I always felt that as long as I ate a balanced diet, I did not need to take any additional vitamins. I was forced to change my thinking about this in recent years.

It started when I began to feel constantly tired. The problem became so strong that simple day-to-day work left me exhausted, even though since my retirement I had fewer duties on my slate. I had to take breaks while doing normal housework, but those breaks did not leave me with renewed vigour. I remained tired and weak all day long, every day, and the simplest task left me short of breath.

After two months of this I fi-nally went to my doctor. She asked me questions and poked around, and then sent me for various tests. Her first suspicion – that it was the onset of diabetes – did not prove true. Further blood tests revealed that I had an extremely low level of vitamin B12.

This vitamin is required for normal nerve function and red blood cell formation. We also need it to break down, use and reform the building blocks of proteins, and to make the genetic blueprint in each of our cells. A serious lack causes a shortage of red blood cells (pernicious anemia), which causes fatigue and shortness of breath and can ultimately lead to numbness or tingling in the fingers or toes, impaired balance and cognitive problems.

Sources of vitamin B12 are seafood, fish, meats, nutritional yeast, fortified cereals, eggs, milk and milk products. Some rice and soy beverages are also fortified with B12.

Although I ate meat, eggs, milk and milk products regularly, I had to admit that fish was not high on my diet. On my doctor’s advice I increased my consumption of seafood. I even forced myself to drink soy beverages, which did not suit my taste. I was willing to do anything to cure my awful fatigue.

All of this made no difference. I continued to drag myself through my days and returned to the doctor after a month. It was then determined that my body had become unable to absorb vitamin B12 through food. In my case, an abdominal operation some years ago contributed to the problem. I learned, however, that the condition occurs in up to 30 per cent of people over 55. The most common culprit is an age-related drop in the output of stomach acid, which strips B12 from food. In some cases, the problem is a decline in the production of intrinsic factor (IF), an enzyme that also plays a key role in that process. You might also need a little extra help if you’re taking certain cholesterol-lowering medication, which can deplete B12.

For lack of stomach acid a multivitamin provides enough extra B12, while for IF problems one needs mega doses, which should be taken only under medical supervision. In my case, it was required that I receive monthly injections of the vitamin. After a relatively short time, a marked increase of the B12 in my blood was measured, and my extreme fatigue and shortness of breath disappeared. It is necessary for me to take those injections regularly for the rest of my life, but there is now a tablet that’s absorbed under the tongue. It seems to work just as well for me as the injections did. I am taking two tablets of 500 mg every day, and have not experienced the debilitating symptoms that had plagued me for a long time before I sought medical advice.

We often pay little attention to slight problems like fatigue. My experience has taught me that even small complaints can have very serious consequences if they are ignored. It pays to visit medical professionals regularly in order to stop minor problems from developing into major ones.

– Joyce Slobogian writes from Brandon, Manitoba and is the author of To Die For, available

at Pennywise Books in Brandon, and online at Amazon.com.