Vitamin B12 Deficiency

Vitamin B12 is essential for the proper development of our red blood cells and nervous system.  Vitamin B12 deficiency can ultimately result in a blood disorder known as anemia (pernicious anemia) which can cause permanent and severe nerve and brain damage.  High vitamin B12 level in elderly individuals may protect against brain atrophy or shrinkage, associated with Alzheimers disease and impaired cognitive function.

Vitamin B12 is known as a complex vitamin for a reason – it’s not easy for the human body to separate the complex B vitamins from their food sources so that they can be absorbed through the intestines.  For this reason vitamin B12 deficiency & low levels of vitamin B12 have been shown to affect nearly half of all people.

B12 needs to be freed from the proteins in food before it can be absorbed by the body.  This takes place in both the stomach and small intestine with gastric acid.  Once the B12 is released from the proteins in food, the body secretes a protein in the stomach that allows for the absorption of vitamin B12.  People with pernicious anemia are not able to secrete this protein in their stomach thus drastically inhibiting their ability to absorb  B12.  Because of the body’s difficulty in absorbing B12  through the stomach, vitamin B12 injections are used to deliver the vitamin directly into the patient’s bloodstream, therefore bypassing the stomach and resulting in much more efficient absorption.  This is the only way B12 can be absorbed by people with pernicious anemia but its a very effective method for anyone with a vitamin B12  deficiency.

Aside from maintaining healthy red blood cells and nervous system, vitamin B12 is needed in order for our bodies to absorb folic acid (also known as vitamin B9) which helps release energy.   Vitamin B12 normally plays a significant role in the metabolism of every cell of the body allowing for energy production which is why taking vitamin B12 for energy is so popular.

People at risk for Vitamin B12 Deficiency:

  • Older Adults who have Atrophic Gastritis - A condition affecting 30-50% of adults over age 50 and hampers their ability to absorb vitamin B12 from natural foods. Supplements are recommended for people in this group.
  • People with Pernicious Anemia - This condition where the intestines cant produce the enzyme that allows for vitamin B12 absorption.  This condition only affects 1-2% of adults and can only be treated with vitamin B12 injections or shots.
  • Vegans and Vegetarians - Because vitamin B12 is naturally found in animal products, vegans are especially at risk of not getting enough vitamin B12 in their diet.  There are some natural vegetarian foods high in vitamin b12 but vitamin B12 supplements could make sense for this group.
  • People taking Certain Medications
    • Proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), which are used to treat gastric or pepetic ulcer disease can inhibit absorption of vitamin B12 .
    • Metformin often used for type II diabetes, may interfere with vitmain B12 absorption in certain people.
    • Histamine antagonists, such as cimetidine (Tagamet®), famotidine (Pepcid®), and ranitidine (Zantac®), used to treat peptic ulcer disease, can reduce absorption of vitmain B12  by slowing the release of hydrochloric acid into the stomach.
    • Bacteriostatic Antibiotics, like Chloramphenicol (Chloromycetin®), can interfere with the red blood cell response to vitamin B12 supplements.
    • Anticonvulsants Anticonvulsants have been shown to interfere with vitamin B12 and vitamin B9 (Folate) metabolism. One study found that people taking folate supplements and anticonvulsants experienced a 50% decline in Vitamin B12 blood levels.
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