Everyone know that vitamins are important for health, and many older adults take a multivitamin.
But did you know that even among seniors who do this, many still end up developing a serious deficiency in one particular vitamin?
It’s Vitamin B12.
If there’s one vitamin that I’d like all older adults and family caregivers to know more about, it would be vitamin B12.
(Second on my list would be vitamin D, but it’s much harder to develop low vitamin D levels if you take a daily supplement, as I explain in this post. Whereas vitamin B12 deficiency does develop in many older adults who are getting their recommended daily allowance.)
A deficiency in any vitamin can be catastrophic for health. But vitamin B12 deficiency stands out because a) it’s very common — experts have estimated that up to 20% of older adults may be low in this vitamin — and b) it’s often missed by doctors.
Geriatricians also like to pay attention to vitamin B12 because a deficiency can cause — or usually worsen — cognitive impairment or walking problems.
So I’ve written an article for A Place for Mom, explaining everything you should know about vitamin B12 in older adults:
“How to Avoid Harm from Vitamin B12 Deficiency in Seniors“
In this article, I explain:
- How vitamin B12 deficiency harms a senior’s health,
- Why low vitamin B12 levels are so common in older adults, and why this problem is often missed,
- Common risk factors for low vitamin B12 levels, and who should be checked for deficiency,
- How vitamin B12 deficiency is diagnosed and treated.
Unlike many health problems that ail seniors, treating low vitamin B12 levels is easy and safe.
The key is to make sure it’s detected, and treat before some of the health harms — like neurological damage — become permanent.
As always, proactive family caregivers can make a big difference. Learn about this important condition by reading the full article posted at A Place for Mom:
“How to Avoid Harm from Vitamin B12 Deficiency in Seniors“
Has your family had any challenges related to vitamin B12 deficiency? I’d love hear from you in the comments below.
Thank you so much for the education. But I have a concern. An adult was transfused 2016 for the first time in life. From that time to present, she has receive 38 units of blood. What several tests have been done, but low bolld is still the problem. Please help me to help this lady.
By low blood, I assume you are referring to a low red blood cell count, which means anemia. (Although it is possible to be low in other types of blood counts, and to sometimes be transfused for this.)
I explain the most common causes of anemia and how doctors evaluate this condition in this article: Anemia in the Older Adult: 10 Common Causes & What to Ask.
I would recommend you review that article and the comments, and then plan to ask the involved doctors more questions about what they think is causing the low blood count. Good luck!
I am 52 Years old. My Alive 50+ Ultra Potency Once Daily Multivitamin has 225mcg of B-12 which is like 3750% of your Daily Value. Is that too much? I also Take a Jarrow formulas Methyl B-12 Lemon Flavored Lozenges 1000mcg and split them in 1/2 and let them dissolve on my tongue Daily. My Blood work last year showed everything good so far. My D level is about 1700Iu a day and my Calcium is about 1200 a day. Magnesium 400mg a day. Hopefully those are all good levels. I know B-12 is good for the heart also, Correct? Any feedback will greatly appreciated!
The good thing about vitamin B12 is that it doesn’t accumulate in the body and doesn’t cause toxicity. It’s true that the RDA for older adults is 2.4mcg/day, however when we treat deficiency, it’s very common to give people 1000mcg orally per day, and many people go on taking that oral dose indefinitely.
If you want to know if your vitamin B12 dosing is ok, I would recommend asking your health provider to tell you what your level is. It’s probably fine, since it sounds like you take a fair amount of it every day and it is also in many foods. Good luck!
I am 81years, a female, had ear problems as a child, have got progressively worse re clarity of sound, one on one talking over a table is fine, otherwise not good, I have to concentrate when walking due to a balance problem. Recently had a bad attack of vertigo, got medication but still seems to be a problem when turning/etc. to the right.
Seriously considering getting a walking stick. I am interested to note how important Vit.B12 is especially in the elderly, I shall go to the local clinic more regularly for a shot.
I have made a note of balance excercises for the elderly.
