Low levels of these 4 key vitamins and minerals could be sapping your energy, causing migraines and putting you at risk for disease.
3 of 4 | Vitamin B12
Like Vitamin D, B12 is involved in many of the body’s key functions. It helps with energy production, formation of red blood cells, nerve transmission and DNA synthesis. One extra-important duty: It helps turn the harmful amino acid homocysteine—produced as a byproduct by cells and a known risk factor for cardiovascular and other diseases—into beneficial methionine, an amino acid that the body uses to metabolize fat and help the liver in its detoxifying function.
New research is also supporting B12’s role in healthy brain function, especially as we age. A study in the journal Neurology found that people over 65 who had high levels of homocysteine (and other blood markers associated with insufficient vitamin B12) scored lower on cognitive tests and had less brain volume than people with normal levels of the B12 markers. And a simple blood test doesn’t always tell the whole story when it comes to this vitamin. “Blood tests have low sensitivity and specificity for detecting B12 deficiencies, and the symptoms can manifest in vague and different ways,” says Katherine Tucker, Ph.D., a professor in the department of health sciences at Northeastern University in Boston and one of the leading B12 researchers in the U.S. “There is a serious under-diagnosis of B12 deficiency.”
In addition, doctors are used to thinking of B12 deficiency as an older person’s problem, due to the aging gut’s reduced ability to absorb the vitamin. But younger people are at risk, too. In one study, Tucker found that up to 40 percent of middle-aged adults might be low in B12. “We think it’s more prevalent, even among younger people, due to the widespread and long-term use of acid blockers, because stomach acid helps your body absorb B12,” says Tucker. “Many doctors don’t even know if their patients are taking over-the-counter acid blockers.”
The recommended dose: The RDA for adults is 2.4 micrograms. Tucker recommends taking 500 to 1,000 mcg per day if you’re on acid blockers or have been diagnosed with low or deficient B12. It may sound like a lot, but if you’re deficient, you need to take more than the RDA to get back to normal. And the body might absorb just a small percentage
of that, especially if you have digestion problems. If you have multiple vitamin and nutrient deficiencies, Tucker suggests taking a B-complex supplement, but not in addition to a multivitamin, which could provide too much folic acid. To prevent a B12 deficiency, a multivitamin is sufficient for most people, but some may need injections, especially if they’re severely deficient.
Warning signs: “The earliest symptoms tend to be tingling or loss of sensation in your fingers or ringing in the ears,” says Tucker. “With progression, it can lead to brain problems and mood disorders with varying symptoms; it just depends on where the myelin coating of the nerves is affected.”The scary thing is that if a deficiency goes untreated for more than a year, the resulting nerve damage—including a possibility of dementia—may be irreversible.
Who’s at risk: The elderly, people who’ve had gastric bypass surgery or GI disorders, vegetarians/vegans and anyone on acid blockers may be deficient in B12.
Get tested: Ask for a serum cobalamin (vitamin B12) blood test. “If you’re below 200 picograms per milliliter on that test, you’re most likely deficient,” says Tucker. “Always
ask your doctor what your number is. If it’s between 200 and 350, you could still be low, so ask for a test for methylmalonic acid. If that’s elevated, you don’t have enough B12.”
How to get it: Fish and shellfish, red meat (especially liver), milk and yogurt are good sources. But if your intestines can’t absorb B12 due to loss of stomach acid with age or from medication, you’ll have to supplement.
Best buy: Bricker Labs Blast B12 ($11
for 4 ounces; vitacost.com); Mega Food Vegan B12 ($14 for 30 tablets; vitacost.com); Premier Research Labs B12-ND ($16 for 2 oz.; purelifenutrition.com)