Vitamin B-12 is a critical component of any diet. It protects the heart, provides energy, and prevents confusion and memory loss in older adults. Animal products are rich sources of vitamin B12, but may not be as easily absorbed as supplements or fortified foods. Those at greatest risk for deficiency are vegetarians and people over 50.
How it functions
Vitamin B12 aids in forming red blood cells and helps maintain a healthy nervous system. Recent studies have also focused on B12 and its effect on heart health. Vitamin B12 and Folic Acid are involved in metabolizing homocysteine, an amino acid found in blood. Elevated homcysteine levels have been identified as a risk factor for cardiovascular disease and stroke.
Vitamin B12 is not quickly excreted in the urine like other water-soluble vitamins. It accumulates and is stored primarily in the liver. The average body stores anywhere from 2 to 10 mg per day and excretes 2 to 10 micrograms per day. About 75% of what we excrete in bile is reabsorbed.
Who is at risk?
Our body has a complex method of absorbing Vitamin B12 and if there is a defect at any step of the process, it can result in low stores. A number of conditions can impact the body’s ability to absorb or absorb adequate amounts of B12.
These conditions include pernicious anemia, fish tapeworm, pancreatic diseases, Crohn’s disease, HIV infection, and multiple sclerosis. Proton pump inhibitors and H2 receptors typically prescribed to treat Acid Reflux, and the diabetes drug Metformin are known to influence Vitamin B12 absorption. Vegetarians and vegans are at risk because they do not consume the foods that provide B12.
Women who are breastfeeding should ensure that they are getting sufficient B12 as deficiency in infants can lead to developmental problems and irreversible damage to their nervous system.
The Complications of Deficiency
It can take years for deficiency to become evident. In the initial stages your B12 levels may be normal even though your storage levels may be depleted. As deficiency progresses you may experience impotence, urinary or fecal incontinence, depression, memory loss, changes in your gait, altered reflexes and numbness or tingling. Later stages may present with anemia, psychiatric disorders and elevated homcysteine levels.
Many of these symptoms can be mistaken in older adults for the “normal” signs of aging, or are very general and may not be immediately linked to vitamin deficiency. Your physician can rule out a deficiency by performing a simple blood test.
How much do you need?
The Institute of Medicine of the National Academy of Sciences provides recommendations for Vitamin B12 intake in the Dietary Reference Intakes (DRIs). The recommended daily allowances for children and adults range from 0.9 to 2.8 ìg/day. There is no upper Tolerable Upper Intake Level for this vitamin.
Vitamin B12 does not have a high potential for toxicity, and there are no known adverse effects with excess intake in healthy individuals. The Institute even recommends that adults over 50 use supplements or fortified food for most of their B12 as it is easier absorbed than other sources.
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