Mira Ilac, MS, RDN, LD is a registered dietitian nutritionist in the department of gastroenterology, hepatology and nutrition at Cleveland Clinic. ClevelandClinic.org
Replacing B-12 in people who are deficient may improve their cognitive function, according to a recent study in Cureus Journal of Medical Science. Of the 202 participants, 84% reported that having their B-12 deficiency treated first with infusions and then with daily oral supplements for three months led to a significant improvement in their energy, concentration, memory loss and disorientation… and 78% had improved scores on the Mini-Mental State Exam (MMSE), which evaluates memory, attention and language. Even among those who said their symptoms didn’t improve, more than half did better on the MMSE.
Brain function is just one of B-12’s roles, along with helping red blood cell production and DNA synthesis. A B-12 deficiency can cause demyelination, loss of the outer sheath of neurons, which helps explain the tingling and numbness in the hands, feet and legs. These symptoms may not show up for a few years and may be accompanied by concentration problems, memory loss, disorientation and, over time, confusion and depression.
Causes of B-12 deficiency: Some medical conditions put you at risk for B-12 deficiency—the autoimmune disease pernicious anemia…diseases that affect the small intestine (where B-12 is absorbed), such as Crohn’s and celiac disease… long-term use of PPIs for acid reflux…taking metformin for diabetes and colchicine for gout…resectioning of the stomach or terminal part of the small intestine…and weight-loss surgery. Because foods highest in B-12 are animal-based, being vegan or vegetarian can cause a deficiency.
Simply getting older also can increase incidence of the naturally occurring condition atrophic gastritis, when the stomach fails to produce enough of the acids needed to extract B-12 from food before it reaches the intestines. This condition may affect about 30% of people over age 50, and the likelihood increases with age.
B-12 to the rescue: Problems caused by a deficiency may be reversed by restoring B-12 levels through diet, supplements and/or injections. Treatment is most effective when the deficiency is caught early. People at risk should have their B-12 levels checked regularly.
To prevent a B-12 deficiency: Adults generally need 2.4 micrograms of B-12 daily. Top sources include beef liver, clams, bluefin tuna, Atlantic salmon, milk, yogurt and eggs, fortified cereals and other enriched foods. Synthetic supplements are effective for people who can’t absorb the B-12 in food.
Work with your doctor to determine what’s best for you based on your bloodwork, health and medications you’re taking. You also may need the B vitamin folate, which works in tandem with B-12.