Feeling sluggish? Check your B-12 level
Talk to a doctor before starting supplements
When baby boomers have trouble remembering words or feel sluggish even after plenty of exercise and rest, low levels of vitamin B-12 might be to blame.
As people age, they are more likely to have a B-12 deficiency. One out of every 31 people over 50 has B-12 levels lower than recommended, the Centers for Disease Control and Prevention has reported.
B-12 plays an important role in brain function and the nervous system and helps make red blood cells, says Dr. David Scrase, an internist and geriatrics specialist with Presbyterian Medical Group.
Low B-12 can masquerade as ailments like dementia, making diagnosis crucial to rule out other problems.
“For people who have dementia, we always check B-12 levels,” says Dr. Denise Leonardi, director of Lovelace Health Plan and a primary care doctor who used to practice in Las Cruces.
Scrase recently saw a patient in her 60s who had experienced memory loss for about 10 years. As it turned out, her symptoms were caused by a B-12 deficiency. When B-12 is the cause of dementia, the symptoms are reversible, although Scrase warns that only about 2 percent of dementia cases fall into that category.
Given its many roles in the body, low B-12 can cause multiple problems. Without enough B-12, an anemia called megaloblastic anemia can develop. A B-12 deficiency can cause fatigue, loss of appetite, weakness, depression, confusion and balance problems, according to the National Institutes of Health Office of Dietary Supplements.
When blood tests show enlarged red blood cells, Scrase tests for B-12 deficiency. He also tests for B-12 when patients have memory loss, gait problems or numbness and tingling.
Many patients have low B-12 for years before symptoms emerge, because B-12 is stored in large quantities in the liver.
“We only need five micrograms of vitamin B-12 a day but the body stores about a thousand times that much,” Scrase says. “If something went wrong, it can take years to figure out.”
MaryVee Cammack, 61, a former patient of Leonardi’s, has taken B-12 on and off since 2004. She was tested for B-12 deficiency after Cammack reported feeling rundown and tired all the time. She was not anemic and had no thyroid problems.
“I had no energy,” she says. “I was just very drained.”
After she started taking B-12, her symptoms improved within about a week.
“I could tell really soon that I was feeling better,” she says. “I remember thinking, ‘This is weird. Why am I feeling better? It must be the B-12.’”
Thinking back on her symptoms, Cammack says she also had trouble remembering words. She has continued to take B-12.
Most people get enough B-12 from foods like meat, dairy and eggs. But as people age, they may absorb B-12 less effectively. As people age they can develop atrophic gastritis, which decreases acid production, Leonardi says. That means there is less of the pepsin and hydrochloric acid needed to break down proteins, which release vitamin B-12. People who eat plenty of meat can still have low B-12.
People over 50 should get more B-12 from fortified foods like cereal or supplements because they can absorb it more easily, according to the National Institutes of Health.
When patients have gastric bypass surgery they are also more likely to have low B-12 levels, says Leonardi. People with digestive problems and those who eat a vegetarian diet, especially vegans who eat no dairy products, also have a greater risk of B-12 deficiencies, says Scrase. People who take the drug metformin for diabetes also may have low B-12.
B-12 has a reputation as a quick energy booster but it is not for everyone, Scrase says. It has an energizing effect only for those with low B-12.
“You’re much better off having the blood test first and then figuring out what’s wrong with you,” says Scrase.
He recommends getting a diagnosis before taking any over-the-counter B-12 supplements, even though any excess B-12 will probably be evacuated in urine.
Although many people with a B-12 deficiency receive monthly shots from a doctor, Scrase has encouraged many patients to switch to pills, which he says are just as effective and much cheaper. While a monthly shot costs about $53, a month’s supply of B-12 tablets is $2.25, he says.
Source: Albuquerque Journal