As You Age, Be Aware of B12 Deficiency

Are you short on stamina? Is your memory fuzzy? Don't assume it's just part of aging. Feeling tired, in a funk, or confused can point to problems you can solve.

One of those problems lies in your nutrition. You could be low on vitamin B12.

This essential nutrient helps make DNA, the genetic material in your body's cells. You also need the vitamin to maintain red blood cells and nerve cells. Along with mental cloudiness, getting too little vitamin B12 may lead to numbness or tingling in your hands and feet.

How much B12 should you get? Experts recommend 6 mcg of vitamin B12 a day.

Plenty of sources

Meeting that goal usually isn't a problem. Natural sources include clams, fish, beef, and dairy foods, says Christine Gerbstadt, M.D., R.D., a Philadelphia spokeswoman for the American Dietetic Association.

But if you're taking a variety of medications for chronic conditions or if you're a strict vegetarian, you're at risk for a deficiency. Perhaps you're not eating as well as you used to. That, too, can lead to a B12 shortfall.

Part of the challenge in meeting your need for B12 is the vitamin's unique structure. You may take in enough B12, but your body must go through a series of steps to process it. As you age, one or more of the steps may break down, according to Hope Barkoukis, Ph.D., R.D., of the nutrition department at Case Western Reserve University School of Medicine in Cleveland.

"It's not about getting B12 into your diet, but about getting it absorbed properly," says Dr. Barkoukis. The vitamin is bound to the protein you eat, and you need stomach acid to release it. If you're taking antacids or other medications to reduce stomach acid, your body can't absorb the B12.

One common drug used to treat diabetes, metformin, hinders vitamin B12 absorption. A change in bacteria that live in the body, common with age, can also cause less B12 to be absorbed, Dr. Barkoukis says.

Intrinsic factor

In addition, your body makes a substance called intrinsic factor, which must be present for vitamin B12 absorption. "Intrinsic factor isn't produced by some elderly people," says Dr. Gerbstadt. Without intrinsic factor, you're at risk for pernicious anemia, a severe lack of red blood cells.

Fortunately, a vitamin B12 deficiency can be detected and treated. Screening tests are available. Dr. Gerbstadt recommends you give your health care provider a food diary showing what you eat in an average week. "A decreased appetite is always the easiest aspect of B12 [deficiency] to identify and fix," she says.

Along with checking your B12 levels, here are some steps you can take:

• Talk to your health care provider or a dietitian about ways to increase your vitamin intake.

• Eat smaller, more frequent meals. Include yogurt or a glass of milk as part of these mini meals, Dr. Gerbstadt advises.

• Make fortified breakfast cereal—a great source of vitamin B12—part of your morning or bedtime routine. "Fortified breakfast cereal is very accessible and affordable and doesn't spoil," says Dr. Barkoukis. The vitamin B12 in fortified foods is not bound to protein, so you don't need stomach acid to absorb it.

• Read labels. On packaged foods, vitamin B12 is shown as a percent of the Daily Value (DV), which describes recommended levels of a nutrient. Foods that are high in vitamin B12 provide 20 percent or more of the DV for the vitamin. Fortified cereals, for example, may offer 25 to 100 percent of the DV for vitamin B12.

• Ask your doctor if vitamin supplements are right for you. Supplements are an excellent source of B12 for people older than 50. For the best absorption, take vitamin B12 with meals. You don't have to worry about overdoing it, says Dr. Barkoukis.