I saw a couple (both in their 80’s) from Texas in the clinic; both healthy and get occasional Vit B12 shots. They’ve had borderline deficiency in past. Both had parents who “felt better and got a boost” after B12 shots. They feel the same after getting their prn B12 shots. I’m now in a clinic setting where I can’t give Vit B12 shots. Previous trial of oral Vit B12 didn’t seem to work as well. My solution was to revisit the history of Vit B12 administration (explaining why oral supplements work), emphasize that much of this work came out of the VA in Denver, reassurance that the vast majority of seniors respond well to oral replacement, and give it another try.

Vitamin B12 deficiency

One thought on “Vitamin B12 deficiency

  • June 26, 2014 at 5:38 pm
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    In the late 70s and early 80s, B12 was marketed as a vitamin boost for those with fatigue. The marketing campaigns were filled with ordinary people describing how tired they had been until they started the B12. The shots had an additional placebo effect, as they must have been VERY potent since you only needed them once a month. This was the sister story to Lawrence Welk and Geritol’s cure of “Iron poor tired blood”. If I had to guess at the failed previous trial, I would guess 1 of 3 scenarios: 1) they were only taking 500 IU a day, perhaps coupled with 2) they were only somewhat compliant, missing doses 2, 3 or 4 days a week, or 3) the placebo shot effect noted above. By the way, B12 incidence increasing as we age is as a direct result of the loss of Parietal Cells in the stomach as we age. We all know that Parietal Cells make intrinsic factor which is necessary to absorb B12 in the colon. Just to add a bonus to this case, though, Parietal Cells also make gastric acid, thus… seniors make less acid as they age. Makes you rethink the widespread use of PPIs, huh?

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