Of all the many B-Vitamins, Vitamin B-12 is one of the water-soluble vitamins which receives the least amount of attention doing many physical exams. My introduction to B-12 was very early, through an aunt, by receiving B-12 shots from her physician during her physical exams. I often ask the reason why, as obtaining a vitamin through a shot was quite strange. Her response always, Vitamin B-12, gives me energy and keeps me from getting tied. Later, realizing it was primarily due to a medical condition known as Pernicious Anemia.
Today, Deficiencies in Vitamin B-12 are relatively common; however, it takes years to show up in our blood panel, making an accurate diagnosis difficult. Nonetheless, Vitamin B-12 is essential, especially as we age, to our overall health and well-being. Deficiencies most often occur in individuals with a diagnosis of celiac or Crohn’s disease. Vitamin B-12 requires the acids in the stomach for absorption. Therefore, people who use heartburn medication regularly to reduce acid production in their stomachs are often deficient. Additionally, as we age, the natural production of acid in the stomach slows down, resulting in one of the leading causes of a Vitamin B-12 deficiency in the elderly.
Evidence-based research shows a deficiency in Vitamin B-12 lead to heart and blood vessel damage, dementia, nerve damage, fatigue/weakness, anemia, and significant changes in vision, mobility, and moods (depression).
However, the most crucial aspect of Vitamin-B-12 is the relationship it shares with Metformin. Metformin is the primary medication provided to individuals diagnosed with prediabetes. Approximately 88 million people 18 years or older have prediabetes. There are also 24.2 million people 65 years and older who are also prediabetic. According to the guideline for the medical treatment of prediabetes, Metformin therapy is the first line of defense given to individuals with a BMI >35 kg and younger than 65 years old. Studies show individuals on Metformin are at risk of a B-12 deficiency. Therefore, recommendations are to evaluate your Vitamin B -12 levels for those currently taking Metformin, especially those with anemia, peripheral neuropathy, and the elderly.
As always, the best source of any nutrient inclusive of Vitamin B-12 is to obtain it naturally through food. The sole food sources are meats, fish, poultry, eggs, and dairy. The fortification of bread and plant-based milk are also good sources of Vitamin B-12. Many vegetarians are also at risk for acquiring a deficiency. Vegans should consume many of the foods fortified with the vitamin or consider a B-12 supplement. Many of the standard multivitamins will provide six micrograms of Vitamin B-12, which will more than meet vegetarians’ needs.
Please note excessive amounts of B-12 can be toxic. Unlike the other B vitamins, the liver stores a great deal of excess Vitamin B-12. Always consult with your Primary Care Physician before taking any form of supplementation, especially mega doses. Foods rich in Vitamin B-12 are your best sources.
Is your Vitamin B-12 Level at Risk?