Paleo Diet News: Low Vitamin B12 Can Mimic Dementia

A friend sent me this interesting article which was in the NY times last month: It Could Be Old Age, Or It Could Be Low B12.  It’s a reminder that low levels of this essential nutrient can create symptoms suggestive of other problems.  In fact, low vitamin B12 can mimic dementia and accelerated aging.

From the article:

Ilsa Katz was 85 when her daughter, Vivian Atkins, first noticed that her mother was becoming increasingly confused.

“She couldn’t remember names, where she’d been or what she’d done that day,” Ms. Atkins recalled in an interview. “Initially, I was not too worried. I thought it was part of normal aging. But over time, the confusion and memory problems became more severe and more frequent.”

Weekly B12 injections were begun. “Soon afterward, she became less agitated, less confused and her memory was much better,” said Ms. Atkins. “I felt I had my mother back, and she feels a lot better, too.”

Now 87, Ms. Katz still lives alone in Manhattan and feels well enough to refuse outside assistance.

Still, her daughter wondered, “Why aren’t B12 levels checked routinely, particularly in older people?”

Why indeed, especially since B12 deficiency is a real likelihood amongst the elderly and followers of particular types of diet.  These can result in low vitamin B12 blood levels:

 Natural plant sources are meager at best in B12, and the vitamin is poorly absorbed from them. Many strict vegetarians and all vegans, as well as infants they breast-feed, must consume supplements or fortified breakfast cereals to get adequate amounts.

Certain organisms, like the bacterium Spirulina and some algae, contain a pseudo-B12 that the body cannot use but may result in a false reading of a normal B12 level on a blood test. Despite claims to the contrary, laver, a seaweed, and barley grass are not reliable sources of B12.

In animal foods, B12 is combined with protein and must be released by stomach acid and an enzyme to be absorbed. Thus, chronic users of acid-suppressing drugs like Prilosec, Prevacid and Nexium, as well as ulcer medications like Pepcid and Tagamet, are at risk of developing a B12 deficiency and often require a daily B12 supplement.

Stomach acid levels decline with age. As many as 30 percent of older people may lack sufficient stomach acid to absorb adequate amounts of B12 from natural sources. Therefore, regular consumption of fortified foods or supplementation with 25 to 100 micrograms of B12 daily is recommended for people over 50.

The take away messages here are:

  • Make sure you’re getting enough B12 in the diet - animal foods are the only source of bioavailable B12
  • If you suspect you or someone you care about has low vitamin B12, have your levels checked - supplementation may be necessary
  • If supplementation is necessary, bear in mind that you may need to take more than the body normally requires, in order to make up for the deficiency.

An enlightened doctor can advise on dosages.  The article points out:

Although most doctors are quick to recommend injections to correct a B12 deficiency, considerable evidence indicates that, in large enough doses, sublingual (under-the-tongue) tablets or skin patches of B12 may work as well as injections for people with absorption problems, even for those with pernicious anemia.

Most often, a daily supplement of 2,000 micrograms is recommended for about a month, then lowered to 1,000 micrograms daily for another month, then lowered again to 1,000 micrograms weekly.


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Brian Cormack Carr is a freelance writer and coach whose mission in life is to help YOU do what you were designed for.
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