Can't find what your looking for?
Need a little extra help?
Please contact us.


B-12 Deficiency Behind Mental Decline?

A recent NY Times article speaks to the fact that an undiagnosed Vitamin B-12 deficiency may be behind the mental decline that is often attributed to the aging process and also such diseases as age-related dementia and Alzheimer’s. They also rightly note that low B-12 levels can be related to poor energy, fatigue, muscle weakness, depression and even incontinence. All of these are commonly accepted as part of normal aging, and maybe it doesn’t have to be this way.

I wanted to highlight a few of the more important points that the article makes and also expand upon the idea of B-12 supplementation to help assure the best results.

Vitamin B-12 must come from animal sources for us to be able to absorb and use it – so strict vegetarians and vegans are at a higher risk.

When B-12 comes from animal sources, appropriate amounts of stomach acid are required to be able to “free” the B-12 for absorption. As we age our hydrochloric acid production decreases and by the time we are older a fair percentage of us will not make enough HCl to do the job. Furthermore, acid-suppressing medicines like Prilosec or Prevacid or Zantac or Tagamet make this problem worse – not just for older people. Furthermore, there is a substance known as “intrinsic factor” that is also required for B-12 absorption – and a portion of the elderly do not have adequate amounts of this either.

Certain other prescription medicines can interfere with this whole process – most commonly Metformin (Glucophage) – and people that have had stomach surgery for weight loss often have a problem here too.

Blood testing is not always accurate in determining a real deficiency because there can be apparently adequate amounts of B-12 in the blood while certain tissues – especially in the brain – are lacking.

If you want to take Vitamin B-12 as a supplement, I strongly recommend using one of the active forms of B-12, called Methyl-Cobalamine (as opposed to cyanocobalamine; which is most commonly used in oral B-12 supplements) and using it in the sublingual form. This means using a lozenge that dissolves in the mouth and allows the B-12 to absorb through the mucosa there.

Who should consider taking a B-12 supplement? Certainly anyone that is vegetarian or on any of the stomach acid-suppressing medicines or is on Metformin. Also, anyone that seems to be aging poorly; especially in the mental function arena. It is cheap, easy and convenient – and just might reverse the time clock a little bit for you.

5 responses to “B-12 Deficiency Behind Mental Decline?”

  1. mary sturm says:

    I’m starting to take this per Brian’s suggestion. I’d be curious what othr experiences are and would appreciate receiving any followup coments via email.

    thanks and I hope I can “remember” to check and see what others have to say….

  2. Kristen says:

    I am very curious about the B-12 losengers. I have a b12 deficiency (pernicious anemia, anti-Antiparietal cell antibody positive. And I’ve been told by multiple doctors (western medicine) that the shots are the only way to keep my b12 and blood counts at a normal range. They said this is beacuse the b12 has to be stored in fat/muscle since my body would not properly process it any other way ie- nasal spray, losenger, pill. Is this in fact true?

    • Hi Kristen… thanks for the question…

      In my understanding of biochemistry, what you are reporting is not accurate. B-12 is a water soluble vitamin; and thus is not really stored in the body. I believe that injections supply a bolus of B-12 into the muscle that then goes readily into the blood for distribution throughout the body. This bypasses the absorption mechanism that is the problem with folks that have pernicious anemia.

      The prescription injection of B-12 is cyanocobalamin… but some studies have shown that using one of the active forms of B-12, like methylcobalamin, under the tongue, achieves excellent B-12 blood levels.

      So, for general purposes, taking 1,000 mcg of methylcobalamin under the tongue, every morning, will be sufficient to keep B-12 blood levels where they should be. There are times when I will recommend as much as 5,000 mcg daily to help reverse the nerve damage that can happen as a result of B-12 deficiency, or to help nerve cells communicate and repair with such issues as shingles or diabetic neuropathy.

  3. Edie says:

    Hi, Brian:

    1. What is the approximate time range (in months or years) that it could take to heal or reverse nerve damage (perhaps moderate to slightly more than moderate nerve damage) due to Vitamin B12 Deficiency where the myelin sheath has been affected/damaged?

    2. Also, besides taking Vitamin B12, what other supplements and recommendations do you suggest to help heal/repair the myelin sheath/nerve damage?

    Please reply and advise to both questions.


    • Hi Edie,

      Here are your answers…

      1. This is hard to know, there are many factors involved, including genetic predispositions… but I would expect that a few months at the quickest… and I would suggest being willing to use a fairly aggressive dosage (3,000 mcg) of the active form, methyl-cobalamine, under the tongue daily, for at least 6 months before giving up.

      2. As it turns out, Medium Chain Triglycerides (MCTs) are a source of ketones that brain and nerve cells can use for energy and there are some indications that they may help reverse degenerative neurological issues. The proper “therapeutic” dosage is 20g of MCTs a day. Here is a link to the MCT oil that I recommend for my patients…

      A little more than a tablespoonful a day would give you that dosage.

      Also, a proper dosage of fish oil is very important to enhance the communication from cell to cell in brain and nerve tissue.

Leave a Reply

Your email address will not be published. Required fields are marked *