By Dalia Garalyte
Estimates suggest that around 25% of adults lack sufficient levels of a crucial compound called vitamin B12, and the deficiency rate climbs to 40% among individuals over 60 years old, which can contribute to cognitive decline, memory loss, and potentially even conditions like MS, Alzheimer's and Parkinson's.
Recent research indicates that due to inaccuracies in B12 testing, the prevalence of deficiency might be even much higher, and a significant decline in our cognitive function might be exacerbated due to something as simple as vitamin B12 deficiency.
Given that B12 deficiency can impact virtually every system and tissue in the body, leading to irreversible health consequences, today we'll delve into the vital importance of vitamin B12, the serious implications of deficiency, and the challenges with traditional B12 testing. Let's get started.
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that our bodies depend on for numerous life-sustaining functions, like: DNA synthesis, red blood cell formation, brain and central nervous system function, pregnancy and foetal development, different enzymatic reactions just to mention few.
With such important roles, it's no wonder that lacking this vitamin can lead not only to cognitive decline but to many other significant problems, which can manifest like:
Fatigue, Brain Fog, and Muscle Weakness: One of the early signs of vitamin B12 deficiency is a feeling of chronic fatigue, accompanied by difficulty concentrating and a sense of mental fogginess. Muscle weakness may also be experienced.
Anemia: B12 deficiency can lead to various types of anemia, including megaloblastic anemia, where red blood cells are abnormally large and ineffective at carrying oxygen.
Nerve Damage and Neurological Changes: B12 deficiency can result in nerve damage, leading to symptoms such as numbness or tingling, particularly in the hands and feet. This can progress to more severe neurological issues if left untreated.
Increased Risk of Neurodegeneration: Prolonged B12 deficiency may increase the risk of neurodegenerative conditions, such as dementia, MS or even Parkinson’s.
Cardiovascular Disease and Stroke: B12 deficiency has been associated with an increased risk of cardiovascular issues and stroke, as it increases homocysteine levels, a marker associated with cardiovascular disease.
Macular degeneration: Elevated homocysteine levels have been associated with an increased risk of age-related macular degeneration.
Mood Disturbances: Deficiency in B12 has been linked to mood disorders, including depression and anxiety. Adequate B12 levels are essential for the proper functioning of the nervous system, which in turn affects mood.
Immune System Issues: Low levels of white blood cells and platelets can result from B12 deficiency, potentially affecting the immune system's ability to defend against infections, cancers as well as regulate blood clotting.
Infertility and Disturbances in Fetal Development: B12 deficiency can impact fertility in both men and women and pregnant women with B12 deficiency may be at risk of giving birth to babies with neural tube defects, developmental delays, and failure to thrive.
Considering these serious effects, you might wonder how a B12 deficiency develops and how to test for it.
Unfortunately, our body cannot synthesize B12 on its own, that’s why incorporating a balanced b12 rich diet or considering supplementation is essential, so you can ensure your body's vitamin B12 requirements are met effectively.
Who's At Risk of B12 Deficiency?
Certain individuals are more prone to B12 deficiency. These include:
Vegetarians and Vegans: B12 is primarily found in animal-based foods, so those who follow strict vegetarian or vegan diets may be at risk unless they take B12 supplements.
Individuals with Malabsorption Issues: Conditions that affect the absorption of nutrients in the gastrointestinal tract, such as pernicious anaemia, Crohn’s disease, ulcerative colitis, celiac or SIBO or low stomach acid can also lead to B12 deficiency.
Individuals with genetic variations: for instance, those who have MTRR, MTR, and other polymorphisms can have reduced B12 absorption and utilization in the body.
Elderly Individuals: As people age, they tend to eat less, as well as their enzymatic function decreases with age reducing their ability to absorb B12 from food and increasing the risk of deficiency.
Individuals with Gastric or Intestinal Surgery: Surgical procedures, like gastric bypass for instance, that alter the structure of the stomach or intestines can affect B12 absorption.
Individuals with certain gastrointestinal deficiencies: IBS, IBD, SIBO, leaky gut or autoimmune diseases like Pernicious anaemia, Chrons and Celiaoc could have impaired B12 levels due to impaired absorption.
Individuals on Certain Medications: Some common medications, such as proton pump inhibitors (PPIs) and diabetic medication like metformin, can interfere with B12 absorption over the long term.
As you can see it's essential to diagnose B12 deficiency early to prevent serious health problems, therefore, testing for B12 deficiency is critical. Unfortunately, the traditional serum B12 test, is not always reliable. The main problem with the standard serum B12 test used by most doctors is that it catches only a small portion of individuals, who are usually in the late progressed stages as people are not getting their B12 levels checked regularly. Standard B12 testing does not always spot functional B12 deficiency. To complicate things further, the definition of "normal" B12 levels varies widely between countries. The standard reference range for B12 levels in NZ may be set too low as recent studies indicate, missing many who are significantly deficient or mildly insufficient.
Nevertheless, more sensitive markers for B12 deficiency, like methylmalonic acid (MMA) and homocysteine, can offer additional insights. Elevated levels of these markers may signal B12 deficiency. However, the most sensitive marker, holoTC (holotranscobalamin II), which can detect early-stage deficiency, but is not yet available in many countries, including New Zealand.
In specific cases, intrinsic factor antibody tests and other specialized tests may also be used to diagnose the root causes of B12 deficiency due to autoimmune conditions like pernicious anaemia.
Although the consequences of a continuous lack of B12 can be considerably severe, the positive aspect is that addressing and reversing this imbalance is quite straightforward and easily treatable with B12 supplements, dietary changes, or injections, depending on the severity of the deficiency and the underlying cause.
If you are worried about your B12 levels and looking for more guidance contact us today.
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