Thankyou
Jannice
Glad you are learning more about your health. Re vitamin B12, I would recommend being checked for deficiency before pursuing injections or another form of supplementation.
You should also know that the medication usually prescribed for vertigo (meclizine) is quite anticholinergic and so should be used with caution by older adults. You can learn more about the risks of anticholinergic medications here: 7 Common Brain-Toxic Drugs Older Adults Should Use With Caution
Vertigo can sometimes be more safely treated with vestibular rehabilitation, which is a special form of physical therapy. It is more work than taking a medication, but safer.
Good luck!
Is it true that your body doesn’t absorb B12 supplements unless you have had some type of intestinal surgery?
The main pathway for absorbing vitamin B12 requires a working stomach and gastric acid. Hence a surgery that removes the stomach can result in vitamin B12 deficiency. However, studies suggest that if high-dose oral supplementation is used, vitamin B12 deficiency can be corrected even if the stomach has been removed or is not providing acid. This is because there are some secondary ways to absorb vitamin B12 (these pathways aren’t very efficient however, which is why a high dose has to be used).
Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials.
Oral Vitamin B12 Replacement: An Effective Treatment for Vitamin B12 Deficiency After Total Gastrectomy in Gastric Cancer Patients
I am 78 years olg and just had a b12 blood test . It was 193.
Some articles say that the threshold should be 300 in elderly people.
What do you think?
193 sounds low. I would certainly recommend discussing this with your usual health providers.
As I explain in the article, a test for methylmalonic acid is recommended as a follow-up. If it’s higher than normal, that would be consistent with vitamin B12 deficiency.
Hi there
I wonder how best to help my mom who is resisting not trusting any one to check her ears (for justified reasons of being treated abruptly by hca staff and mom’s alone there she’s afraid of some staff) in an assisted living facility Edmonton Alberta. She’s not looking well -hasnt had blood work in a few years won’t let staff touch her – her ears are bothering her she won’t do her hearing aids – she sounds garbled but I can hear her over the phone trying to talk to the hca who is ignoring her.. but it’s as if she’s trying to say it’s painful it’s sore….but the staff don’t listen. I noticed she doubled plugged up a few weeks back. The staff say they can’t do oil in her ear until they look inside – but she won’t let them- is there any thing you can recommend to help get mom’s ears checked her throat etc – also b12 she needed for years I hope they give it to her but I can’t be sure – can you let me know what tests in blood work to ask staff to do -if they can get her blood drawn – she’s really not happy there and I wish I could go get her bring her here to Ontario but there are some other siblings that are being uncaring of her situation at 89 years – it’s so hard. I’m on the phone day night checking her snacks -shes celiac. The good isn’t gluten free and I found out she’s not getting enough food at breakfast and lunch.
If you could let me know what blood tests and other tests they should do – I’d appreciate your help very much.
She’s been through terrible situations and all her kids are Ontario she way out in Edmonton Alberta alone no kids and it’s a huge risk I keep trying to get my youngest brother to realize – he did the unthinkable to her with taking control of her assets etc he shouldn’t have – I couldn’t get help to stop him. He’s left mom far away from him and my sister and me. I wish there was protection for divorced elderly parents to be protected from the kids that took the other side in the divorce. He’s just heartless doesn’t visit her but 1time a year and doesn’t provide for her extra help she needs – it wasn’t her wishes to live in care she was an RN – she didn’t want to have her condo sold her keep sake family things trashed taken to the dump etc – I’m trying my best to be on the phone to check on her and staff but it’s a big worry with her almost crying nono please no you do it…when I try to talk to her on the phone…it’s like it’s hurting her ears.
Any help or recommendations would be so very appreciated – mom doesn’t deserve this kind of care -day after day strangers being rough pushy not compassionate -do TV’s blasting all day affect the hearing -her roommate is hollering at her to answer the phone and says nasty things to mom -ive asked management to get a new roommate but they don’t seem to be listening -she should be with me (for years and years I did nurses aid work and lived with elderly people up to 96 yrs of age) so it was always my hope my goal to be available to attend my own mother when she needed help – I wish I could just go get her but I don’t know who to turn to for help for mom -with being told my youngest brother took my name off her pa pd – he controls everything – sadly.
