Is It Old Age or Is It Something Else? Consider Vitamin B12

gold health vitamin b12 or old age

Did you know:

Nerve damage from long-term inadequate vitamin B12 is irreversible?

Older males have lower vitamin B12 levels compared to younger males and older females?

Vitamin B12 deficiency was associated with higher risks of depression in older females?

As we age, it is harder and harder for our digestive tract to release vitamin B12 from food?

Bioavailability of vitamin B12 can be 50% higher in supplements compared to food sources?

This article summarizes the critical role of vitamin B12, its relationship with aging, deficiency conditions and negative effects, health benefits, food sources and the role of supplementation.

As their grandpa, Stephen approached 75, our children increasingly noticed that he was becoming not like himself.

The usual energetic grandpa who was always keen to get up before dawn to go fishing with his family became more and more homebound. He still looked after himself well, but the reduction in energy level was obvious.

Another aspect of changes was his memory and cognition, with increasing occasions he could no longer accurately recall what he did with his grandchildren for the day. His ability to read stories to them and their usual favourite game of chess was becoming increasingly difficult and rare.

Were these just parts of normal aging? Or were there other factors to be considered?

Vitamin B12 Essential biological functions

vitamin b12 functions

Vitamin B12 or cobalamin is one of the essential vitamins. Essential vitamins are vitamins that are vital to our body’s functions but cannot be produced by our body. This means that we have to rely on our diet or supplements to get enough vitamin B12 for our body’s needs.

An added factor is the water-solubility of vitamin B12, making it hard to be stored in the body and increasingly reliant on daily intake from diet or supplements.

In the US and UK, about 6% of adults under the age of 60 have vitamin B12 deficiency. This rate rises to 20% in the population over 60 years of age. Meaning 1 in 5 seniors has vitamin B12 deficiencies. [1]

In New Zealand, 8% of the population may be deficient in vitamin B12. A study carried out among various ethnic groups living in New Zealand discovered over 20% of vitamin B12 inadequacy. [2]

Vitamin B12 is critical in the normal functioning of our body in many impressive ways:

vitamin b12 in nerve function

Vitamin B12 in Nerve Function

Vitamin B12 plays a critical role as a co-enzyme in the maintenance and restoration of healthy nerve cells thus the healthy function of our nervous system. Its essential function in DNA synthesis is especially important in the generation and maintenance of the outer surface of the nerves providing electrical insulation. This cell integrity facilitates fast and efficient nerve cell communications. [3]

vitamin b12 in red blood cell generation

Vitamin B12 in Red Blood Cell Production

Vitamin B12 is crucial during the process of red blood cell duplication and differentiation. It works with vitamin B9 (folate) to assist iron in the production of read blood cells. Deficiency in vitamin B12 leads to extra large abnormally developed red blood cells. These abnormal red blood cells cannot easily pass oxygen and energy from our blood to our cells, contributing to reduced energy and various health complications. [4]

vitamin b12 in dna synthesis

Vitamin B12 in DNA Synthesis

Vitamin B12 is the essential cofactor for two critical enzymes in DNA synthesis. It is also required in the generation of amino acids. Thus vitamin B12 is crucial in DNA and protein synthesis, being the basis of all the human body’s normal functions. [5]

Aging and Vitamin B12

To maintain an optimal level of vitamin B12 in our body, it is not only important to have adequate dietary intake, but more critically to have effective absorption of the key vitamin.

We are at greater risk of inadequate vitamin B12 as we age. This is not because our body needs more vitamin B12, but the age-related changes in our body, especially in the gut and digestive tract, lead to reduced absorption of dietary vitamin B12.

This is especially apparent in the absorption of protein-bound vitamin B12, which is the main food source of vitamin B12 present in meats. Reduced levels of stomach acids and digestive tract inflammation as we age contribute to the increasing difficulties in releasing free vitamin B12 from food proteins. [7]

The unhealthy growth of stomach bacteria also competes for vitamin B12 for their own use, reducing the available vitamin B12 for the essential function of our body as we age. [7]

A study done by Auckland University shows that older males in particular have lower vitamin B12 levels compared to younger males and older females. This is also the case even after supplementation. [19] Emphasizing the consideration of a higher level of dietary intake or supplementation in older males.

vitamin b12 and aging

Other factors that may contribute to inadequate vitamin B12 include:

Low intake of animal products, vegetarians and vegans [10]

Regular medication use, especially those that suppress stomach acid for reflux or ulcer conditions [11]

Digestive tract surgeries [12]

Digestive disorders such as Crohn’s and celiac disease [13]

Excessive alcohol consumption [14]

Signs to Consider Vitamin B12 vs Other Age-related Conditions

The blood level of vitamin B12 is not the best indication of vitamin B12 deficiency, as some people with a deficiency can show normal blood levels. [9] A combination of methods should be evaluated for more accurate reflection.

