Vitamin B12 and Your Brain

December 19, 2009

Topic: Vitamin B12 and Your Brain 

 Competency:  #15 Vital Vitamins Reference: Neurology Sept 2008, Sept 9, (11) p 826

 If you take 107 healthy adults with no dementia, ages 61 to 87 and measure their ability to think, reason, remember (AKA: cognitive ability) and compare that to their B12, folate and homocysteine levels over the next five years, you will find a very interesting relationship.  Those folks whose B12 is in the bottom third of serum B12 will have a six times higher risk of “cognitive decline” over just five years compared to the folks whose B12 is in the top two thirds.   Ouch.  Six times.  We need to focus on B12 here.  

Why do we get in trouble so easily?  What’s going on and is there any hope for us. B12 is the biggest of the vitamins, making it the hardest to absorb.  We absorb it through our distal intestine, but it takes a special substance called “Intrinsic Factor”  in the stomach to bind it and shepherd it all the way through the gut to the terminal ileum.  As we age, we naturally make less.  In addition, unknown to most of you, the use of all those wonderful proton pump inhibitors (the most commonly prescribed drugs in America) severely inhibit the absorption of B12.   

Hence, if you are a bit older and happen to be on Prilosec (Aciphex, Protonix, Nexium) you may be at risk for B12 deficiency.  Just what is deficient? Here is the interesting conundrum.  The sickness model says you have enough B12 if your blood level is over 100 picograms.  But OPTIMAL is really 500 picograms.  There is a lot of real estate between disease state and optimal.  Considering that about 40% of Americans are “insufficient” and as many as 20% of folks over 65 are severely deficient, B12 deficiency becomes one of the most serious public health problems of the elderly, and one of the leading causes of “cognitive decline.” 

 Is there any good news?  Well, yes.  You can see your physician and get a blood test and get B12 shots if you are low.  Shots make sure you get it in you, even if you are older, have a lousy tummy and are on a proton pump inhibitor.  So, add that to your list of questions to ask your doctor.  You can also now absorb it through “passive diffusion”, even without intrinsic factor.  New supplements are coming onto the market place with unique and innovative cofactors that bind B12 and help transport it into your blood.  This transport agent called SNAC (sodium N-[8-2-hydroxybenzoyl amino]caprylate) increases passive absorption by as much as 10 fold.  AND, if we keep up with your B12, we can even reverse some of the neurological symptoms of deficiency.  Isn’t that smart! 

WWW.  What will work for me?  B12 deficiency is one of those secret hidden causes of cognitive decline we are all at risk for.  Rather than waiting till you get sick, think about a B12 strategy and to talk to your doctor about it.  A supplement of B12 with SNAC sounds like a cheap insurance policy to me.  Let’s go for the optimal model instead of the sickness model.  Learn your B12 serum level number.

Column written by Dr John E Whitcomb, MD,Brookfield Longevity, Brookfield, WI.   (262-784-5300)