Vitamin B12 deficiency becomes more common when we age. How can seniors make sure they maintain optimal B12 levels? Let’s take a look at the research.
Vitamin B12 is essential for the formation of red blood cells, DNA synthesis, the function and development of brain and nerve cells, bone health,and overall energy and mood. It is not made by the body and the best sources of it are fish, shellfish, organ meat (liver), red meat, eggs, poultry, milk, cheese, dairy, fortified cereals and nutritional yeast, and enriched soy or rice milk. If relying on cereals and nutrition yeast for your B12, it is important to verify that they are fortified, as it’s not always the case. There are also plant based foods, such as dried green and purple lavers (nori), that contain B12, but they would have to be consumed in substantial quantities in order to meet the recommended dietary allowance (RDA) of 2.4 micrograms. B12 is a water-soluble vitamin, so any excess not being used will be excreted through urine.
It is estimated that vitamin B12 deficiency is present in approximately 10% to 15% of the population over age 60. There are a variety of causal factors for this, including the depletion of B12 as a side effect to certain medications, decreased digestive enzyme production with aging, which makes digestion and absorption of B12 and other supplements more difficult, malnutrition as a result of poor diet, a plant-based diet without sufficient supplementation, and a variety of other medical factors. The deficiency goes largely unrecognized because the clinical symptoms are often varied, non-specific, and subtle. The consequences if left untreated, however, can be quite serious. Diagnosis of vitamin B12 deficiency is not always straightforward, as some deficient people show normal levels in blood tests. Homocysteine and methylmalonic acid tests are more sensitive for B12 deficiency, though there are inconsistencies in this testing as well. One study contends that all people over 65 years of age who are malnourished in institutions or psychiatric hospitals should be tested for B12 deficiency.
Many of the signs of B12 deficiency are also indicative of other health issues, so it is important to speak with your healthcare provider about your symptoms and concerns. Fatigue is very common with B12 deficiency and it can cause megaloblastic anemia, a condition of larger than normal sized and smaller amounts of red blood cells due to low B12 in diet or poor absorption. Paresthesia in hands and feet, often referred to as pins and needles, is not uncommon in B12 deficiencies. Other symptoms include gastrointestinal issues like bloating, constipation, nausea, and diarrhea; depressive symptoms, memory loss, confusion, and pale yellow skin.
Since B12 is primarily derived from food sources that come from animals, people who do not eat meat, fish, poultry, or dairy (vegetarians and vegans) should include fortified foods like nutritional yeast or cereal or a B12 supplement in their diet. A common risk factor in people over 50 is inadequate stomach acid or decreased stomach acid due to medication. People who take H2 blockers, proton pump inhibitors, or antacids may have difficulty absorbing B12 from food. Intestinal surgeries that affect the stomach or the ileum may also impact B12 absorption. This study contends that chronic alcohol abusers may also be B12 deficient.
In this study, immediate and delayed recall tests, verbal fluency tests, and letter search tests were administered to subjects ages 45-69 at the beginning and end of the study period. Participants with the highest levels of folate scored the best on verbal fluency and immediate recall test. High vitamin B12 levels were also associated with better word recall and higher verbal fluency scores. Though more research is necessary, B12 supplementation has proven to be beneficial to normal functioning of the brain and nervous system, cognitive functioning, normalizing red blood cell production, and even just a welcome boost to energy levels and moods.
Most healthy people under age 50 can easily reach the RDA of 2.4 micrograms of B12 by eating a normal diet. After that, people should make a conscious effort to get as much B12 in their diet as possible and to seek supplementation, especially if you are over 60 since absorption can be more challenging. It is important to check your B12 levels and discuss them with your physician, particularly if you are experiencing any of the potential systems of B12 deficiency. The good news is diet and supplements can usually do the trick. Look for a high quality product like Care/of’s vitamin B12, The Energizer, or B-complex, The Busy B’s, to meet your supplement needs.
Side effects from taking B12 are very rare. If you experience any kind of allergic reaction, seek medical help immediately. Otherwise, little more than occasional muscle pain, itching, or tingling at the site when getting B12 injections have been reported.
Vitamin B12 deficiency is not uncommon in people over 60 years old. It’s largely a byproduct of aging, though it can be exacerbated by medical conditions, diet, and lifestyle choices. Once you reach age 50 you should be more conscious of the amount of B12 in your diet and become aware of potential symptoms of deficiency. (If you’re vegetarian or vegan, you should always be aware of the possibility of B12 deficiency in your diet, regardless of age.) B12 supplementation is fairly straightforward, but lack of absorption can actually be the problem. Communication with your physician or healthcare provider is key to maintaining an adequate level of B12 as part of a healthy lifestyle.