Together with these difficulties in diagnosis, symptoms of vitamin B12 deficiency usually develop slowly and can easily be confused with other chronic health conditions.

Signs of inadequate vitamin B12 that can be mistaken as onsets of other age-related neurodegenerative diseases include: [6]

signs of vitamin b12 deficiency



Memory loss



Mood swings

Reduced cognitive function

Difficulty in concentration

Hearing difficulties

Reduced eyesights


Pale skin

Shortness of breath

Muscle weakness


Weight loss

As these symptoms progress, changes in nerve cells can occur leading to numbness and tingling in the hands and feet. Maintaining body balance can also become increasingly difficult. [6]

Health Concerns of Inadequate Vitamin B12

Anemia can develop when we are deficient in vitamin B12 for the longer term. This means that our body cannot produce enough healthy red blood cells to provide for normal needs. Early symptoms include most of the above-listed signs. As the condition prolongs, it can cause damage to the heart, brain and other organs. [20] Vitamin B12-related anemia is also an autoimmune condition that can in turn attacks critical cells in our stomach that further diminishing vitamin B12 absorption. [21]

Misdiagnosed or untreated vitamin B12 deficiency can lead to Irreversible nerve damage over longer terms. Most people respond well to vitamin B12 deficiency treatment. But if left untreated for 6 months or longer the nerve damage can be permanent. [22]

health concerns of insufficient vitamin b12

More and more evidence links inadequate vitamin B12 to the increased risk of several age-related disorders. These include:

Heart disease [15]

Cognitive dysfunction [16]

Dementia [17]

Osteoporosis [18]

A trivial fact as our society develops in its nutritional recognition is the increasing emphasis on folic acid (vitamin B9 folate). With more and more of our food sources fortified with folic acid, the balance between the two B group vitamins is causing concern in their balanced ratio to support nerve functions. [7] From 2023 folic acid will become compulsory to be added to several food groups in New Zealand [8]

Vitamin B12 Health Benefits

vitamin b12 energy booster

Possible Energy Booster

Vitamin B12 has been well-recognized as a potential energy booster. All B groups of vitamins, including vitamin B12, are critical in energy production and metabolism. [24]

Vitamin B12 is an important factor in the process of our body’s production of healthy red blood cells. Under the condition of insufficient vitamin B12, red blood cells cannot develop properly, resulting in underdeveloped cells, which are larger and irregular in shape. These abnormal red blood cells can no move from the bone marrow to the bloodstream, severely affecting energy metabolism, and preventing oxygen from being carried to our organs and cells. [25]

One of the earliest signs of insufficient vitamin B12 levels in the body is low energy or fatigue [6]. In such circumstances, vitamin B12 supplementations can help boost energy levels. [26]

vitamin b12 as mood lifter

Potential Mood Lifter

While more research is needed in the areas of the effects of vitamin B12 on mood, we have learned that vitamin B12 is an important part of the production and metabolism of serotonin, the good mood chemical. [27] Insufficient vitamin B12 can lead to reduced serotonin production, leading to a negative mood. A study has shown that using a combination of antidepressant medication and vitamin B12 supplements provided a better outcome in improving depression symptoms compared to an antidepressant alone. [28]

A comprehensive review has found that insufficient vitamin B12 was associated with increased risks of depression in older females. [29] Vitamin B12 deficiency was found to double the risk of severe depression in older women compared to an adequate vitamin B12 level. While sufficient vitamin B12 levels have been found associated with better outcomes in depression recovery.

vitamin b12 support memory and brain

Support for Memory and Brain

Vitamin B12 provides a protective effect on neurons in the brain. Reduced numbers and quality of these nerve cells were associated with memory loss or dementia. [39] Vitamin B12 deficiency has been associated with memory loss in older adults. [40] Even mild insufficiency of vitamin B12 has been found to contribute to poor memory and cognitive performance [41]

Our brain is also the epic centre of energy consumption. Vitamin B12’s effect in maintaining energy production and oxygen transport through healthy red blood cells is also crucial in the normal functioning of our brain.

vitamin b12 support heart health

Support Heart Health

Vitamin B12’s supportive effect on heart health is associated with lower homocysteine, an amino acid, levels in our blood, which is in turn associated with reduced risks of heart disease. [42,43] This is also associated with heart attack and stroke incidences.

