Dementia risk could increase with low levels of essential vitamin

“Normal” levels of vitamin B12 may not be enough to ward off dementia, new research finds.

Researchers at University of California San Francisco studied 231 healthy older adults (averaging 71 years of age) who did not have dementia or mild cognitive impairment.

Blood tests showed that their B12 levels averaged 414.8 pmol/L, while the recommended minimum level in the U.S. is just 148 pmol/L.

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Participants who had lower B12 levels were found to have “slower cognitive and visual processing speeds” when taking tests, which is linked to “subtle cognitive decline,” according to a UCSF press release.

The effect was more pronounced with age.

The people with lower levels also had more lesions in the white matter in their brains, which can be a warning sign of cognitive decline, dementia or stroke, the researchers found.

The findings were published in Annals of Neurology on Feb. 10.

Based on these results, the researchers recommend updating the current B12 requirements.

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“Previous studies that defined healthy amounts of B12 may have missed subtle functional manifestations of high or low levels that can affect people without causing overt symptoms,” said senior author Ari J. Green, MD, of the UCSF Departments of Neurology and Ophthalmology and the Weill Institute for Neurosciences. 

“Revisiting the definition of B12 deficiency to incorporate functional biomarkers could lead to earlier intervention and prevention of cognitive decline.”

“Revisiting the definition of B12 deficiency to incorporate functional biomarkers could lead to earlier intervention and prevention of cognitive decline.” (iStock)

The researchers did acknowledge that the study only included older adults, who may have a “specific vulnerability” to lower levels of B12.

Those lower levels, however, “could impact cognition to a greater extent than what we previously thought, and may affect a much larger proportion of the population than we realize,” according to co-first author Alexandra Beaudry-Richard, who is currently completing her doctorate in research and medicine at the UCSF Department of Neurology and the Department of Microbiology and Immunology at the University of Ottawa.

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“In addition to redefining B12 deficiency, clinicians should consider supplementation in older patients with neurological symptoms even if their levels are within normal limits,” she suggested in the release. 

“Ultimately, we need to invest in more research about the underlying biology of B12 insufficiency, since it may be a preventable cause of cognitive decline.”

“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment.”

Dr. Brett Osborn, a Florida neurosurgeon and longevity expert, said the study supports the idea that “normal” vitamin B12 levels are “grossly inadequate” for protecting the brain from age-related decline.

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“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment — slower processing speeds, increased white matter hyperintensities on MRI (a marker of small vessel disease), and elevated tau protein (a biomarker of neurodegeneration). This is concerning to say the least,” Osborn told Digital.

The current minimum recommendations weren’t designed for optimal cognitive function or longevity, according to Osborn.

One neurosurgeon and longevity expert recommends supplements of B-complex vitamins, including B12, to ensure healthy levels of homocysteine, an amino acid that is produced during protein metabolism. (iStock)

“Instead, they were based on population averages — an inherently flawed approach when the ‘average’ person today is metabolically unhealthy. This is yet another example of mainstream medicine lagging behind the science.”

In Osborn’s clinic, he recommends supplements of B-complex vitamins, including B12, to ensure healthy levels of homocysteine, an amino acid that is produced during protein metabolism.

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“When homocysteine is elevated — a potential proxy for low B12 — brain function declines,” Osborn said.

The doctor did note that the study is observational, and that “correlation doesn’t prove causation.”

“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment.” (iStock)

“But do you really need a randomized controlled trial to tell you that optimizing B12 intake benefits brain health? That’s like waiting for a study to confirm that eating vegetables is good for you,” Osborn said. 

“The data are there. The science is crystal-clear.”

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Like the researchers, Osborn called for an update to the “normal” lab levels.

“It’s time to start defining health by optimal levels — not by whatever happens to be ‘average’ in an increasingly sick population. Because who wants to be normal when you can be optimal?”

“No clear evidence has been found to suggest benefit in B12 supplementation in patients without a deficiency.”

Dr. Earnest Lee Murray, a board-certified neurologist at Jackson-Madison County General Hospital in Jackson, Tennessee, agreed that this study raises the question of redefining what levels constitute a B12 deficiency.

“Previous studies have recommended supplementation in patients with a known vitamin B12 deficiency to mitigate cognitive issues; however, no clear evidence has been found to suggest benefit in B12 supplementation in patients without a deficiency,” Murray, who was not involved in the study, told Digital. 

The neurologist cautioned against people taking “mega-doses” of vitamins.

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“Often, high levels of vitamins, especially B12, won’t cause issues; however, it can happen,” Murray said. 

“I would recommend that patients who are older or at risk of developing cognitive decline discuss with their physician about being tested — not just for vitamin B12 levels, but also for other markers that could suggest improper absorption of vitamin B12.”