The B vitamins benefit your body in a variety of ways, keeping eyes, skin, hair, and liver healthy, improving nerve function, and efficiently burning fat and creating energy. When it comes to nerve health, vitamin B12 is of special importance, with a proven impact on memory, cognitive function, and physical mobility.
Unfortunately, nearly half of all Americans have low levels of vitamin B12, with around 40 percent of people over 60 testing B12 deficient. The majority of these people do not realize they have this deficiency, as it is not a routine test. What’s more, the vitamin B12 supplements many people take are ineffective, as B12 is best absorbed sublingually (under the tongue). In other words, if you swallow a pill to supplement your B12 intake, you receive little benefit.
What is Vitamin B12?
Also known as cobalamin, due to the presence of the cobalt element, B12 works closely with B9, commonly known as folate or folic acid. Together, these vitamins help create red blood cells, help your body use iron more efficiently, and help produce your body’s building blocks, DNA and RNA. In addition, B9 and B12 help strengthen immune function and even help regulate mood. Another B vitamin, B6, joins them in controlling homocysteine levels, commonly associated with heart disease.
One of B12’s main functions is forming the protective sheath surrounding nerves, called myelin, as well as facilitating nerve function. This directly impacts communication between the brain and nervous system.
Diagnosing B12 Deficiency
The medical field in Japan and Europe considers a patient to have vitamin B12 deficiency if testing reveals levels below 500 pg/mL to 550 pg/mL. Meanwhile, the low end of “normal” in America is 200pg/mL to 350 pg/mL.
Many experts disagree with America’s low vitamin B12 deficiency threshold, recommending treatment for patients testing below 450 pg/mL, especially if these patients also present other B12 deficiency markers, such as elevated urinary methylmalonic acid, holotranscobalamin, and/or homocysteine.
Some researchers speculate that Japan’s lower rates of dementia and Alzheimer’s disease may be due, in part, to its standards for B12 deficiency.
Certain groups are significantly more likely to suffer from vitamin B12 deficiency. Topping this list is vegetarians and vegans, as vitamin B12 is only found in animal products. Some sources claim you can find B12 in certain plant-based foods, such as seaweed and brewer’s yeast, but this is incorrect. What’s more, the B12 analogs found in these plant-based supplements (called cobamides) actually increase the body’s need for vitamin B12 while simultaneously blocking its ability to absorb it. In other words, ingesting bogus, plant-based B12 actually makes your vitamin B12 deficiency worse than if you had done nothing at all.
Vegan children, in particular, suffer from B12 deficiency, even if they eventually incorporate animal products into their diets. Studies reveal that vegan children experience issues on memory tests, spatial abilities, and fluid intelligence. This does not mean you cannot follow a vegan or vegetarian lifestyle. What it does mean is that you must take a true vitamin B12 supplement.
Other groups at increased risk for B12 deficiency include people who:
- Are over age 60
- Have a history of miscarriage and/or infertility
- Have certain digestive issues, such as celiac, Crohn’s disease, IBS, and ulcerative colitis
- Regularly use acid-suppressing medications or PPIs
- Take certain diabetes drugs, such as metformin
The Symptoms of Vitamin B12 Deficiency
The signs of B12 deficiency occur over time, often leading to delayed diagnosis, especially when testing is not performed. Many of these symptoms mimic other health issues, including:
- Common signs of aging, such as memory loss, cognitive decline, Alzheimer’s, and dementia
- Cardiovascular disease
- Autoimmune disease
- Mental health issues, such as anxiety, depression, and bipolar disorder
How do these symptoms manifest? Physical symptoms that patients may experience include:
- Bleeding gums
- Heart palpitations
- Lack of appetite
- Mouth sores
- Muscle weakness
- Neuralgia, numbness, and/or tingling
- Shortness of breath
Diagnosing and Treating Vitamin B12 Deficiency
If you belong to one of the high risk groups, or experience any of the symptoms of vitamin B12 deficiency, talk to your doctor about performing a B12 test. If your insurance refuses to cover it, you may order a home test kit for around $60.
For patients with advanced B12 deficiency, treatment should include B12 injections. Remember, the body struggles to absorb vitamin B12 in pill form, making injections the most effective means of correcting a deficiency.
Some patients require regular B12 injections that will continue throughout their lives. If you suffer from digestive disorders such as Crohn’s disease, you likely fall under this category.
If you want to take an oral supplement, remember to look for one that dissolves in your mouth, rather than one you swallow whole. The type most commonly seen is cyanocobalamin, but this is not the best B12 supplement. Instead, look for hydroxycobalamin or methylcobalamin.
If you’d like more information on vitamin B12, vitamin deficiencies, or testing, contact the team at Clancy Medical Group or work directly with your healthcare provider.