Vitamin B12 deficiency can manifest through skin hyperpigmentation, appearing as darkened patches on the skin and nails that may serve as early warning signs of the condition.
According to health platform JJ Medicine, this hyperpigmentation represents "increased pigmented areas on the skin, which will occur as darkened patches."
The skin changes are believed to result from increased melanin synthesis. Remarkably, these visible symptoms may be the sole indicator of B12 deficiency in some patients.
"This could actually be an early manifestation of a vitamin B12 deficiency in some patients," JJ Medicine explained.
Neurological manifestations are abundant in B12 deficiency
GETTY"And in some patients, this may be the only clinical finding of a vitamin B12 deficiency. They may not have other signs and symptoms."
B12 deficiency is notoriously difficult to diagnose because it masquerades as other conditions, earning it the nickname "the great masquerader."
The condition presents with an extensive range of symptoms that can affect multiple body systems.
"What are the symptoms of B12 deficiency? What aren't the symptoms of B12 deficiency?" stated Dr Michael Greger on the health podcast Nutritionfast.org.
The deficiency can cause "everything from abdominal distension and chronic diarrhoea, to shortness of breath and swollen, red, painful feet."
Neurological manifestations are particularly abundant in B12 deficiency.
The condition can also produce "Parkinson's-like symptoms, skin darkening, that resolve with supplementation," according to Dr Greger.
Some patients may even develop "bilateral useless hand syndrome," a symptom Dr Greger noted he had "never heard of before".
Vegans and vegetarians face a heightened risk of B12 deficiency, with the NHS identifying these dietary trends as major contributing factors alongside natural age-related decline. The timeline for developing a deficiency can be surprisingly rapid.
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Symptoms of B12 deficiency can take years to appear
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"Vitamin B12 levels start to drop within months of cutting out meat," Dr Michael Greger stated on the health podcast Nutritionfast.org. This swift onset occurs despite the numerous health benefits associated with plant-based eating.
Dr Greger acknowledged the advantages of adopting more plant-focused diets but warned against complacency.
"Yes, there are all sorts of benefits of adopting a more plant-based diet. But underestimating the risk of developing B12 deficiency nullifies the benefits of a vegetarian diet, or even a diet centred around plant foods."
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