Vitamin B12 deficiency is estimated to affect 10%-15% of individuals over the age of 60.
A recent study in Israel of elderly hospitalized patients found 40% had low or borderline serum B12 levels. Vegetarians are another group with inadequate dietary B12 intake since much of our B12 comes from meat consumption. A recent study showed 50% of long term vegetarians have B12 deficiency, with decreased serum B12 levels and elevated homocysteine levels.
Vitamin B12 deficiency can cause unusual neurological symptoms such as tremor, gait disturbance, severe pain, and can mimic MS (multiple sclerosis) or even Parkinson’s Syndrome. The physical signs and symptoms can often mimic other diseases and the diagnosis is frequently missed.
An excellent book on the topic is: Could it Be B12? An Epidemic of Misdiagnosis by Sally M. Pacholok, R.N. and Jeffrey J Stuart, D.O.
Most doctors do not test for B12, and even they do a blood test, they do the standard serum B12 which is unreliable (11). A more accurate test called the methyl malonate test has been devised. (12) This is the best test and the one that we do routinely in the office. The substance, Methyl Malonate is elevated in the urine and serum in patients with B12 deficiency. We have added this test to our standard panel, so everyone will be routinely screened with the most advanced and accurate test for B12 deficiency.
Should the B12 level be low in spite of oral or sublingual B12 supplements, then inexpensive B12 injections can be taken at home. Recent work by Kuzminski showed that daily 2 mg. oral B12 serves as well as monthly 1 mg intramuscular B12 injections. (13). We also test for Serum Homocysteine which is elevated in B12 deficiency, and of course the standard serum B12 test is aso included in our panel.
It is important to discover B12 deficiency early, since nerve damage can be irreversible if not discovered right away.