Vitamin B12 deficiency: Often underdiagnosed and overlooked


Vitamin B12 has a good reputation as a quick way to increase energy and improve wellbeing, but its benefits go far beyond that. It’s an essential nutrient needed for proper development and performance of the central nervous system, formation of healthy red blood cells, synthesis of DNA and other functions.

Unfortunately, many people are deficient in the nutrient and the deficiency is underdiagnosed and often overlooked – particularly in seniors. Up to 20 percent of Americans over the age of 60 in the United States are lack sufficient B12 and many of them don’t know it.

Dr. Michael Weir, director of the Biomedical Science program at Keiser University’s Port St Lucie campus, said that in addition to the aging process, diets can be a culprit in lack of the vitamin. “Keto and vegan diets have high potential to cause vitamin B12 deficiency,” he said. “We need red meats and animal products to get necessary levels.

“On the other end of the dietary scale, our carb-heavy American diet has a negative effect as well. Too many carbohydrates can deplete our body’s storage of B12.”

The list of B12 deficiency symptoms is long and may surprise you. According to Dr. Weir, the most common symptoms are numbness or tingling in fingers or toes, pale skin, fatigue, depression, balance issues and mood swings.

According to Better Health While Aging Newsletter, the deficiency is often missed because these symptoms are common in older adults and may have other causes. Also, the impact of B12 deficiency tends to come on slowly, with gradually increasing symptoms, which makes it harder to pinpoint. But it will almost always get worse over time unless treated.

According to Johns Hopkins University, you’re at highest risk if you have a family history of the deficiency, have had part or all your stomach or intestine removed, or have an autoimmune disease such as Type 1 diabetes, Crohn’s disease or HIV.

In order to be available for absorption, B12 must be freed from the protein to which it is attached. This takes place in the stomach, where hydrochloric acid severs the bonds. The vitamin is then combined with another protein made by the stomach that the body can absorb.

But changes in digestion as people age, including a decrease in stomach acid production, can reduce the body’s ability to absorb B12. Regular use of antacids and ulcer medications also can interfere with absorption. And according to Harvard’s T.H. Chan School of Public Health, vitamin B12 is a water-soluble vitamin, so any unused amount will exit the body through the urine, leaving little reserve.

Many doctors do not routinely test for vitamin B12 deficiency. But if you suspect that you may be deficient in this important nutrient, experts say you should discuss it with your healthcare provider and request a test.

Healthline’s list of foods that are the best sources of vitamin B12 include:

• Animal liver and kidneys
• Clams
• Sardines
• Beef
• Fortified cereal
• Tuna
• Fortified nutritional yeast
• Trout
• Salmon
• Fortified nondairy milk
• Milk and dairy products
• Eggs

Because of food choices or physical limitations, some people need vitamin B12 supplements to maintain the suggested recommend level. According to Mayo Clinic, when taken at appropriate doses, vitamin B12 supplements are generally considered safe. While the recommended daily amount of vitamin B12 for adults is 2.4 micrograms, higher doses have been found to be safe.

It’s common to start treatment for a significant vitamin B12 deficiency with weekly intramuscular shots. This bypasses any absorption problems in the stomach or intestine and is a good way to get an older person’s vitamin B12 level back to normal quickly.

Your doctor may also recommend additional tests or investigation to find out the cause of the deficiency.

Dr. Michael Weir earned a B.S. in Pre-Med/Biology in 1985 from Saint Augustine’s University in Raleigh, North Carolina, and an M.S. in biological sciences with a concentration in biotechnology from the University of Massachusetts-Lowell in 1989.

After serving as a research associate at Massachusetts General and Brigham and Women’s hospitals in Boston for one year, he was admitted to medical school at New York Medical College in 1990 and graduated in 1995 with an M.D., followed by a four-year residency in obstetrics and gynecology at Bronx-Lebanon Hospital Center in New York. After his residency. Dr. Weir decided to enter the world of academia to help develop future biomedical healthcare professionals. He has lectured extensively in the areas of biochemistry, genetics, molecular biology, immunology, pathology and the biology of cancer.

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