Healthcast 698 - Vitamin B12 and Brain Aging

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Health now a days requires following a fresh food diet, with supplements to fill the gaps in nutrition.

Vitamins have been treated with disdain by medical doctors since I was in medical school half a century ago. Doctors have routinely told their patients that vitamin and mineral supplementation is unnecessary if a person has a “normal diet”.    Sadly no one in our society has a normal, whole food, nutritious diet without fast food, high sugar and fat additives to make us consume more food, or preservatives.  That is the first piece of misinformation the government tells doctors and society about our diets.

Second piece of misinformation that confuses doctors who are not trained in nutritional and preventive medicine is that the reference ranges on a lab sheet are healthy levels.  The truth is that the reference range is the lowest range of vitamin blood levels that keep a person alive, not the optimal levels that can keep people healthy!

The governmental agency, the FDA, that is paid for by you the taxpayer, does not look out for you as an individual but looks out for the health of the country (financially, and to keep people as a group healthy enough to stay alive, but they do not have the individual patient in mind when they make the rules about supplements, or what medications individuals can take or even afford, and they don’t promote health, they only promote NOT DYING! Public health is not the health of individual citizens it is about just keeping people alive even if they are unhealthy without a quality of life. You should know this difference when your doctor who probably still believes everything the FDA and the medical societies say, so they tell you that you are healthy even if you feel terrible, can’t walk or can’t sleep!

Preventive medicine is the medicine that I do.  Medicine that has as its goal, health and a productive quality of life is what we do.  Health in the current American society cannot be obtained listening to the rules of the FDA.  They don’t represent you as an individual. 

Health now a days requires following a fresh food diet, with supplements to fill the gaps in nutrition we all have, and healthy exercise every day, replacement of the hormones that decline with age, and medications to treat the diseases that lead to disability and death.  Even when taking medications, we have to be aware of the vitamins that each medicine overuses and causes deficiencies, and we need to replace them if we take certain meds, eg Metformin requires that you take extra methyl-B12, and Statins requires you to take CoQ10 daily to replenish normal levels that statins use up.

Today I want to talk about the role of B12 vitamin that is generally found in animal products, especially meat, and fowl. B12 is essential to normal muscle growth and strength, and normal neurologic function, including thinking, memory, and normal sensory and motor function of the peripheral nerves.  If you have peripheral neuropathy and you have not been given methyl B12 and Methyl folate then that should be your first move to see if you replace your vitamins, you can reverse your symptoms.

What not to do: Don’t get blood work and believe your doctor that your B12 is ok if he uses the reference ranges in your blood work.  The blood reference ranges represent the lowest level of a vitamin that can keep a healthy young person alive, not the blood level that is optimal for any person to maintain health. The optimal B12 level is 400-1500, not 250-800 like some labs show as the reference range. The next thing to know about B12 is that 1/3 of the American population has a gene that doesn’t allow them to make B12 in their diet into the active form, methylated-B12 so they can actually use it!

Vitamin B12 is essential to life and is necessary for a human’s ability to think and maintain  normal  brain function.  B12 has many functions in the body including maintaining normal sensory nerves and motor nerves. I’d like to  concentrate on B12’s function in the brain.

A recent study in Annals of Neurology 2025 found that Vitamin B12 deficiency causes changes in the brain that symptomatically looks like memory loss and inability to problem solve, and over time results in dementia and cognitive impairment.

Symptoms of B12 Deficiency

• Balance problems
• Memory problems
• Psychosis
• Nerve Damage
• Megaloblastic anemia

By the time these changes occur they are usually irreversible and adding B12 to the diet may not treat these changes in neurologic function.

The most important thing discovered was that the blood levels of B12 listed in the reference range are too low, and these problems occur when patients have what is considered “normal B12 levels”.

They found that people need higher B12 blood levels than the reference ranges to prevent these changes, what I have been telling patients for over 20 years!

Who is at risk for B12 deficiency, and therefore rapid aging of the brain?

B12 is only found in animal products such as beef, lamb, seafood, poultry and dairy foods so Vegans are at high risk for dementia and other neurologic diseases.

• Vegans
• If you drink more than one mixed drink, one glass of wine or two beers a day you are at risk for B12 diseases.
• If you take Metformin and don’t replace B12, you are at risk.
• If your blood level is 200- 400 pg/ml you are deficient in B12.
• Taking antacids or omeprazole decrease your ability to absorb B12
• Some patients lose the ability to make a stomach enzyme that allows them to absorb B12.

Brain Aging is diagnosed by the appearance of the symptoms listed above, as well as CT scans or MRI findings revealing brain shrinkage.

The Caveat That Makes B12 Treatment Much More Difficult

Over one third of Americans cannot take B12 as cyano-cobalamine.  They have an MTHFR genetic defect that makes them unable to methylate the cyano-cobalamine into something that can be used by the body. For those people B12 must be taken as Methyl-B12 and not cyano-cobalamine.  Blood tests for genetic changes in MTHFR genes or a high Homocysteine are diagnostic of this inability to use B12.  The confusing thing is that these patients appear to have normal B12 levels on blood tests but they cannot use it so that fools doctors into thinking that they are safe from the diseases caused by low B12. 

Take away from this Blog:

• You should supplement with methyl B12 to prevent brain aging
• Blood levels of B12 are not healthy reference ranges—you need more
• You need a higher than 400 pg/ml blood level to avoid brain aging
• If you have MTHFR or don’t know you should only supplement with methyl B12
• If you take Metformin, you should take more B12 than recommended
• Dose of methyl B12 should be about 5,000 mcg/day