The Proper Vitamin B12 Dosage for Seniors

21 October 2019 Assisted Living

Experts keep learning more about the importance of getting enough vitamin B12 in your diet, especially for seniors. But what is the right vitamin B12 dosage for seniors who want to enjoy the health benefits of this important vitamin? Read more to learn what vitamin B12 does and whether you should start taking supplements to improve your health.

What Is Vitamin B12?

Vitamin B12, also known as cobalamin, is an essential nutrient that has many roles in the human body. It helps make DNA, supports the normal function of nerve cells, and keeps the nerve and blood cells healthy. It helps produce red blood cells that prevent a type of anemia called “megaloblastic anemia,” which makes you feel tired and weak.

Your body needs vitamin B12, but it can’t produce it. You must eat foods that contain it naturally or that are fortified with the vitamin. There are also vitamin B12 supplements or you can get it from a multivitamin. Finally, there are prescription vitamin B12 supplements given to people who have B12 deficiencies.

People with another type of anemia called “pernicious anemia” have problems absorbing vitamin B12. The condition prevents people from making intrinsic factor, a protein in the stomach that allows them to absorb vitamin B12 from foods or dietary supplements. People with this condition might have any of several other conditions including chronic gastritis, autoimmune conditions, or they may have had all or part of their stomach removed.

You can get B12 from eating animal foods or foods that are B12 fortified. Some good sources include:

  • Beef liver and shellfish
  • Meat, fish, poultry, eggs, and milk
  • B12 fortified cereal, nutritional yeast, and other food products

Other sources of B12 include supplements in pill form, sublingual (under the tongue) tablets, a nasal gel, or prescription shots from your doctor. The latter is usually reserved for people who have a vitamin B12 deficiency.

What Is a Vitamin B12 Deficiency?

A B12 deficiency means you don’t have enough of the vitamin in your body and there is a shortage of healthy red blood cells. Red blood cells carry oxygen to various parts of your body. Without them, your tissues and organs become deprived, preventing them from working efficiently.

People at Risk of Vitamin B12 Deficiency

Some people are at a greater risk of not getting enough B12, even if they eat a diet with a high concentration of the vitamin. One example is older adults who don’t have enough hydrochloric acid in their stomach to separate the vitamin from the protein it is attached to. Experts recommend that adults over the age of 50 get their B12 by eating fortified foods and/or taking dietary supplements. They usually have fewer problems absorbing the vitamin from these sources.

Other at-risk groups include those with pernicious anemia or those with risk factors associated with the inability to make intrinsic factor. This includes gastrointestinal surgery and digestive disorders. Vegetarians and vegans who eat little or no animal foods might also be at a higher risk.

Health Benefits of Vitamin B12

Research continues on the benefits of B12 and some of the potential problems that occur if you don’t get enough. To date, experts know that vitamin B12:

– works with vitamin B6 and B9 (folate) to control high levels of homocysteine in the blood, reducing the risk of cardiovascular disease.

– deficiency is associated with dementia and low cognitive function. Although not proven, there might be some benefit to taking B12 supplements to help prevent or treat dementia.

Why Vitamin B12 Deficiency Is Common in Seniors

The amount of vitamin B12 you need daily depends on your age. The recommended daily allowance for adults of all ages is 2.4 micrograms. This number is higher for women who are pregnant or breastfeeding. Most multivitamins contain much higher levels of B12 in addition to numerous other vitamins.

Once you ingest B12, either in B12-rich foods or in supplement form, acids and enzymes in the stomach and small intestine begin breaking it down. Once processed, the small intestine absorbs the B12 and stores it in the body, primarily in the liver. The B12 in the liver might meet the body’s needs for several years. That means you can stop consuming B12 without developing a B12 deficiency for a long period of time.

Although most seniors get enough B12 in their diet to keep them healthy, their bodies lose the ability to absorb the vitamin. Digestive problems often occur with aging, making it harder for them to produce the acids and enzymes needed to process the B12. These risk factors might make it impossible to determine the right vitamin B12 dosage for seniors:

  • Failing to produce enough stomach acid due to a weakening of the stomach lining or from medications they are taking
  • Taking Metformin for diabetes, which has been associated with a high incidence of vitamin B12 deficiency
  • Alcoholism, which may cause irritation to the stomach, and/or a poor diet
  • Surgery involving the removal of any or all of the stomach or small intestine
  • Conditions like Crohn’s disease that reduce the ability of the stomach or small intestine to absorb the vitamin

Vitamin B12 deficiency is more common in older adults, but it’s also missed quite often. Many of the same symptoms of B12 deficiency are common in older adults. Fatigue, anemia, memory problems, or difficulty walking might appear as normal signs of aging.

Another reason the condition is often missed is that it occurs slowly. The initial deficiency is mild, and so are the symptoms. You might attribute them to another health condition. It’s important for seniors and their loved ones to recognize the symptoms of vitamin B12 deficiency and have their condition diagnosed as soon as possible. B12 deficiency is easily treated, and treating it can prevent non-reversible damage from occurring.

Do I Need to Be Checked for Vitamin B12 Deficiency?

