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.