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Am I getting enough vitamin B12?

Friday April 15, 2022
Am I getting enough vitamin B12?

Despite being a key nutrient in helping our bodies to function, vitamin B12 deficiency is more common than you think. Read our essential guide to explore the reasons and learn how to manage and address vitamin B12 shortfalls.

  • Vitamin B12 performs essential functions in your body and is vital for maintaining brain health, nerve function, a healthy heart and the formation of red blood cells.

  • The National Institute for Health and Care Excellence states that vitamin B12 deficiency is prevalent in approximately 6% of the population under the age of 60 years, rising to 20% for those over 60 years.

  • Individuals following a vegan diet, or have gastrointestinal disorders, poor pancreatic function, malabsorption issues or undergone bypass surgery may struggle to achieve good vitamin B12 status.

  • Studies have shown vitamin B12 deficiency can be reversed with B12 specific food supplements.


How common is vitamin low vitamin B12?


The statistics


The National Institute for Health and Care Excellence states that vitamin B12 deficiency is prevalent in approximately 6% of the population under the age of 60 years. However, this sharply rises to 20% of those aged 60 years and over.


Ageing


As we age, our body becomes less efficient in absorbing vitamin B12. The mechanism by which vitamin B12 is absorbed into circulation is dependant on a digestive protein called intrinsic factor. During ageing, the gastric secretions that provide intrinsic factor decrease and so does vitamin B12 absorption.


Lack of vitamin B12 in plant-based foods


A further factor is that vitamin B12 is only naturally occurring in animal derived foods and must be fortified into non-animal derived foods. This means that those that eat little, or no animal derived foods would not absorb any vitamin B12. Startlingly, total vitamin B12 deficiency is fatal and to address this, the body can produce very small amounts via bacterial fermentation in the large intestine. However, this is not considered reliable, and so, consumption, fortification or supplementation would be necessary.


Who is at risk of low vitamin B12?


An important aspect to be aware of is that a vegan diet does not provide any vitamin B12, and vegetarian diets may also provide suboptimal quantities. Other people that may struggle to achieve a good vitamin B12 status are those with gastrointestinal disorders, poor pancreatic function, malabsorption issues or have undergone bypass surgery. In addition, some medications block the absorption of vitamin B12, such as proton pump inhibitors.


How much vitamin B12 do you need?


Public Health England recommends a minimum intake of 1.5 micrograms for adults in the UK. When compared to food supplements this is a fraction of what they offer. This is because Public Health England recommend the bare minimum to ward off deficiency, in fact this quantity may even be too little for those with existing health issues.


To put this into perspective, one egg would provide 0.5mcg of vitamin B12 (a third of the minimum daily intake), while liver is the most vitamin B12 dense food and a 75g serving would provide an incredible 71mcg of vitamin B12.


What are the signs of low B12?


There is a long list of symptoms that can occur in vitamin B12 deficiency and they may include: sore tongue, lethargy or fatigue, weakness, loss of nerve function that reduces sensations, makes movement difficult and contributes to poor organ function. Other symptoms may involve visual disturbances and memory loss.


It is important to appreciate that total vitamin B12 deficiency is fatal. If you are experiencing several of the symptoms of vitamin B12 deficiency it is advisable to seek a diagnosis from your GP.


What foods are rich in vitamin B12?


A common characteristic of water-soluble vitamins is that they are not stored in the body - this means that they are needed regularly. Adding vitamin B12 rich foods to your daily meals will support your intake of the nutrient. Among B12 rich foods are:

  • Lamb liver

  • Clams

  • Tuna

  • Salmon

  • Beef

  • Milk

  • Yogurt and cheese

  • Eggs

  • Turkey

  • Fortified foods, such as nutritional yeast and cereals


Can taking supplements help reverse vitamin B12 shortfalls?


Although commonly considered a nutrient solely for vegans, achieving a good absorption rate of vitamin B12 can be an issue for many. Subsequently, studies have not only investigated the beneficial effects of vitamin B12 on health but also the best methods of reversing a deficiency. This has led researchers to investigate consumption of vitamin B12 supplement as a standalone liquid or capsule format as well as combined with other nutrients.


The Beyond Ageing Project investigated the administration of vitamin B12 and folic acid on the cognitive and depressive symptoms in older adults. The supplemental nutrients were taken for a 2-year period and cognitive measures were taken at 12 months and 24 months. Overall cognitive functioning was reported to improve especially in immediate and delayed memory performance.


The British Journal of Clinical Pharmacology published a study that compared sublingual (taken under the tongue) vitamin B12 against oral B12 in reversing vitamin B12 deficiency. The participants each had low blood concentrations of vitamin B12, they were randomly required to take 500mcg of vitamin B12 either sublingually, orally or as part of a B complex. Each of the supplementation types were equally effective in raising vitamin B12 concentrations when used daily for 4 weeks.


In a similar fashion a study published in the Journal of Clinical Therapy compared the efficacy of a daily oral vitamin B12 supplement to intramuscular vitamin B12 (administered via an injection into a muscle). The participants were either on a restricted diet or had gastrointestinal abnormalities. Following 60 days of treatment both those receiving oral and intramuscular vitamin B12 had improved vitamin B12 concentrations that indicate oral supplementation performed comparably to intramuscular B12.


Where do I go for food supplements?


Local independent health stores are a great starting place for food supplements as staff are often trained and can provide you with advice on your individual needs. When choosing high quality supplements check the label and ensure they contain 100% active ingredients and no binders or fillers. To find your nearest health store, visit: www.findahealthstore.com.


References

Castelli MC, Friedman K, Sherry J, Brazzillo K, Genoble L, Bhargava P, Riley MG. Comparing the efficacy and tolerability of a new daily oral vitamin B12 formulation and intermittent intramuscular vitamin B12 in normalizing low cobalamin levels: a randomized, open-label, parallel-group study. Clin Ther. 2011 Mar;33(3):358-371.e2. doi: 10.1016/j.clinthera.2011.03.003.


Sharabi A, Cohen E, Sulkes J, Garty M. Replacement therapy for vitamin B12 deficiency: comparison between the sublingual and oral route. Br J Clin Pharmacol. 2003 Dec;56(6):635-8. doi: 10.1046/j.1365-2125.2003.01907.x.


Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M, Kljakovic M, Crisp D, Christensen H. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms--the Beyond Ageing Project: a randomized controlled trial. Am J Clin Nutr. 2012 Jan;95(1):194-203. doi: 10.3945/ajcn.110.007799. Epub 2011 Dec 14.


The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.

 

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