Why Vitamin B12 is the Must Have Vitamin for Older Adults

If you were to ask me what vitamin every older adult should make sure they have, I always recommend Vitamin B12.

Vitamin B12 benefits in the elderly are experienced with daily doses as small as 500 micrograms (mcg) per day.

For Dietitians I recommend speaking with a patient’s Doctor to see if adding vitamin B12 to their daily regimen would benefit them. I’ve got the benefits to help strengthen your argument here.

If you’re a Dietitian, check out the end of the article for takeaway points on how to put Vitamin B12 into your clinical practice!

colourful vitamins.

What is Vitamin B12?

Vitamin B12 also known as Cobalamin, is found naturally in animal foods in our diet. It is also widely available as a vitamin supplement pill.

Vitamin B12 is essential in brain development and function, blood cell formation, cell growth, aids in the immune system function, nerve cell development and bone health.

It is quite obvious that all of those are essential functions to keep our body functioning, making it a key vitamin that you need to be taking everyday for overall health.

Understanding Vitamin B12 Deficiency

Studies have found that vitamin b12 deficiency occurs in as much as 33% in older adults and elderly. In one study, it found only 38% of people had adequate levels.

Our bodies cannot manufacture vitamin b12 on its own, it needs either a food or supplement source daily to build up sufficient levels. This puts vegetarians, vegans, and the elderly at risk of deficiency if they do not ingest meat or supplements.

Vitamin B12 goes through a few steps before it can be absorbed. First someone ingests either a supplement or a food source with vitamin B12. It then travels to the stomach, which releases hydrochloric acid (HCl), this allows the release of vitamin B12 from the food source.

It then binds with a protein called, Intrinsic Factor (IF) to travel to the intestine for absorption.

Deficiencies are caused by either malabsorption or inadequate intake of food and supplements that contain vitamin B12.

Vitamin B12 deficiency does not occur quickly, as we have stores in our bodies that can last for a few years. But there has been issues noted with birth defects, and cognitive, memory, and aging issues.

Why are Seniors at Risk of Vitamin B12 Deficiency?

Seniors are at higher risk of a vitamin B12 deficiency for several reasons:

Inadequate Food Intake

As we age we are at an increased risk for decreasing appetite and malnutrition. As a result of this, food choices that are selected may be low in animal proteins. Without animal proteins, vitamin B12 is not being ingested through the diet.

Low Red Meat Intake

Red meat can be a difficult meat to chew, especially if served as a dryer texture such as Steak and Roast Beef. Older adults who have dental issues may have an aversion to these meats, which are major sources of vitamin B12.

Achlorydia (low stomach acid production)

The stomach acid production decreases naturally as we age. If there is not enough HCl in the stomach, vitamin B12 cannot detach from the food source. Without this detachment, it does not bind to IF and cannot be absorbed in the small intestine.

Decreased Nutrient Absorption

Older adults intestines do not absorb nutrients in the same quantities as a younger person. This means that they need to ingest higher amounts of food in order to have the same levels of nutrient absorptions. The issues comes that they do not typically eat as much food.

Medication Interactions

Many older adults take multiple medications also known as poly pharmacy. There are a few medications that can interfere with the absorption of vitamin b12 such as Metformin, Proton Pump Inhibitors (Omeprazole), H-2 Receptor Blockers (Ranitidine), among others.

Having multiple medications such as these can block the absorption of vitamin B12.

pill organizer.

Signs and Symptoms of Vitamin B12 Deficiency

There are some common signs and symptoms of a deficiency, though it will vary depending on the risk factors for each person. A deficiency is considered at <200 pg/ml or <75 pmol/L.

Here are a few signs that more vitamin B12 is needed:

Memory impairment
Attention deficit
Vision difficulty
Anemia diagnosis

It’s important that if you or your patient are experiencing any of these symptoms, a deficiency should be confirmed through a blood test. Especially if they are at higher risk for being deficient.

Risks of a Vitamin B12 Deficiency

It takes awhile for someone to become vitamin B12 deficient because our livers maintain the stores for a long time.

But when we do become vitamin B12 deficient, the effects are significant. Here are a few problems that may occur if you or a patient is B12 deficient:

Poor cognitive function
Age related macular degeneration
Megaloblastic anemia
Pernicious anemia

Vitamin B12 Benefits for Elderly

Vitamin B12 benefits for the elderly are literally life changing!

Here are a few major benefits:

Improved Cognitive Function

There are some fantastic studies that suggest that having adequate vitamin B12 levels can improve cognitive function and Dementia if there is a deficiency.

Anemia Prevention

Red blood cells need adequate levels of vitamin B12 in order to form properly. Keeping our blood healthy and happy can keep away pernicious and megaloblastic anemia!

Energy Levels

Vitamin B12 plays a role in energy metabolism, by having adequate levels it promotes increased energy and endurance.


Vitamin B12 has been shown to play a role in Serotonin and Dopamine. Both of these hormones play a role in affecting our mood. Having adequate vitamin B12 levels in our blood can help to ensure production is best!

How to Improve Vitamin B12 Levels

Vitamin B12 is thankfully an easily accessible vitamin through both improving diet and taking a daily supplement. I recommend a food first approach, but in the elderly this can be difficult.

Taking a Vitamin B12 supplement can give just as great results in health benefits as food though, so don’t be discouraged if eating animal products isn’t your thing.

Foods with Vitamin B12

Animal products are the number one source of naturally occurring vitamin B12. Increase these foods if you suspect you may be low!

Canned Tuna
Low Fat Milk
Fortified Cereals

vitamin b12 food sources, portion size, and vitamin b12 content.

Vitamin B12 Supplements

If you are recommending a Vitamin B12 supplement, it’s important to take a look at the doses. The doses range from 100 micrograms (mcg) to 5,000 mcg.

You can also get them in liquid or pill form.

The form of vitamin B12 doesn’t matter, if you have difficulty taking pills or don’t want to add another to your daily intake, then liquid can be a great option.

What does matter is the dosage.

The daily recommended intake for adults is 2.4 micrograms.

Most vitamin B12 options on the market are far above the recommended daily intake. I usually recommend going with the lowest dose you can find to meet your daily needs. But always check with your Doctor before starting a new vitamin or medication.

When to Check Vitamin B12 Levels

If you are:

Over the age of 65 years old
Vegetarian or Vegan
Recent anemia diagnosis
Recent Dementia diagnosis, or current
On the medications listed above

If you fall into any of the above categories, I recommend that you get your vitamin B12 level tested. The first step is to increase the amount of Vitamin B12 food sources, and supplement with a vitamin after!

Vitamin B12 benefits for elderly are worth checking blood levels and supplementing where needed.

You can find more great information like this by clicking here!

Dietitian Takeaway Points

  • If your patient is on long-term use of Metformin, H-2 Receptor Blocks, or Proton-Pump Inhibitors, ask the Doctor to check B12 levels.
  • If the Doctor will not, discuss implementing a daily vitamin B12 dose as a precaution for low levels.
  • If a patient has mild to moderate Dementia or cognitive impairment, discuss adding Vitamin B12 to their daily routine.
  • Check the menu to ensure there is adequate servings of Vitamin B12.
  • A deficiency is considered at <200 pg/ml or <75 pmol/L
  • Finally, check out the number 1 Long Term Care Dietitian’s Clinical Reference Guide Here!
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.

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