Although vitamin B12 is recognized as “water soluble”, it does not automatically eliminate in the urine but accumulates in several organs (liver, kidneys, bone marrow, etc.). Despite this, B12 deficiencies are widespread. We are talking about 39% of the general population, and much more among vegans, vegetarians and the elderly.

B12 is mainly present in foods of animal origin, meat, poultry, fish, eggs and dairy products, etc. It is an important vitamin, since it is necessary in particular for the metabolism of lipids and proteins. The synthesis of myelin (nerve sheath) also involves vitamin B12. One of the problems with this is that the manifestations of impairment are initially unspecific and rather mild:

  • Tiredness, weakness, appetite disturbances, loss of balance, sleep disturbances, etc.

However, if the B12 deficiency is not detected in time, some symptoms are serious and irreversible such as:

  • Disruption of the formation of neurotransmitters and hor   mones which can lead to mental and cognitive imbalances,
  • Increase in the level of homocysteine which can cause cardiac diseases, circulatory diseases (ex: vascular dementia),
  • Neurological damage that can cause tingling or inexplicable pain, coordination problems, etc.

In some cases, severe symptoms such as arteriosclerosis, infarction, stroke, paralysis, incontinence and many other symptoms may be associated with vitamin B12 deficiency.

When you reach your fifties and above, it is generally recognized that the risk of B12 deficiency is increased:

  1. The diet of the elderly is generally not very varied, their appetite is weak, and therefore the B12 intake is especially reduced.
  2. The elderly body has some difficulty absorbing B12 well. Atrophic gastritis affects approximately 10 to 30% of the elderly, and results in particular, in a decrease in gastric acidity, essential for the absorption of B12.
  3. Stress, cigarettes, alcohol and other drug use, high-dose coffee, high-dose sugar, and certain medications, including all antacids, Metformin, certain hormones, etc. are other factors decreasing the absorption of vitamin B12.

In conclusion, it is clear that the elderly should have an annual check of their B12 level, consume foods concentrated in B12 or enriched in B12, and/or take supplements which contain it. In more severe cases, some doctors will treat B12 deficiency with intramuscular injections. As a pharmacist, I would say that taking B12 orally is generally as effective as injections.

Do you want my opinion? I think that a dose of vitamin B12 orally between 1000 and 2000 mcg/day should be given automatically to all the elderly, considering that there is, to date, no case of toxicity caused by any dose of vitamin B12. Considering that B12 supplements are safe, effective, and inexpensive, how can we justify not recommending them to our patients? Thus, certain irreversible sequelae could be avoided.

Two Quebec nutritionists, Lucie Bergeron and Francine Pouliot, analyzed vitamin B12 concentrations in 126 elderly people when they were admitted to their CHSLD (CHSLD Ladouceur). The report is striking: 100% of patients in the dementia-related unit had a B12 level below 185 pmol/l, of which 43% had a rate of less than 110 pmol/l. For me, vitamin B12 deficiency is very underestimated and underdiagnosed.

In addition, Health Canada recommends that people over 50 consume foods fortified with vitamin B12 or take a vitamin B12 supplement. Foods rich in B12 are:

  • Meat, poultry, and in particular, organ meats (beef, veal, lamb) and rabbit.
  • Crustaceans and mollusks, especially oysters and mussels.
  • Fish, especially mackerel, sardines, trout, tuna.
  • Cheeses (emmental, camembert) and dairy products.
  • Eggs, but in less quantity.
  • Some soy or rice drinks are fortified.

N.B. : It is still recommended to reduce the consumption of red meat to only a few times a month. Therefore, other foods rich in vitamin B12 should be favored.

Consult the Nutrition Facts table on a food label to find out if it is fortified with vitamin B12. The purpose of an article like this is to prevent these relatively common deficiencies.

Are you sure you want to risk missing B12?

To ask the question, is to answer it…