Thanks for your time and help and I really like your website!
I posted this for mom…heres hope for a miracle…that I can make things better for mom, Reggie C Knowles very soon.
Jen
Waterloo On Canada
N2k4G9
Sorry to hear of your mother’s situation. If she is refusing to let anyone touch her, it might indeed be difficult to get bloodwork done. In principle, to check on vitamin B12 status, we would check the blood vitamin B12 level and then also consider ordering a methylmalonic acid level, as I explain in the article.
In terms of advocating regarding her living situation and perhaps her hearing: all of this is very difficult to do if you aren’t able to visit the site and work closely with the facility staff. If you are concerned about her hearing, this should be brought to the attention of her usual doctor or whichever health professional is supervising the medical care of the residents of her facility.
It does sound like your mother’s care is being overseen by a sibling, and that perhaps you disagree with the decisions being made. I’m not sure what your options are in Canada. In the US, generally one would have to look into one’s state laws and consult with an elder law attorney. Sometimes it is possible to petition a court to remove someone as an older person’s guardian, but this is a time-consuming process and also often expensive to pursue. Good luck!
Dear Dr. Kernisan,
I am vegetarian for two years and my hair has been thinning, nails became dry and brittle and I became fatigued over a span of 5 months. Due to circumstances I wasn’t able to see a doctor right away, so I started supplementing Biotin, Folic acid and 1,000 mcg of B12. Had blood tests last week: Ferritin is 25 ug/L and he didn’t test for B12. My nails are getting better but still fatigued. He recommended iron supplement.
Is 1,000 mcg of B12 considered a high dose for sublingual tablets?
Thank you very much for sharing this info!
1000mcg of B12 is a fairly common oral dose used to treat vitamin B12 deficiency.
If you are concerned about possible vitamin B12 deficiency, I would recommend asking your doctor about testing for this specifically. You could be low on iron and also be low on vitamin B12; the only way to assess vitamin B12 status is to test first the serum level of vitamin B12 and then also methylmalonic acid if the vitamin B12 level is low-normal. Even though you have been taking a supplement, since you are still feeling tired and having symptoms, further evaluation would be reasonable. There are also many other conditions that can cause fatigue (e.g. low thyroid), so be sure to ask your health provider about getting checked for other conditions that might cause fatigue. Good luck!
Hi,
My dad has been so poorly he doesn’t want to live anymore (having other chronic pain issues to deal with, being this poorly was the last straw). He was diagnosed with low B12 about 6 months ago. He had a series of B12 shots that made him about 80% better, which was great. He started to go downhill again, so had another B12 shot – again making him a lot better. He had another shot about 2 weeks ago, but it doesn’t seem to have worked this time. Either it’s not a B12 issue or the shots don’t seem to be enough now. Can he ask for shots once a week (he’s been told once every 5 weeks) or would this be bad for him? Maybe he should be using high mg tablets on a daily basis to keep his levels up? Or may there be an underlying issue as to why his body doesn’t want to absorb it?
Thank you for your help!
Hm. Before pursuing another series of weekly vitamin B12 shots, I would recommend talking to his doctor and making sure they have tested his vitamin B12 levels (and also methylmalonic acid, if his vitamin B12 level is borderline) to see if he is low.
Poor absorption of vitamin B12 is usually only a potential issue when people take it orally, and should not be an issue when taking injections.
It’s certainly possible that there is another underlying health issue which is causing him to feel poorly, and he may need further evaluation, especially if his vitamin B12 levels are in fact ok. Good luck, I hope he feels better soon.
hello
I am 58 years old and Less Of B12.
Feelings pain in feet bottom in morning.
Frozen shoulder And laziness.
I’m also suffered Blood pressure high.
Prostate Bph. Urine infection.
My muscles are loosing now.
How to avoid medicine And be healthy too.
Feel my eye closed. Why this happens to me.