Usually, getting the correct vitamin B12 dosage for seniors isn’t the problem. It’s more about identifying potential risk factors that might put someone at a greater risk of a deficiency. If you or your older loved one has any of the health problems or associated risk factors of a vitamin B12 deficiency, it’s a good idea to have your, or their, levels checked.

If you or your aging parent is experiencing problems with memory and brain function, dementia is always a concern. Those same symptoms could mean they need to be tested for a vitamin deficiency instead. Getting tested is fast, easy, and important.

Diagnosing and Treating Vitamin B12 Deficiency

Request a vitamin B12 serum level from your doctor. Most doctors also test for folate since a deficiency causes similar symptoms. Even if B12 levels are low, you might not have anemia. If the results are borderline, request a confirmatory blood test if the doctor doesn’t order one. A high methylmalonic acid test usually means there is a vitamin B12 deficiency.

If the test shows a deficiency, the doctor will prescribe the appropriate vitamin B12 dosage for seniors. Usually, this involves intramuscular injections of vitamin B12 of 1000 micrograms. This high dosage bypasses any problems in the stomach or intestine interfering with absorption.

Doctors sometimes prescribe high doses of oral vitamin B12 supplements between 1000 and 2000 micrograms per day. While these supplements raise B12 levels, they take longer to work than injections given in the muscle. That makes them better for maintaining B12 levels than for treating a deficiency.

Seniors aren’t always happy about getting shots, but it can be difficult to ensure they take their supplements regularly each day. It depends on the individual’s ability to follow a medication schedule whether shots or oral supplements are the best choice.

In addition to prescribing B12 injections or supplements, the doctor might order additional tests. If the cause of the deficiency is unknown, additional tests should reveal what caused the condition.

What if My Treatment Exceeds the Recommended Vitamin B12 Dosage for Seniors?

Some types of vitamins are toxic when given at too-high levels. Vitamin B12 doesn’t pose any risk when you take more than necessary. However, there may not be any benefit of taking more than the recommended dosage after you reach the recommended levels. The biggest concern is in identifying and treating a deficiency to prevent harm to your body and brain.

Although taking high levels of vitamin B12 like those given to treat a deficiency isn’t dangerous, it can cause side effects including:

  • Dizziness
  • Anxiety
  • Vomiting
  • Headache
  • Nausea

High supplementation can also interact with some types of drugs including those used to treat digestive problems, gout, diabetes, and gastric reflux. Also, if you’re taking vitamin C supplements, it can reduce the levels of B12 in your body. Don’t stop taking your vitamin C while taking B12 supplements. Instead, plan when to take each vitamin to prevent any problems and get the full benefit of each.

When taking both types of supplements, you should wait a couple of hours after taking the vitamin B12 to take the vitamin C supplement. Talk to your doctor about any potential interactions. He might advise changing drugs or timing doses to offset any potential interactions between them and your vitamin B12.

Nutrition for Seniors in General

Good nutrition is important for any person at any age. Getting the right balance of nutrients helps your body stay strong, supports various functions, and gives you energy. Some types of nutrition aid in maintaining your weight or in preventing disease. The problem for many people is that those needs change as they age.

Your body changes as you get older, slowing down and developing a higher risk for many health conditions. Your lifestyle also changes as you get older. Seniors who live alone and have health conditions and impaired mobility might have difficulty shopping for healthy foods, much less preparing them.

Sometimes medications affect a person’s taste buds or make their mouth dry. They might make them not want to eat at all. The sense of smell diminishes or changes and some people have problems chewing or swallowing their food. Any of these factors can cause older adults to eat a diet that is lacking nutrition.

One of the big advantages of assisted living is that seniors have the option to have healthy meals provided to them on a daily basis. The goal is to eat foods with a lot of nutrition without adding a lot of extra calories. You should also eat a variety of foods from each category including:

  • Fruits
  • Vegetables
  • Lowfat or fat-free dairy with added vitamin D and calcium
  • Seafood, lean meats, poultry, and eggs
  • Beans
  • Nuts & seeds

Even though you won’t have the same energy as you did when you were younger, it’s important to stay active. Even if you limit your physical activity to walking, it can help restore your appetite. Also, make sure you drink plenty of liquids. You can lose your sense of thirst as you age, making it easy to become dehydrated.

In addition to vitamins B12, D, and calcium, which are all very important as we age, older adults should also pay special attention to potassium and fiber. Including a variety of the foods listed above and eating vitamin D and vitamin B12 fortified foods should be enough for most people.

If you suspect you have a vitamin deficiency, go to your physician for a blood test. Symptoms of different types of deficiency are similar. They also share symptoms with some health conditions. If you do have a vitamin B12 deficiency, taking the standard vitamin B12 dosage for seniors isn’t enough to raise your levels. You will need the higher levels provided by prescription strength injections or oral supplements.

How Assisted Living at Bethany Homes Can Help

Aging comes with many changes and limitations that are new to your way of life. When performing daily tasks gets to be too much, worries over nutrition often take a backseat. Bethany Homes offers a full range of services that include assisted living and care, Alzheimer’s & memory care, and in-home care for a broad range of needs. Enjoy home-cooked meals that are delicious and nutritious with your dietary considerations in mind. Obtain the level of personalized assistance that you need and always have access to physicians and healthcare providers when you need them. Contact us today to learn more about our services and schedule a tour today.