Older Adults and Vitamin B12
By Reed Mangels, PhD, RD
What do we know about vitamin B12?
- It’s an essential nutrient.
- Vegans need to use vitamin B12 supplements and/or foods fortified with vitamin B12.
- People, possibly including lacto and lacto-ovo vegetarians who eat few animal products often need to use vitamin B12 supplements and/or foods fortified with vitamin B12.
A recent study (1) adds to our knowledge about vitamin B12 and supports the U.S. recommendations that older adults (those 51 years and older), whether or not they are vegan, use supplements and/or fortified foods to get their vitamin B12 (2).
In this study, which was conducted in Ireland, 15% of older adults had a condition called atrophic gastritis. People with this condition produce low amounts of acid in their stomachs. Acid is needed to separate vitamin B12 from protein so that it can be absorbed. The vitamin B12 in fortified foods and supplements does not require stomach acid for absorption. Not surprisingly, those older adults with atrophic gastritis were more likely to be deficient in vitamin B12.
Another issue related to vitamin B12 is the use of a category of drugs called proton pump inhibitors. These medications are used to suppress stomach acid and to treat conditions like reflux and ulcers. Because these drugs reduce stomach acid, they also reduce vitamin B12 absorption. In the study from Ireland, proton pump inhibitors were used for more than 6 months by more than a third of older adults. Those taking higher doses (more than 30 milligrams daily) had a higher risk of vitamin B12 deficiency.
Although older adults using vitamin B12-fortified foods 5 or more times a week were at lower risk of developing a deficiency of vitamin B12, some older adults using fortified foods, especially those with atrophic gastritis, were at risk of vitamin B12 deficiency. This may be because of the relatively low amount of vitamin B12 used to fortify foods in Ireland.
Vitamin B12 deficiency in older adults has been associated with depression, confusion, dementia, poorer bone health, and heart disease (3) so it is important that older adults are aware of the need to get their vitamin B12 from supplements and fortified foods.
That’s where vegans come in. Many of us are aware of the need for vitamin B12 supplements; we know which foods are fortified with vitamin B12. We can share this information with older friends and family members who should be using fortified foods and/or supplements as their main source of vitamin B12.
To read more about vitamin B12 see:
Vitamin B12 and Nutritional Yeast
Does Your Favorite Plant Milk Provide Vitamin B12?
References
1. Porter KM, Hoey L, Hughes CF, et al. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr. 2021;114(4):1286-1294.
2. Institute of Medicine, Food and Nutrition Board: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B-6, Folate, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.
3. Porter K, Hoey L, Hughes CF, Ward M, McNulty H. Causes, consequences and public health implications of low B-vitamin status in ageing. Nutrients. 2016;8(11):725.