.Please reply
I would recommend a comprehensive consultation with a good health provider. It may take several visits to get to the bottom of things, as your situation sounds complicated.
Dear Dr. Leslie: I like your comments and helping people. I am 94.5 years old and in relatively good health but as you might suspect I do have some problems- one of which is driving me nuts. Had to give up on any athletic acts and am told I am out of balance-to the right. Sometimes I walk like a drunk. This after pretty intensive testing. No explanation or reasons and told to take P.T. and that it was hard to cure and a very lengthy go around. At 94 years it occurs to me that I probably don’t have time left for their P.T.
Do you have any ideas about getting back my balance other than lengthy P.T.? I’m game for just about anything. Bee
Hello Bee,
That’s great that you are in relatively good health at age 94.5.
Re your balance, hmm…I find it odd that they didn’t have an explanation, especially if they did extensive testing. How to improve your balance really depends on what they think is causing the issue, so I wonder if it wouldn’t be possible for you to return to your health providers and ask for them to explain what they think is going on. It’s possible that they didn’t give an explanation because they thought you wouldn’t understand. (I hope it’s not that they assumed you were “too old” to understand or be interested!)
Also, is the PT general physical therapy for balance, or did they propose “vestibular rehabilitation”, which is more specifically about addressing balance and vertigo issues?
In general, if you are in good health, then perhaps we shouldn’t say that you “don’t have time left” for PT. It’s always a good idea to work on balance when one is older, and might also eventually help with your specific issue.
Good luck and take care!
I have had 2 bloodwork done 12/18&8/19
Both had low white blood count
Dr suggested see hematologist, could it be low b12 and or iron, my supplements do not have iron in them .
redblood count slightly low too on 8/19 draw
If you are low in iron, tests should show a low ferritin level. If you are low in B12, we’d expect a low or low-normal vitamin B12 level and an elevated methylmalonic acid.
I would recommend asking the hematologist to explain what might be causing your low white blood cell count, and how concerned you should be. Good luck!
Due to a slip and fall I broke my left femur (hip) which resulted in a compound fracture. I had to have immediate surgery where I had a rod and two screws inserted. The surgeon informed me prior to surgery that it was likely I might need a transfusion due to blood loss resulting from teams. My hemoglobin got down really low and I was given a blood transfusion. I had a CBC done every day for 4 days until dischargefrom from hospital. When discharged from hospital hemoglobin was 7.6. Haven’t had it repeated since discharged. Last visit to my physician he seemed to think I looked quite well and said he didn’t think any lab work was necessary. I feel good, am walking every day wI thout quadcore cane andit amI not tired. Still have some discomfort at times when I overdue. Vital signs are within normal range. Should I be taking any supplements? Surgery was June 10, 2019.
Sorry to hear of your fall. It does sound like you’ve been recovering and feeling well, which is reassuring. Your hemoglobin at discharge was quite low, so even though you are feeling ok, I think it’s not unreasonable to ask your provider if it can be checked on, just so you know what your baseline is now.
Supplements to treat low hemoglobin are only indicated if there is a documented nutrient deficiency (e.g. low iron, B12, etc). Good luck!
My mom is 80 years old and has had to get 3 blood transfusions and tonight is on her 4th. They are saying she has a B12 vitamin deficiency. Shouldn’t the DRs be giving her B12 shots. She is becoming very sick and weak and they keep masking the problem with blood transfusions. Can you help me understand what I should be doing to try to help her more. Any advise you can give will be helpful. Last blood count was 21.6.7
I’m sorry to that your Mom is having these difficulties. I’m not sure how to interpret that number you gave for her latest blood count, a hemoglobin level of 21 does not really make sense, and that would also be extraordinarily low if it were her B12 level. In any case, it is unusual, in my experience, for someone to need repeated blood transfusions for the anemia from B12 deficiency. I wonder if there is another cause of her symptoms and her need for transfusions. In terms of shots, we often start with an intramuscular B12 injection before putting someone on oral B12 replacement, especially if the B12 level are very low. Here’s a podcast that might be helpful.