Vitamin B12 and the Elderly
Vitamin B12 is a water-soluble vitamin mostly found in meat, fish, eggs, milk, and liver. This vitamin is essential for growth, nerve system functions, and the production of blood cells.
Elderly individuals often experience a deficiency in this vitamin due to various reasons, leading to symptoms that can be progressively identified through regular health check-ups, such as numbness in the extremities, diminished joint and movement sensation, weakness, frequent forgetfulness, blood pressure drops when standing, paleness, and abnormally large red blood cells. In severe cases, a deficiency may lead to lower than normal levels of red blood cells, white blood cells, and platelets, causing more severe symptoms and slower recovery compared to younger individuals.
Interestingly, elderly individuals may have low levels of vitamin B12 in the blood without any apparent symptoms. Conversely, low levels of Vitamin B12 can cause prominent blood system symptoms while nerve system symptoms may be hard to detect. Elderly patients with nerve system symptoms may present with complex issues that can complicate diagnosis. Therefore, it’s advisable to regularly check vitamin B12 levels annually in the elderly, and treatment should be correctly administered if levels are below normal.
Why the Elderly May Have a Vitamin B12 Deficiency
There are various reasons for Vitamin B12 deficiency in the elderly, such as:
- Atrophic Gastritis and Hypochlorhydria which decrease stomach acid production, reducing Vitamin B12 absorption
- Long-term use of acid-reducing medications without appropriate indications (Histamine-2 Blocker, Proton Pump Inhibitor) which reduces stomach acid production and Vitamin B12 absorption
- Stomach or intestinal surgery
- Diseases of the small intestine, such as Crohn’s Disease, Sprue, Malabsorption Syndrome
- H. pylori infection in the stomach
- Pancreatic Insufficiency
- Small intestine parasite infection (Fish Tapeworm)
- Individuals on a long-term vegetarian diet
- AIDS or side effects from HIV antiviral medications
- Autoimmune-related anemia
- Certain diabetes medications, such as Metformin
Treating Vitamin B12 Deficiency
Treatment for Vitamin B12 deficiency can include Vitamin B12 injections and oral supplements, with the dosage, duration, and administration method depending on the severity and cause of the deficiency.
Besides diagnosing and treating Vitamin B12 deficiency, identifying its cause is crucial as lack of addressing the root cause may lead to recurrence. Often, the primary causes are linked to age-related physiological decline and irrational medication use. This highlights the importance of regular health check-ups and reviewing all medications with a physician to adjust the type and amount as needed, minimizing side effects.
