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Americans
Need More B12

8 min read

Essential Takeaways

  • Surveys in the USA and the UK found that 6% of those aged 60 and above are deficient in vitamin B-12 and the risk of deficiency was found to increase with age
  • Vitamin B12 keeps the nerve cells and blood cells of the body healthy and forms DNA, the genetic substance in cells
  • The recommended levels of B12 can be acquired from different foods such as beef liver and clams

A critical analysis of 3,000 men and women in the continuing Framingham Offspring Study showed 39 percent of the individuals with less than 258 picomoles per liter of vitamin B-12 levels in the plasma. This was way above the currently accepted deficiency standard of 148 pmol/L. However, some individuals have been found to show neurological symptoms in the upper range according to Katherine Tucker who led this study. 

Almost 9 percent of the population studied fell under the current deficiency standard while over 16 percent fell under 185 pmol/L. Surveys in the USA and the UK found that 6% of those aged 60 and above are deficient in vitamin B-12 and the risk of deficiency was found to increase with age. Approximately, 20% demonstrated marginal status in later life. In addition, the deficiency was found to be much more prevalent in developing countries. Approximately 47 million of the American population are deficient in B12, and most of them are unaware of their condition. 

What vitamin B12 Is

Vitamin B12 is naturally found in some foods and added to other foods. The vitamin is soluble in water and can be found as a supplement for the human diet and prescription medication. Cobalamins are compounds with B12 activity hence the vitamin exists in various forms and contains cobalt. The forms of B12 that are active in human metabolism are known as Methylcobalamin and 5-deoxyadenosylcobalamin.

Free vitamin B12 combines with intrinsic factor, and the resultant complex is absorbed through endocytosis into the ileum. About 56% of a 1 mcg oral dose of B12 absorbed, but absorption goes down when the intrinsic factor’s limit is passed.

Pernicious anemia is the autoimmune condition that alters the gastric mucosa and causes gastric atrophy. The parietal cells are then destroyed causing an inability to form the intrinsic factor hence malabsorption of B12. Pernicious anemia if untreated leads to deficiency of B12. This may cause megaloblastic anemia and neurological complications even where there is sufficient dietary intake of the vitamin.

What Vitamin B12 Deficiency Means

The indicators of B12 deficiency include megaloblastic weight loss, anemia, fatigue, weakness, constipation and sometimes one may loose appetite. One should note that in some instances the feet and hands may also be numb. Other indicators of B12 deficiency are such as problems keeping balance, depression, poor memory, dementia, confusion, and also the mouth may be sour. The neurological indicators of B12 deficiency may manifest minus anemia thus the importance of early diagnosis and intervention to avert irreversible damage. Indicators of a B12 deficiency specific to infants are such as inability to thrive, developmental delays, movement disorders and megaloblastic anemia. However, most of these signs are general may not necessarily suggest an insufficiency in vitamin B12. Deficiency in B12 is typically treated with vitamin B12 injections as this technique is not subject to potential barriers to absorption. High doses of the oral form of vitamin B12 may also be appropriate.

Atrophic gastritis is a condition affecting 10%–30% of older adults and which decreases the production of hydrochloric acid in the stomach. Decreased hydrochloric acid levels may further lead to an increase in the growth of normal intestinal bacteria that utilise vitamin B12. This serves to further reduce the amount of vitamin B12 present in the body.

People suffering from atrophic gastritis are often incapable of absorbing the vitamin B12 that is naturally found in food. . It is for this reason that the IOM suggests that adults aged over 50 years get most of their vitamin B12 from vitamin supplements or fortified foods.. Still, some elderly patients suffering from atrophic gastritis may need much higher doses than the RDA to avert subclinical deficiency.

Role of Vitamin B12 in our daily living

Vitamin B12 keeps the nerve cells and blood cells of the body healthy and forms DNA, the genetic substance in cells. It also helps prevent megaloblastic anemia which makes people fatigued and weak. There are two steps necessary for the body to extract B12 from food. Hydrochloric acid first separates the vitamin from the food protein to which it is attached in. Vitamin B12 then combines with intrinsic factor and is then absorbed by the body. 

The vitamin B12 also acts as a cofactor for L-methylmalonyl-CoA mutase and methionine synthase. Methionine synthase acts as a catalyst in the process of converting homocysteine to methionine. Methionine is necessary for the production of S-adenosylmethionine which is a universal methyl donor for up to100 varying substrates. These substrates include lipids, DNA, proteins, RNA, and hormones. L-methylmalonyl-CoA mutase performs the conversion of L-methylmalonyl-CoA to succinyl-CoA during the degeneration of propionate. This is a crucial biochemical reaction in the metabolism of fat and protein. Succinyl-CoA is also essential for the synthesis of hemoglobin.

A deficiency of B12 diminishes the ability of the body to develop new cells. This may result in heightened physical and cognitive aging. Severe deficiency may cause serious health complications such as permanent damage to the nervous system, but signs of B12 deficiency may go unnoticed as they are often mistaken for those of depression, Alzheimer’s disease, and other illnesses. The average American takes in enough B12 through diet but that the problem of deficiency usually arises from a reduced capability to absorb the vitamin B12.

Sources of B12

Every vitamin that the body requires has its specific source and there is need to know the specific source of the vitamin in discussion. B12 naturally occurs in many animal foods. It is also present in some fortified foods to which it is added. Plant foods that are not fortified do not contain vitamin B12. The recommended levels of B12 can be acquired from different foods such as beef liver and clams. These are the best foods from which to derive B12. Other sources are meat, fish, eggs, poultry and dairy products including milk. There are also breakfast cereals and other food products fortified with B12. 

Vitamin B12 is also present in many multivitamins. There are also dietary supplements which have only vitamin B12, or a blend of vitamin B12 and other nutrients such as folic acid and other B vitamins.

It is also available in sublingual forms. These are not necessarily better than the swallowed forms.

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