The People's Perspective on Medicine

Are You Suffering Senility or Vitamin B12 Deficiency?

Symptoms of a vitamin B12 deficiency may mimic senility, with poor concentration, constipation, balance problems and tingling or numbness in hands or feet.
Old man confused with many question marks

Whether they admit it or not, a lot of middle-aged and older people worry about senility. By this, they mean cognitive difficulties or even dementia, perhaps coupled with physical frailty. However, getting old by itself does not necessarily bring on such declines. Instead, the trouble might be a vitamin B12 deficiency, as one reader reports.

Early Onset Senility?  

Q. A few years ago I thought I was experiencing early onset senility: depression, lack of concentration, near-paralysis when faced with decisions to make. It threatened to ruin my career.

At the time, my doctor told me it was stress and that I should take it easy. Then I started waking at night with the painful sensation that my hands were three times their normal size (they weren’t). A new doctor ran tests that showed a vitamin B deficiency. A transdermal patch with vitamin B12 made an immediate and dramatic difference. We never found a reason for the deficiency.

Symptoms of Vitamin B12 Deficiency:

A. Vitamin B12 deficiency can lead to symptoms such as numbness and tingling in hands and feet, balance problems, constipation, weakness, poor appetite, memory difficulties, burning tongue, confusion, depression and even dementia. In addition to testing for low vitamin B12 (cobalamin) levels in blood, doctors may need to test for high levels of methylmalonic acid. The combination offers a more reliable assessment of vitamin B12 deficiency.

Vitamin patches are relatively new and somewhat controversial. You can usually correct vitamin B12 deficiency with a fairly high dose of oral cobalamin. (You require only a few micrograms of vitamin B12 daily, so just 1 milligram would be a whopping dose, far more than you can absorb. A healthy person can absorb about 10 mcg or a 500 mcg dose.) Ask your doctor to monitor you to make sure you are achieving the proper level of this essential nutrient.

Causes of Vitamin B12 Deficiency:

Frequently, doctors can’t determine why someone develops a vitamin B12 deficiency, so that aspect of your experience is not surprising. When people don’t make adequate stomach acid they don’t absorb the vitamin effectively. Often, older people have trouble absorbing cobalamin from their food (CMAJ, Aug. 3, 2004). Perhaps this helps explain how a deficiency might be confused with senility. In addition, patients with pernicious anemia lack intrinsic factor, which is essential for vitamin B12 absorption. Such individuals will need transdermal patches or injections to get around their absorption difficulties. 

Plants do not contain vitamin B12, so strict vegetarians and vegans run the risk of low levels of this nutrient. Moreover, certain medicines, especially those that suppress stomach acid production, can also contribute to deficiency. The diabetes drug metformin and the antibiotic chloramphenicol have also been associated with inadequate vitamin B12 levels. If you are concerned about the possibility of senility, be sure to ask your health care provider to check your vitamin B12 levels first.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Andres E et al, "Vitamin B12 (cobalamin) deficiency in elderly patients." CMAJ, Aug. 3, 2004.
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There could be 2 reasons for vitamin B 12 deficiency
One is that if you take medication for heartburn it eliminates stomach acid which is needed for vitamin B12 production. Two is if you have parasites (worms) they eat away all your vitamin B12.
Hope this helps

Parasites could lead to vitamin B12 deficiency, but it is an unusual cause in the US:
https://www.mdedge.com/ccjm/article/100687/gastroenterology/unusual-cause-vitamin-b12-and-iron-deficiency

I have to have a B12 shot monthly, as I’m not absorbing many nutrients from foods due

toggastric

Was told by UK GP they do not do B12 test as a general rule.

After my mother’s experience, this has become a campaign of mine. I seriously wonder how many elderly people are stuck in dementia wards for a simple, undiagnosed B12 deficiency.

My mother’s symptoms came on quickly: at most a couple of months. The worst of it in her case was logic loops: the refrigerator was leaking and needed to be replaced. I explained that I had accidentally left the freezer compartment door open, which accounted for the water on the floor; but she insisted that because there was water on the floor, it proved that the refrigerator wasn’t working!

Our friendly neighborhood neurologist guessed immediately what the problem was. After 5 days on B12 supplements, the fog lifted and she said, “Wow, I was really crazy, wasn’t I?”

Most critically, when I told her primary physician this story, the response was a dismissive “Oh well, too much of a vitamin does as much harm as too little.” The neuro told me sadly that he had made no headway either, in trying to alert his fellow physicians to this well-documented phenomenon–even in a community like ours, with a preponderant elderly demographic.