With our heart’s intensive need for energy to keep their critical functions, vitamin B12’s role in energy production also plays an important part in assisting red blood cells and oxygen delivery from our hearts.

vitamin b12 in bone health

Support Bone Health

Insufficient vitamin B12 levels have been associated with reduced bone mineral density in the femur and hips, especially in males. [31] This contributes to the reduced integrity of the bone and increased risks of osteoporosis, falls and breakages. [32,33]

Older females are 4 times more likely to develop osteoporosis than males. Vitamin B12 deficiency has been lined with low activity in bone generation. Studies conclude that adequate vitamin B12 intake is important in maintaining bone health and density. [34]

vitamin b12 support immune system

Support Immune System

Vitamin B12 helps support the immune system through its function in the regulation of gut bacteria balance. Insufficient vitamin B12 can cause changes in the gut environment resulting in increased risks for inflammation and oxidative stress. This can be reflected in multiple systems such as the respiratory, digestive and nervous systems. Vitamin B12 supplementation can support the immune system to fight off cold and flu by reducing symptom severity, speeding up recovers, and reducing the need for oxygen and intensive care support. [24]

vitamin b12 in macular degeneration

Potential Help in Macular degeneration (AMD)

Adequate levels of vitamin B12 can be a potential help in reducing the risk of developing macular degeneration. A randomized controlled trial showed a daily supplementation of vitamin B12 reduced the risk of AMD by 40%. [23] This is due to the effect of vitamin B12 supplementation in reducing a specific amino acid in our blood, called homocysteine, [35,36] which in turn has been associated with the development of AMD. [37,38] Researchers studied vitamin B12 supplementation for 7 years, finding fewer cases of AMD in the supplement group with 34-41% lowered risks. [23]

vitamin b12 healthy skin hair nails

Vitamin B12 in Healthy Hair, Skin, and Nails

Our hair, skin and nails are constantly growing and replacing their old cells. New cell generation becomes critically important in the health and integrity of these parts of our body. With vitamin B12’s importance in cell generation, sufficient levels are needed to facilitate healthy hair, skin and nails. [44] A variety of skin conditions such as vitiligo (patched skin discolouring), angular stomatitis (inflamed and cracked mouth corners) hair changes, nail discolouration, and hyperpigmentation have been associated with insufficient vitamin B12 levels. [45] Vitamin b12 supplementation has been shown to improve such conditions. [46,47]

Other Conditions

Vitamin B12 can have supportive effects on the following health conditions:

Pernicious anemia [55]

Heart disease [57]

Age-related macular degeneration (AMD) [59]

Fatigue [25]

Breast cancer [60]

Male infertility [30]

Vitamin B12 Food Source

food sources of vitamin b12

Good food sources of vitamin B12 include beef, pork, lamb, poultry, eggs, liver, seafood, shellfish, dairy and some fortified nutritional yeast.

Vitamin B12 in plant food is harder to be digested and absorbed, putting vegetarians and vegans at risk for vitamin B12 deficiency.


Natural food sources of vitamin B12 need the aid of stomach acid and enzymes to be released and absorbed. Decreased levels of these digestive factors from any reason, whether it is aging or medications, can cause difficulties in natural source vitamin B12 absorption. Up to 30% of seniors may not have sufficient stomach acid to obtain an adequate amount of vitamin B12 from natural sources. [48]

Vitamin B12 in supplements is in free form and is less dependent on stomach acid to be released and absorbed. Its bioavailability in dietary supplements can reach 50% higher levels compared to food sources. This can provide a reasonable alternative for dietary vitamin B12 intake, especially in older adults. [49,50,51]

vitamin b12 supplements

People that can benefit from vitamin B12 supplementation include:

Older adults [52]

Vegans and vegetarians [53]

People experiencing fatigue or negative mood [54]

People with pernicious anemia [55]

People with digestive disorders [56]

People with heart and blood vessel disease [57]

People with dementia [58]

People with Age-related macular degeneration (AMD) [59]

People with breast cancer [60]

For adults, the easiest way to get vitamin B12 is to take at least 2000mcg vitamin B12 supplement weekly or 50mcg daily. Vitamin B12 is well tolerated with no known toxic effects in larger amounts up to 1000mcg daily due to its water-soluble nature.

If also taking vitamin C supplements, it is recommended to take the two supplements at a 2 or more hours gap.

Back to Stephen

After considering all possibilities of Stephen’s condition. Our family decided to give vitamin B12 a try. Stephen has experienced noticeable improvements in his energy levels and cognitive functions. Though no longer able to go fishing at dawn enthusiastically, he is now keen to join us on a peaceful lake fishing trip or enjoys games of chess with the children. His general participation in life and conversations has improved greatly. Our children are blessed to have their grandpa back! Thanks to vitamin B12 supplementation!

Gold Health Vitamin B12

gold health vitamin b12 with nz kelp

Gold Health Activated Vitamin B12 uses the active form of vitamin B12 fortified by New Zealand grown and sourced kelp.

• Active form of vitamin B12 is easily absorbed in our digestive tracts and utilised by our cells

• New Zealand kelp is high in antioxidants a rich natural source of micronutrients, including vitamin B12, iodine, potassium, and many other trace elements.

