Feeling off balance can be unsettling. Your balance depends on many of your systems working together, including your brain, nerves, muscles, eyes, inner ears and blood pressure.
When you’re off balance, you may stumble, notice unsteady walking, have trouble walking in the dark or be afraid you might fall.
Vitamin deficiency is one possible cause of balance problems. That’s because some deficiencies can affect your nerves, muscles or coordination. Getting checked is important, because many causes of balance problems are treatable.
“The most important deficiencies to consider are vitamin B12, thiamine (B1), vitamin E and vitamin D,” said Meenakshi Minghelli, MD, a geriatric medicine specialist with Banner - University Medicine.
Vitamin B12 and nerve-related balance problems
Vitamin B12 helps support nerve function because it helps maintain the protective covering around nerves that allows messages to travel quickly between the brain and the body. A vitamin B12 deficiency can affect the nerves that control balance, coordination and awareness of where the body is in space.
Older adults and people with absorption issues may be at higher risk for balance problems caused by B12 deficiency. With low levels of B12, you may have symptoms like:
- Numbness and tingling
- Burning
- Weakness
- Difficulty walking or gait changes
- Balance problems
Other vitamin problems that may affect balance or fall risk
You could also have balance problems due to low levels of these vitamins and minerals:
- Vitamin B1 (thiamine): Low levels can affect your nerves, coordination and walking, especially if you have poor nutrition or heavy alcohol use.
- Vitamin E: Severe deficiency is uncommon but can affect your nerves and coordination.
- Vitamin D: Low vitamin D may contribute to muscle weakness and fall risk.
- Folate: Low folate can lead to anemia and fatigue, which may make you feel weak or less steady.
- Vitamin B6: Too little (or too much) B6 from supplements can affect your nerves.
- Copper: Deficiency could happen after weight-loss surgery or from too much zinc.
Balance problems are often caused by something else
Don’t assume that a balance problem is caused by a vitamin deficiency. Other common causes include:
- Medication side effects
- Inner ear problems
- Vision changes
- Low blood pressure
- Dehydration
- Abnormal heart rhythms
- Diabetes-related peripheral neuropathy
- Arthritis, foot pain or muscle weakness
- Stroke or TIA
- Parkinson’s disease or other neurologic conditions
- Thyroid disease
- Digestive system disorders
- Alcohol use
- Poor nutrition
Because so many different things can cause balance problems, primary care is a good starting point. “Many causes, including vitamin deficiencies, are treatable and getting checked early can improve your symptoms and help prevent permanent nerve damage,” Dr. Minghelli said.
Who should ask about vitamin testing?
Not everyone with balance problems needs vitamin testing. Talk to your provider about testing if you fall into one of these higher-risk groups:
- Older adults with new balance problems or falls
- People with numbness, tingling or burning in the feet
- People with limited diets or poor appetite
- People who eat little or no animal products
- People with digestive conditions that affect nutrition
- People who have had weight-loss surgery
- People taking metformin or long-term acid-reducing medicines
- People with heavy alcohol use
- People with numbness, tingling or memory changes
- People with unexplained fatigue, weakness, anemia or walking changes
- People who have fallen multiple times
What your primary care provider may check
To uncover the cause of your balance problems, your primary care provider will ask about your symptoms, medications and lifestyle:
- When they started and whether they are getting worse
- If you’ve had falls or near-falls
- Dizziness or unsteadiness
- Numbness, tingling, weakness or foot symptoms
- Medication and supplements you take
- Diet, alcohol use and medical history
They may also perform certain tests:
- Blood pressure, including position changes if needed
- Vision, ear symptoms, walking, strength, reflexes and sensation
- Blood tests for B12, blood counts, thyroid, diabetes markers, vitamin D or other tests based on symptoms
They may refer you to:
- Neurology: If there are signs of a brain or nervous system problem
- ENT: When balance problems occur with hearing loss, ringing in the ears, ear fullness or other symptoms
- Vestibular physical therapy: To help treat inner ear weakness, dizziness, post-concussion symptoms, poor balance and fall risk
Should you start taking vitamins for balance?
Don’t assume supplements will fix balance problems. Supplements help most when there is a true deficiency. “High-dose supplements can cause harm if you take them without medical guidance,” Dr. Minghelli said.
- Vitamins A, D, E and K can build up and cause liver damage, kidney stones or bleeding
- Too much vitamin B6 can cause nerve symptoms
- Supplements can interact with prescription medications
Ask a provider what testing, dose and supplements are right for you.
When balance problems need urgent care
Get emergency care for:
- Sudden trouble walking or loss of balance
- Face drooping
- Arm or leg weakness, especially on one side
- Trouble speaking
- Sudden confusion
- Sudden severe headache
- New vision loss or double vision
- Fainting
- Chest pain or shortness of breath
- A fall with head injury
- Rapidly worsening weakness or numbness
The bottom line
Vitamin deficiencies can sometimes lead to balance problems, especially when they affect your nerves, strength or coordination. But feeling unsteady can also come from medications, inner ear issues, vision changes, blood pressure, diabetes, neuropathy or neurologic conditions.
If you are feeling unsteady, falling more often or noticing numbness, tingling or weakness, a Banner Health primary care provider can help check for common causes (including vitamin deficiencies) and help you figure out what can help.
FAQs about vitamin deficiencies and balance problems
Can low B12 cause balance problems?
Yes. Low vitamin B12 can affect nerve function and may cause numbness, tingling, walking changes or balance problems.
What vitamin deficiencies can affect balance?
Vitamin B12 is one of the better-known deficiencies linked with balance and nerve symptoms. B1, vitamin E, vitamin D, folate and too much B6 may also affect nerves, strength or fall risk.
Can balance problems from vitamin deficiency be reversed?
Sometimes, especially if the deficiency is found early and treated. Long-standing nerve problems may take longer to improve or may not fully reverse.
Should I take B12 if I feel unsteady?
Ask your provider first. B12 may help if you are deficient but balance problems can have many causes that need evaluation.
When should I worry about balance problems?
Get medical help if balance problems are new, worsening, causing falls or come with numbness, weakness, dizziness, confusion, vision changes or trouble speaking.
