Full disclosure: I’ve never been a vitamin person. I don’t even take a basic multi, even in gummy form. Blame it on sheer laziness or the fact that I always thought I ate well enough to get my nutrients from food, despite my heavy reliance on processed flour. Croissants are vitamins for the soul, aren’t they? In any case, I was wrong. For the past three years, I’ve suffered from a list of burdensome ailments ranging from bouts of low blood sugar to increasingly frequent panic attacks. So after spending a few too many hours on WebMD, I scheduled an appointment with my internist, fearing for the worst. The good news was that I wasn’t dying. The bad news? I was deficient in vitamin B12.

B12 is kind of like the Beyoncé of B vitamins, which is to say you absolutely need her in your life, and sometimes you need more than you know. B12 is essential in helping your body synthesize DNA, so it’s no wonder I was walking around feeling like half a human. It also keeps your blood and nerve cells healthy. A deficiency of B12 can present in a number of annoying ways: fatigue (check), depression (check), and anxiety (double check). But more serious deficiencies can have even scarier consequences including memory loss, nervous system damage, and dementia. In infants, B12 deficiency can present as failure to thrive and lead to motor problems. Basically, B12 is a big deal.

According to the USDA, the two most bountiful sources of B12 are clams and and beef liver, which to me sound like gross and grosser. Next on the list are fortified breakfast cereals, rainbow trout, and salmon, followed not too far behind by other fish, beef, dairy products, and eggs. Vegans and vegetarians are urged to seek out veggie-friendly fortified cereals and non-dairy substitutes, but nori and shiitake mushrooms are also good plant-based sources.

So why wasn’t I getting enough? I like a nice spicy salmon roll or juicy steak as much as the next omnivore, but there are a number of reasons you may not be getting your fill. Certain medications, including birth control pills, can decrease your ability to absorb B12. Same goes for heavy drinking. In extremely rare cases (about .1% of the general population), B12 deficiency is caused by pernicious anemia, an autoimmune condition that interferes with B12 absorption in the stomach. Whatever the reason, all it takes is a simple blood test to find out if you need a little extra.

Serious cases of B12 deficiency are typically treated with injection supplements. In my case, my doctor recommended a sublingual (under the tongue) spray, which I got at my local health food store. He prefers sprays to the pills and sublingual tablets because of their superior bioavailability (the amount that gets absorbed by the body). I’m currently on a double dose, which is about 16,000 percent of your daily requirement, and have an appointment to check my blood levels in four months. And I have never felt better. After only three weeks, my energy levels are more even, I’m not getting panic attacks in the middle of the night (or much at all), my depression is more manageable, and I’m no longer having hypoglycemic episodes.

If you think a B12 deficiency might be the reason you’re feeling all kinds of blah, the best way to find out is to ask your doctor for a blood test.

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