• Acacia fibre is carefully chosen and added to support a healthy gut to facilitate natural vitamin B12 absorption from foods.

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1.     Vitamin B12

2.     Vitamin B12 Status of Various Ethnic Groups Living in New Zealand: An Analysis of the Adult Nutrition Survey 2008/2009

3.     B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin

4.     New Insights into Erythropoiesis: The Roles of Folate, Vitamin B12, and Iron

5.     Vitamin B-12

6.     Vitamin B12 Deficiency

7.     Vitamin B12 deficiency in the elderly

8.     Folate and the addition of folic acid to food

9.     Vitamin B12 and ageing: current issues and interaction with folate

10.  Vitamin B12 Intake From Animal Foods, Biomarkers, and Health Aspects

11.  Proton Pump Inhibitors, H2-Receptor Antagonists, Metformin, and Vitamin B-12 Deficiency: Clinical Implications

12.  The Effects of Bariatric Surgery on Vitamin B Status and Mental Health

13.  Prevalence and Risk Factors for Functional Vitamin B12 Deficiency in Patients with Crohn's Disease

14.  Effects of moderate alcohol consumption on folate and vitamin B(12) status in postmenopausal women

15.  Vitamin B12 deficiency – A 21st century perspective

16.  Association between Vitamin B12 levels and cognitive function in the elderly Korean population

17.  Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia

18.  The Role of B-Vitamins in Bone Health and Disease in Older Adults

19.  Circulatory and Urinary B-Vitamin Responses to Multivitamin Supplement Ingestion Differ between Older and Younger Adults

20.  Pernicious Anemia

21.  Pernicious Anemia: The Hematological Presentation of a Multifaceted Disorder Caused by Cobalamin Deficiency

22.  Various Neurological Symptoms with Vitamin B12 Deficiency and Posttreatment Evaluation

23.  Folic Acid, Vitamin B6, and Vitamin B12 in Combination and Age-related Macular Degeneration in a Randomized Trial of Women

24.  Be well: A potential role for vitamin B in COVID-19

25.  Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence

26.  The Many Faces of Cobalamin (Vitamin B12) Deficiency

27.  Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study

28.  Vitamin B12 Supplementation in Treating Major Depressive Disorder: A Randomized Controlled Trial

29.  Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis

30.  Vitamin B12 and Semen Quality

31.  B-vitamin status in relation to bone mineral density in treated celiac disease patients

32.  Vitamin B12 status is a risk factor for bone fractures among vegans

33.  B-Vitamins and Bone Health–A Review of the Current Evidence

34.  Low Plasma Vitamin B12 Is Associated With Lower BMD: The Framingham Osteoporosis Study

35.  Hyperhomocysteinemia

36.  The Effect of Vitamin B12 and Folic Acid Supplementation on Serum Homocysteine, Anemia Status and Quality of Life of Patients with Multiple Sclerosis

37.  Homocysteine and the risk of age-related macular degeneration: a systematic review and meta-analysis

38.  Homocysteine and risk of age-related macular degeneration: a systematic review and meta-analysis

39.  Neuroenhancement with vitamin B12-underestimated neurological significance

40.  Vitamin B12 and Folate Status in Cognitively Healthy Older Adults and Associations with Cognitive Performance

41.  Vitamin B-12 concentration, memory performance, and hippocampal structure in patients with mild cognitive impairment

42.  The current status of homocysteine as a risk factor for cardiovascular disease: a mini review

43.  Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies

44.  Hair, Nails, and Skin: Differentiating Cutaneous Manifestations of Micronutrient Deficiency

45.  A review of vitamin B12 in dermatology

46.  Hyperpigmentation as a Primary Symptom of Vitamin B12 Deficiency: A Case Report

47.  Dermatologic findings of vitamin B12 deficiency in infants

48.  Vitamin B12 and older adults

49.  Bioavailability of vitamin B12

50.  Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study

51.  Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study

52.  Vitamin B12 deficiency in the elderly: is it worth screening?

53.  Foods and Supplements Associated with Vitamin B12 Biomarkers among Vegetarian and Non-Vegetarian Participants of the Adventist Health Study-2 (AHS-2) Calibration Study

54.  Vitamin B12 Supplementation: Preventing Onset and Improving Prognosis of Depression

55.  Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia

56.  Vitamin B12 absorption and malabsorption

57.  Association between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: A Cumulative Meta-Analysis of Randomized Controlled Trials

58.  Vitamin Supplementation and Dementia: A Systematic Review

59.  B Vitamins and Incidence of Advanced Age-Related Macular Degeneration: The Alienor Study

60.  Vitamin B12 deficiency: a new risk factor for breast cancer?