As You Age, Be Aware of B₁₂ Deficiency

Are you short on stamina? Is your memory fuzzy? Don't assume it's just part of aging. Feeling tired, in a funk, or confused can point to problems you can solve.

One of those problems lies in your nutrition. You could be low on vitamin B₁₂.

This essential nutrient helps make DNA, the genetic material in your body's cells. You also need the vitamin to maintain red blood cells and nerve cells. Along with mental cloudiness, getting too little vitamin B₁₂ may lead to numbness or tingling in your hands and feet.

How much B₁₂ should you get? Experts recommend 2.4 mcg of vitamin B₁₂ a day. Pregnant or lactating women need slightly more per day. 

Plenty of sources

Meeting that goal usually isn't a problem. Food sources include clams, fish, beef, and dairy foods.

But if you're taking a variety of medications for chronic conditions or if you're a strict vegetarian, you're at risk for a deficiency. Perhaps you're not eating as well as you used to. That, too, can lead to a B₁₂ shortfall.

Part of the challenge in meeting your need for B₁₂ is the vitamin's unique structure. You may take in enough B₁₂, but your body must go through a series of steps to process it. As you age, one or more of the steps may break down.

Typically, a low B₁₂ level is not from a dietary deficiency, but instead from the body's inability to process it. The vitamin is bound to the protein you eat, and you need stomach acid to release it. If you're taking antacids or other medications to reduce stomach acid, your body can't absorb the B₁₂.

One common drug used to treat diabetes, metformin, hinders vitamin B₁₂ absorption. A change in bacteria that live in the body, common with age, can also cause less B₁₂ to be absorbed.

Intrinsic factor

In addition, your body makes a substance called intrinsic factor, which must be present for vitamin B₁₂ absorption. Without intrinsic factor, you're at risk for pernicious anemia, a severe lack of red blood cells. Elderly people are unable to produce sufficient amounts of intrinsic factor.

Fortunately, a vitamin B₁₂ deficiency can be detected and treated. Screening tests are available. Dietitians recommend you give your health care provider a food diary showing what you eat in an average week. A decrease in appetite is sometimes indicative of a B₁₂ deficiency.

Along with checking your B₁₂ levels, here are some steps you can take:

• Talk to your health care provider or a dietitian about ways to increase your vitamin intake.

• Eat smaller, more frequent meals. Include yogurt or a glass of milk as part of these mini meals.

• Make fortified breakfast cereal—a great source of vitamin B₁₂—part of your morning or bedtime routine. The vitamin B₁₂ in fortified foods is not bound to protein, so you don't need stomach acid to absorb it.

• Read labels. On packaged foods, vitamin B₁₂ is shown as a percent of the Daily Value (DV), which describes recommended levels of a nutrient. Foods that are high in vitamin B₁₂ provide 20 percent or more of the DV for the vitamin. Fortified cereals, for example, may offer 25 to 100 percent of the DV for vitamin B₁₂.

• Ask your doctor if vitamin supplements are right for you. Supplements are an excellent source of B₁₂ for people older than 50. For the best absorption, take vitamin B₁₂ with meals.