Many doctors who know that B-12 deficiency can cause neurological damage believe that it only happens to elderly people. It can happen at any age, but it most often happens after 40 and increases in frequency as years pass.
Ironically, when elderly people show the signs of neuropathy, most doctors just assume it is age and don't diagnose and treat them either!

There are several problems, causing people to go undiagnosed until very serious damage is done. 1) many doctors don't know that testing for B-12 is important 2) many doctors think that a B-12 test result within a "normal" range is sufficient 3) many doctors just check for anemia, thinking that anyone who has B-12 deficiency must be anemic 4) very rare doctors don't even know that malabsorption of B-12 exists, or ignore signs of megaloblastic anemia (both are Inexcusable and megaloblastic/macrocytic anemia (wrongly referred to as "pernicious anemia") should cause even the dullest doctor to suspect B12 deficiency. The knowledge is much older than the doctors).

Anyone with neurological symptoms should be checked for B-12 deficiency. The patient should always request and get a copy of lab results. Never take a doctor's word that the B-12 result is "normal" or "fine," or even "high." And remember that even if it is in the "normal" range, that does not mean you are not deficient.

After years of reading medical literature on B12 and related subjects and speaking with many people, including patients and experts, I think that anyone with neurological symptoms should take B-12 (at least 1000 mcg) and B complex at a different time of day, regardless of B-12 testing results.

It is good to be tested, unless the patient has to spend time waiting or fighting to get proper testing, in which case it is better just to take the vitamin (and keep taking it) in hopes of stopping the damage and allowing repairs to begin. The longer deficiency persists and worsens, the worse the damage will be.

Proper functioning of one vitamin is dependent on the others, so it is a good idea to supplement the other B vitamins in appropriate amounts, just in case.

rose