The current medical consensus is that most people, if they eat well, don’t need to take any vitamins at all. But Vitamin B12, like Vitamin D, is an exception. If you want to take any vitamins at all, Vitamin D and Vitamin B12 are the ones most valuable for most people.
Vitamins are chemicals that our body needs, but we cannot produce these chemicals ourselves. So we must consume vitamins— through either our diet or by supplementation.
Vitamin B12 is a rather complicated vitamin, and is picky about how it is absorbed in the gut. If there is not enough acid in a person’s stomach, the person will not absorb Vitamin B well. Stomach acid is needed to break apart the vitamin B12 compound that comes attached to proteins in the food. The acid breaks apart that bond, to liberate the B12 so it can be absorbed.
The silent epidemic
And here is the silent epidemic: between 10 to 30% of people over the age of 50 (and even younger) don’t produce enough stomach acid for B12 to be well absorbed. Acid production goes down as we age, and beyond that, many people suppress their acid production with medications like the “proton pump inhibitors” (Prilosec and others). Especially people who take these medications long term run a risk of B12 deficiency.
Symptoms of B12 deficiency
The symptoms in Vitamin B12 deficiency usually appear slowly over many years, and might seem like normal aging. But it is not; the symptoms are from a lack of this critical vitamin, especially necessary for good brain and nerve function. People in later stages of B12 deficiency may present with depression, cognitive slowing, even dementia or psychosis (after years of serious deficiency). Earlier symptoms include fatigue, tingling in arms or legs, numbness, and muscle weakness. Most people, and many doctors, don’t initially think of a vitamin deficiency as the cause.
Food sources of Vitamin B12
This is a rather unique vitamin in that it is found mostly in animal and fish protein sources, including meat, eggs, milk, cheese, along with fish. It is not found in fruits or vegetables, so vegetarians have a higher risk of B12 deficiency, and vegans even more.
Recommendation for Vitamin B12 supplementation
Because so many people are at risk for Vitamin B12 deficiency, the National Academy of Medicine (USA) has recommended that adults over the age of 50 get most of their B12 intake from supplements. This could be food supplemented with the vitamin (such as some cereals) or vitamin pills. These synthetic (non-dietary) sources are recommended, since from these sources, Vitamin B12 is already in a liberated form, and does not need stomach acid to release it.
Dose of Vitamin B12
A person can be diagnosed with a B12 deficiency by a blood test, and those with severely low levels will need B12 intravenous infusions improve. If your doctor diagnoses a deficiency on a blood test, he will tell you the dose to take. For most adults, as a daily maintenance dose to prevent a deficiency, 500 to 1000 micrograms is about right for most people. Mega-doses should be avoided.
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