As a general rule, if you have a healthy diet with plenty of fresh vegetables and protein, you should be getting enough of most nutrients the old-fashioned way, as part of the food you eat.
But surveys show that around a fifth of people over 60 in the UK are deficient in vitamin B12.
Why is this? B12 is produced by micro-organisms in the guts of animals, so it’s plentiful in meat, eggs and dairy products. If you’re on a long-term vegan diet, you can get it from yeast extract, some algae or supplements. It’s essential for a healthy nervous system, so it’s routinely supplemented in pregnancy. But deficiency can also lead to less well-defined problems, like fatigue, depression, a fast heartbeat or poor digestion, and long-term deficiency causes irreversible damage to the nervous system. This can show up as tingling or numbness, mood changes or memory loss, and even psychosis or dementia.
So it’s important to get enough.
And even if your diet contains plenty, various health issues can reduce your ability to absorb B12, including inflammatory bowel problems, long-term use of medications like ranitidine and metformin, and overconsumption of alcohol. Any inflammatory condition, in fact, causes increased loss of red blood cells, and hence a greater need for B12 and iron to replace them. Elderly people are more likely to be deficient because poor absorption of nutrients is more common as we get older.
Things are rarely clear-cut where nutrition is concerned, but it’s safe to say that if you have a long-term history of any of these issues, it’s worth giving vitamin B12 some attention; and unless your deficiency is very severe, a general supplement of B vitamins is recommended, because an excess of one nutrient can affect the balance of others.