Vitamin B12 – Does it really matter for the body?

Are you deficient in vitamin b12

In India, 60-70% of the population is believed to have lower vitamin B12 blood levels, with nearly 80% of urban middle class having this deficiency. Low levels of vitamin B12 contribute to the higher incidence of vascular diseases and with low folate levels accounting for higher prevalence of hyperhomocysteinemia, (characterised by high levels of protein, homocysteine in the blood ) among Indians. Hence, vitamin B12 & folate are essential for heart health.

Alert: 8 out 10
Indians are
vitamin B12

Most surprising to the researchers was the fact that low B12 levels were as common in younger peopleas they were in the elderly.
B12 deficiency is often missed for two reasons.

• It’s not routinely tested by most physicians.
• The conventional serum B12 test that most doctors run only picks up a small fraction of people who are actually B12 deficient.

This test measures the total amount of B12 in the blood and does not rule out functional B12 deficiency, which means low levels of active B12. The low end of the laboratory reference range for serum B12 is too low. Many people who are B12 deficient have so-called normal levels of B12.
For example, the lab reference range goes down to 211 pg/mL in most cases, yet it’s well established in the scientific literature that people with B12 levels between 200 and 350, levels that are mostly considered to be normal in the U.S., may exhibit clear B12 deficiency symptoms.
In Japan and Europe, the lower limit for B12 is between 500 and 550, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia, and memory loss.


Some experts have speculated that the acceptance of higher levels of normal in Japan and the willingness to treat levels considered normal in the U.S. explain the low rates of Alzheimer’s and dementia in that country.
Unfortunately, few clinicians are aware of them, and they are rarely used in clinical practice. You can’t find what you’re not looking for, so this is the real problem with B12. This is a serious problem because B12 deficiency can take years to become clinically evident, and the effects can be irreversible.
Screening for B12 deficiency is completely harmless and over treatment is hard to do because B12 is so safe to supplement with, whereas misdiagnosis is not because of the potentially irreversible neurological damage, which is completely preventable.

Primary Causes of B12 deficiency include:

Inadequate intake (common in vegetarians and vegans
Intestinal malabsorption due to low stomach acid
Celiac Disease
Crohn’s disease, or other gastrointestinal conditions
Pernicious anemia
Atrophic gastritis (caused by H. pylori infection)
Diabetes : Diabetics are at higher risk of deficiency of vitamin B12. Metformin, commonly prescribed drug to diabetics, has the tendency to reduce its absorption.
Vitamin D3 intake: Deficiency of vitamin D3 often leads to drop in vitamin B12 levels. A D3 deficiency inhibits the absorption of calcium. Calcium is essential for transporting B12 to the stomach. Although your diet is sufficient in Vitamin B12 rich foods such as meat & eggs, if your diet lacks vitamin D3, you may suffer a drop in B12.
Being vegetarian: Vegetarians have a 4.4 times higher risk for vitamin B12 deficiency. Eating a poorly planned vegetarian diet could contribute to the deficiency.
Antibiotics: Antacids prevent vitamin B12 absorption. Since many people depend on antibiotics to cure a variety of ailments, they often suffer from acidity, and end up taking antacids & this could be contributing to B12 deficiency.

Children and B12 Status

While kids are not at particular risk unless they fall into the other categories we’ve just talked about, the effects of B12 deficiency in kids can be particularly alarming.

Studies have shown that kids raised until age six on a vegan diet are still B12 deficient even years after they started eating at least some animal products. In one study, the researchers found a significant association between cobalamin status and performance on tests measuring fluid intelligence, spatial ability, and short term memory, with formerly vegan kids scoring lower than omnivorous kids in each case.
The deficit in fluid intelligence is particularly troubling, the researchers said, because it involves reasoning, the capacity to solve complex problems, abstract thinking ability, and the ability to learn.Any defect in this area may have far-reaching consequences for individual function.

Now, I recognize that there are many reasons why people choose to eat the way they do, and I respect people’s right to make their own choices. I also know that, like all parents, vegetarians and vegans want the best for their children. This is why it’s critical for those who abstain from animal products to understand that there are no plant sources of B12, and that all vegans and most vegetarians should supplement with it. This is especially important for vegetarian or vegan children or pregnant women whose need for B12 is even greater than adults.

Things to Consider When Supplementing

There are two forms of vitamin B12 that you’re likely to come across – methylcobalamin and cyanocobalamin. Cyanocobalamin is much more common in multivitamins and B12 vitamins, but there are lots of strong arguments to replace this ingredient with methylcobalamin.
In short, Cyanocobalamin is the synthetic (less expensive) form of B12, while methycobalamin or adenosylcobalamin is the form that mimics nature more closely.
So if you’re considering supplementing, make sure you are using the better (methylcobalamin) form.


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