With September being Healthy Aging Month, we are featuring a post from guest writer Ellen Troyer on the importance of Vitamin b12 in healthy aging.
Vitamin B12 deficiency is a common condition in the elderly, as well as in many of us over the age of 50. It is repeatedly overlooked in spite of multiple clinical manifestations that affect the blood, neurological, gastrointestinal, and cardiovascular systems, as well as skin and mucous membranes.
B12 deficiency is linked to fragility and falls projected by the Centers for Disease Control and Prevention to become responsible for more than 40 billion dollars annually in U.S. government health care costs by the year 2020.
This deficiency is also linked to cognitive impairment and geriatric nutritional syndromes such as protein-energy malnutrition and failure to thrive.
We’re not sure why B12 shots for the elderly fell out of favor, but it may be time to reconsider the need. We recommend increasing the daily amount of oral supplemental B12, since deficiency is a pandemic in older adults due to age-related decreased production of gastric intrinsic factor necessary for absorption of vitamin B12 in the small intestine.
Intrinsic factor is a glycoprotein produced in the stomach. A number of studies suggest that B12 deficiency can cause irreversible damage to the brain and nervous system at levels only slightly lower than normal. Symptoms include fatigue, depression and poor memory. Unfortunately, these symptoms are too often immediately treated with pharmaceutical drugs without micronutrient deficiency consideration.
B12 refers to cobalt-containing compounds known as cobalamins, including cyanocobalamin, an artificial form of B12 from activated charcoal included in most vitamin supplements, as well as the natural downstream metabolite of cyanocobalamin called methylcobalamin, which has a much higher absorption rate, and the type of vitamin B12 included in Biosyntrx multiple vitamins, Macula Complete and Oculair.
Dietary B12 is only available from meat, fish, shellfish, poultry and milk. This is bad news for vegans unless they religiously take B12 supplements or consume a lot of B12 fortified foods, which most vegans don’t.
Vitamin B12 plays a significant role in the metabolism of every cell of the body, including DNA synthesis, fatty acids synthesis and energy production. Given these facts, hopefully the designers of the AREDS3 formulation will acknowledge that micronutrient symphonies perform best when all the players show up, particularly considering that fewer than 10 percent of the population consume even five servings of fruits and vegetables a day, and a large number of older folks don’t understand that they still need to take a well-designed daily multiple vitamin when taking an AREDS study formulations.
Vitamin B12 safety
The Institute of Medicine (IOM) has never established a safe upper limit (UL) for vitamin B12 because of its low potential for toxicity. However, it does interact with some prescription drugs, but far more often prescription drugs increase the risk of B12 deficiency with the most concerning being Metformin, a hypoglycemic agent used to treat type 2 diabetics, now reaching epidemic proportions in this country.
Small studies suggest that up to 30 percent of people who take metformin become B12 deficient and this deficiency is strongly associated with diabetic neuropathy, diabetic retinopathy and macular edema in type 2 diabetics.
Dementia and cognitive function associated with B12 deficiency
Vitamin B12 deficiency causes an accumulation of homocysteine in the blood and is suggested to decrease levels of substances needed to metabolize neurotransmitters.
Observational studies show positive association between elevated hymocysteine and the incidence of both Alzheimer’s and dementia. Low vitamin B12 status has also been positively associated with cognitive decline.
The IOM RDA for vitamin B12 for those 14 and older is only 2.4 mcg per day, which is well, well below the amount considered therapeutic.
Ellen Troyer, with Spencer Thornton, MD, and the Biosyntrx staff
PEARL: B12 deficiency is easily cured in most people. Although it was once thought oral B12 was not readily absorbed, we now know the oral absorption rate from the natural methylcobalamin form of supplemental B12 is much higher than the synthetic cyanocobalamin included in most multiple vitamins. So before you fill the script you received from a doctor too busy to test your B12 level before recommending the antidepressant du jour, request a B12 blood test. The results might surprise you both, and the treatment side effects can improve overall health, increase energy and elevate mood.
References for today’s Friday Pearl column, plus a surgical instrument announcement from our friends at Crestpoint Management can be found here.
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