Vitamin B12 Deficiency

actions and neurological functions in your body, including DNA synthesis. Your body can’t make vitamin B12 on its own, so it must be obtained via your diet or supple- mentation. A deficiency can be serious and leads


to a number of related changes, including personality disturbances, irritability and depression, along with a wide range of symptoms, including joint pain, “pins and needles” sensations, numbness and short- ness of breath. One of the lesser known symptoms,

however, may affect your voice. If you frequently experience hoarseness, a vita- min B12 deficiency could be to blame.

Hoarseness, Vocal Fold Palsy Linked to B12 Deficiency Researchers from the department of

nutrition science at East Carolina Univer- sity reviewed 89 case studies of vitamin B12 deficiency, looking for causes, clinical manifestations and outcomes. Neurologi- cal, psychiatric, oral, dermatological and other “rare signs and symptoms” were reported, signaling just how varied the symptoms can be. One of the case studies involved a

61-year-old man who suffered from vita- min B12 deficiency as a result of excessive alcohol consumption. His symptoms in- cluded gradually progressive hoarseness along with vocal fold palsy. Vocal fold palsy occurs when one or both vocal folds become paralyzed and

itamin B12, a water-soluble vitamin also known as cobalamin, plays a role in numerous biochemical re-

do not move properly. If one vocal cord does not move properly, it can lead to a hoarse voice, whereas if both vocal folds aren’t working, it can cause trouble with breathing. Typically, vocal fold palsy is related

to surgical procedures, such as thyroid surgery or carotid artery surgery, or neck or chest tumors, but often the cause is unknown. In the original case report, which was published in The Journal of Laryngology & Otology in 2011, the re- searchers wrote:6 “A 61-year-old man presented to the

emergency medical ward with an eight- week history of gradually progressive hoarseness and weakness of both lower limbs … The patient’s hoarseness was constant in nature, requiring repeated throat-clearing.” He was treated with vitamin B12 re-

placement therapy, which resolved his symptoms: “… At follow up the patient’s voice

and vocal fold function were noted to have improved. Both his voice and lower limb function continued to improve. Over the following three months, the patient made a full recovery, mirroring the normalization of his serum B12 levels. We believe that this case demonstrates

a strong relationship between vitamin B12 deficiency and vocal fold palsy”

Metformin Linked to B12 Deficiency, Hoarseness In another case, a 55-year-old man

with Type 2 diabetes also suffered from hoarseness, leading him to visit an otolar-

yngology (ear, nose and throat) clinic. Bilateral vocal fold paralysis was detected as a result of vitamin B12 deficiency, and according to the researchers, the condition resolved after his vitamin B12 levels in- creased:

“Hoarseness of the patient progres- sively recovered after a month of treatment

Hoarse Voice? It Could Be a

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