When should you be tested for vitamin B12?

How does one get deficient in B12? The classic cause, most frequent in older adults, particularly those of northern European ancestry, is pernicious anemia, in which the body is unable to absorb B12 due to lack of the protein needed to allow it to pass through the intestine into the body. It was thought that dietary lack was uncommon because B12 is found in so many foods, but these are all of animal origin, and it is easy for strict vegans to become deficient if they do not take supplements. There may be decreased absorption of B12 after gastric bypass surgery or in the setting of gastrointestinal diseases such as celiac or Crohn’s diseases. Some medications, particularly the diabetes treatment metformin or long-term use of acid-suppression, may cause decreased absorption.

Read the full article at KevinMD.com

Many older adults are deficient in vitamin B12 and folate

Key findings:

  • One in eight adults over 50 were low to deficient in vitamin B12 while one in seven were low to deficient in folate

  • The prevalence of low or deficient folate increased with age, from 14% among those aged 50-60 years to 23% among people over 80 years old. Low folate status was also more common in smokers, the obese, and those who lived alone

  • Low or deficient vitamin B12 was more common in smokers (14%), people who lived alone (14.3%) and those from lower socio-economic backgrounds (13%)

  • Use of both vitamin B12 and folic acid supplementation was low, with higher rates among women than men but less than 4% overall taking supplements of either vitamin

Read the source article here.

Vitamin B12 Breakthrough for more complete Vegetarian and Vegan diets

Vitamin B12 (known as cobalamin) is an essential dietary component but vegetarians are more prone to B12 deficiency as plants neither make nor require this nutrient.

But now a team, led by Professor Martin Warren at the University’s School of Biosciences, has proved that common garden cress can indeed take up cobalamin.

The amount of B12 absorbed by garden cress is dependent on the amount present in the growth medium, and the Kent team was able to confirm B12 uptake by showing that the nutrient ends up in the leaf.

I can’t wait for the silly money and marketers to grab this and run.

Read the source article here.

 

Vegan Diet, Subnormal Vitamin B-12 Status and Cardiovascular Health

Abstract

Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products). Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80%) in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases.

Conclusions

Metabolic vitamin B-12 deficiency is prevalent in vegetarians and, in particular, in vegans. Those subjects with normal or relatively high salt intake may be associated with unhealthy early vascular changes in function and structure, which have not been well documented in the past. In individuals with subnormal vitamin B-12 status, vitamin B-12 supplementation may significantly improve such vascular changes. Regular monitoring of vitamin B-12 profile may thus be beneficial for early detection and treatment of metabolic vitamin B-12 deficiency, and possibly prevention of atherosclerosis-related diseases.

You can download a copy of the full study at this link.

It’s not easy to overcome confirmation bias.  So my research often takes me to studies and articles that challenge my firmest held beliefs.  This literature review study does confirm one of my longest held beliefs.  Some of the sickest people I see are the shoppers in health food stores.

Take some B-12.  Or as this study demonstrates get your B-12  from dairy, meat, and fish and shellfish.

 

Metformin and Cognitive Impairment

In a retrospective study, diabetic patients who were taking metformin had worse cognitive performance than those not taking the drug (odds ratio 2.23, 95% CI 1.05-4.75), Eileen Moore, PhD, of the University of Melbourne in Australia, and colleagues reported online in Diabetes Care.

Additionally, patients with diabetes who had vitamin B12 levels less than 250 pmol/L also had worse cognitive performance (OR 2.29, 95% CI 1.12-4.66), and the association between metformin and cognitive impairment was weakened after adjusting for vitamin B12 levels, they stated.

via In Some Patients Metformin Impairs Thinking.

Lower Cognitive Scores – Low B12?

Medical News: Brain Takes Multiple Hits from Low B12 Levels – in Neurology, General Neurology from MedPage Today

Markers of B12 insufficiency all predicted lower global cognitive scores over nearly five years of follow-up, Christine C. Tangney, PhD, of Rush University Medical Center in Chicago, and colleagues found.