He told me that he had one patient who called the repairman 5 times for a refrigerator that was working perfectly. How fascinating that people project problems with their own circuitry onto their electrical appliances…

I am a 78 year old man with long history of coping with coronary arteriole sclerosis, including quadruple bypass surgery. For 2 years now, I”m taking daily metoprolol (25mg) and lisinopril (20mg) for hi blood press, plus rosuvastatin (10mg) to lower cholesterol. I believe one (or a combination) now cause side effects, above described as “B-12 deficiency problems”. Constipation is really a show-stopper. For that, I take mag bisulfate, stool softener and a couple laxatives daily, just to poop every 2-3 days. I’ll try a B-12 supplement (fingers crossed), and of course will converse with my doctor next scheduled visit, regarding your B-12 info. Sure wish I could control constipation. I should have some clue, regarding B-12, before then.

What dietary recommendations do you have for those who wish to keep their B12 levels up?

People who include animal protein such as eggs, dairy products, fish or meat in their diets usually get enough vitamin B12. The exceptions: those who are on medications that block absorption of this vitamin and those whose underlying conditions (such as pernicious anemia) interfere with absorption. Those individuals will need supplements. So will strict vegans.

Very interesting! I am 63 and diabetic I have B12 deficiency. Currently I am taking 2000 micrograms of b12 and it’s helping. My doctor wants me to take metformin but I been holding off and take cinnamon every day. I am really not sure I want to take metaformin

I had five falls in 14 months.Notable damage each time, including a front lobe concussion. I went to a neurologist. My memory was shot, and I could not focus on anything. He put me through several tests. First ever to test my B12. It was very deficient, but I did not have pernicious anemia. He started me on weekly injections of B12. That was more than two years ago. I have not fallen since and regained memory. I’ve just started every two weeks this past week.

Isn’t the B-12 Deficiency blood test a notoriously bad indicator of deficiency? My mother’s levels were in the normal range and her hematologist would not test further. She had fifteen symptoms of pernicious anemia including macrocytosis, ataxia, extreme fatigue, gastritis, and cognitive impairment, in addition to thyroid disease and another autoimmune skin disease. I convinced her doctor to give her B-12 shots, but he would only prescribe four. She died a horrible death three months ago after suffering greatly. I only realized that it was probably pernicious anemia a year before her death and it was late stage. I never want this to happen to anyone again, but I don’t know where to start to get the word out that a B-12 test is a bad indicator of deficiency.

Serum B12 test alone is not adequate. Doctors need to use additional tests to get an accurate picture of B12 levels.

I tried this and it is for real. I take the Vitamin B12 and my hands are fine. I have stopped and the numbness returns. Upon starting it again the numbness disappears. My hands feel normal!

Your article on Vitamin B-12 was a gem.

I recently moved to another state needing to find all new doctors.
By way of my Rheumatologist, I was referred to his doctor as a Primary Care physician.
I told the Primary doctor that I was a bit dizzy, balance issues, confusion etc.
He tested me and sure enough, very low in B-12.
I do my own injections.
I can think more clearly, balance is still an issue but my ENT feels that it is an inner ear problem so I have had a brain MRI and will have a neck one as well. Haven’t received the results yet.
In the meantime, thank-you so much for this article!

I have been suffering from forgetfulness for a few years. I can be in a discussion with friends and go to make a comment on the subject of which I know and I will go completely blank. This happens to me a lot and is very embarrassing. I am afraid people might think I am losing my mind.

I also have a back injury that happened in 1995, then suddenly in 2018, February, I started having serious burning and tingling and itching of my feet and bottom of my shins. This came out of the blue, I could hardly walk and it was very painful, and still is.

I also take Metformin daily, 1/2 tablet twice day. My doctor says my B 12 is good but I wonder. I have been thinking of going to an endocrinologist instead of my primary doctor treating my diabetes, I don’t think I am getting all the info I should. He never told me how or what to eat or if I should change my eating habits. Anyway, I should get a better check up.

I have read that sublingual B12 is as effective as injections. The vitamin is absorbed directly into the bloodstream through the mucus membranes, so does not depend on stomach acid for absorption.

Unfortunately the standards set by laboratories that doctors abide by are down around 300 when they test your blood. But according to my mothers dementia doctor; a leading specialist at the Ohio state University Hospitals, for the brain – this number needs to be at least 500.

Thank you for this information. I believe i have a B12 deficiency. I have all the symptoms you mentioned.

I have a friend who had all the signs above, the doctor gave him b12 shots he was changed man he looked good and felt good but his wife insisted he had dementia. She found another doctor who did what she said and put him on abillify. Almost immediately he slipped into dementia . Now a year later full blowen dementia. He can do almost nothing. It is so very sad to see this. But he does whatever his wife said to do and did not question anything.

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