this timeline and offers strategies to overcome this plateau.

“Every obesity intervention eventually results in a body weight plateau, after which no further weight loss occurs,” stated Kevin Hall, PhD, a researcher at the National Institutes of Health (NIH). His study, published in the journal Obesity on April 22, aimed to determine when people reach a weight-loss plateau based on their chosen weight loss method.

Hall’s findings indicate that the timing of the plateau varies depending on the method used. He utilized data from various clinical trials to develop a mathematical model that predicts when weight loss is likely to stall.

According to his research, those who relied solely on calorie restriction to lose weight reached a plateau earlier than others, typically around the 12-month mark. “As you lose weight, your metabolism declines, causing you to burn fewer calories than you did at your heavier weight,” the experts at the Mayo Clinic explain. “To lose more weight, you need to either increase your physical activity or decrease the calories you eat. Using the same approach that worked at first may maintain your weight loss, but it won’t lead to more weight loss.”

On the other hand, those who used weight-loss drugs like semaglutide (Wegovy and Ozempic) or tirzepatide (Zepbound and Mounjaro) were able to continue losing weight for a longer period, with their plateau typically occurring around the two-year mark.

The longest duration of weight loss was observed in those who underwent weight-loss surgery. According to Hall’s research, these individuals typically experienced about three years of weight loss before reaching their plateau.

Regardless of the method used, all groups eventually reached a point where they stopped losing weight. “What’s happening is that they still experience an increase in appetite, the more weight that they lose,” Hall explained to CNN. “If they had no appetite circuit, in other words, the drug just kind of kicked in and their intake stayed at this very low level. It would take many, many years for them to reach a plateau and they would lose, you know, an exorbitant amount of weight.”

So, what can you do to continue your weight-loss journey once you’ve hit this plateau? Hall suggests combining different methods. “Another very common thing now is that people who didn’t lose as much weight from bariatric surgery as they thought, will go on one of the GLP-1 receptor agonist so they’re adding interventions on top of each other,” he told CNN.

However, Hall emphasizes that maintaining healthy habits is the most crucial aspect of continuing your weight-loss journey, regardless of the methods you choose. “A persistent effect is required to maintain the weight loss,” he shared. “The whole point here is that whatever you do, you have to keep doing it. And so you’ve gotta be happy with that lifestyle intervention for the rest of your life. Otherwise, it’s not going to have the added benefit.”

Remember, while we strive to provide the most current information from top experts and new research, our content should not replace professional guidance. Always consult your healthcare provider directly for advice about your medication or any other health-related concerns.

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