Can numbness, tingling and weakness be symptoms of a nutritional deficiency?

Yes. Although there are other possible causes of these symptoms such as multiple sclerosis, strokes and other brain or spinal cord problems, vitamine and mineral deficiencies can cause these symptoms.

I saw a patient in my office this week who had not been back to see me for regular visits because she “felt fine” and did not feel she needed to follow up with me. This was despite me explaining to each patient that they need to continue to get regular evaluations to avoid nutritional deficiencies.

Unfortunately she was sent back to me by her neurologist because she had developed symptoms of numbness and tingling in her legs.

I ordered several lab tests including vitamin B1, B6, B12, copper and zinc levels as well as a CBC and a complete metabolic profile to find out what might be causing the problem. However, this gives me an opportunity to review some vitamin and mineral deficiencies that are known to cause neurologic problems if vitamin and mineral supplements are not taken to prevent these problems.

A gastric bypass operation also bypassed the first part of the small intestine called the duodenum which helps to absorb the B vitamins and minerals such as iron, calcium and copper.

If a gastric bypass patient does not take a daily multivitamin that contains vitamin B1, also called thiamine, a thiamine deficiency can occur resulting in confusion, unsteadiness and weakness numbness of the legs. This can occur after several weeks or a few months of not taking the vitamins. If this would happen urgent intervention is needed with replacement of this vitamin with an IV directly into the blood stream as well as with treatment by mouth. If this is treated promptly it is likely that these symptoms will improve rapidly.

After several years of not getting enough vitamin B12 after a gastric bypass can result in visual changes, numbness and painful tingling and weakness of the legs and can cause anemia. Many people including women that are menstruating need to take supplemental Vitamin B12 in addition to the multivitamin each day.

Also, we also need a small amount of the mineral copper each day to meet our body’s needs and to avoid symptoms that are similar to vitamin B12 deficiency. This only happens after several years of not getting enough copper. Usually we get enough of this mineral in our diet. However if someone is taking Zinc it make absorbing enough copper more difficult. Also denture paste contains Zinc and could get in the way of absorbing enough copper if a person has had a gastric bypass.

Having discussed these issues it is important to understand that these are very infrequent problems and can be avoided by having your vitamin levels checked at least once a year, taking a multivitamin and any other supplements as directed and keeping your follow up appointments.

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