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X Fact
August 26, 2020
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Are Older People More Likely to be Vitamin B12 Deficient?

That older people have lower vitamin B12 levels is beyond dispute as this has been well documented since the early 1950's when it was shown that B12 levels were lower in 51-70 year olds when compared with 15-40 year olds, and those over 71 had even lower vitamin B12 levels. The question is whether this is a 'normal' feature of aging.  If it was a normal 'physiologic' phenomenon, then the biochemical indicator of cellular B12 adequacy (MMA) would not be abnormal in up to 75% in this population and improve after B12 supplementation. Abnormalities of gastric function are responsible for the lion's share of low B12 levels in older individuals and the most common cause is Food-Cobalamin Malabsorption (FCM) which is the result of decreased stomach acid production needed to split vitamin B12 from its protein dietary source. If B12 cant be freed from dietary protein, then it cannot be picked up by Intrinsic Factor and escorted to the B12 receptor in the distal small bowel (ileum) for absorption.

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Methylmalonic acid (MMA) is a compound that reacts with vitamin B-12 to produce coenzyme A (CoA). Coenzyme A is essential to normal cellular function. When vitamin B-12 deficiencies occur, methylmalonic acid levels increase.

Intrinsic Factor
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Intrinsic Factor

Intrinsic factor is a protein that helps your intestines absorb vitamin B12. It is made by cells in the stomach lining. Intrinsic factor binds to vitamin B12. After attaching, intrinsic factor and B12 travel to the intestines to be absorbed into the bloodstream. Vitamin B12 is needed for red blood cells to form and grow‍‍.

Who Wrote This X Fact
Jonathan Bortz MD
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Jonathan’s background as a practicing diabetes specialist for 15 years and 17-year career developing nutritional prescriptive products for the pharmaceutical industry has contributed to his ability to understand nutrients, how they work and why they are important.

Over the years he has acquired broad and in-depth knowledge in minerals, essential fatty acids and other nutrients, but has special expertise in Vitamin B12 and choline metabolism. He is often asked to speak at national and international venues to articulate why B12, folate and choline are so important to gene function, brain development, liver and cardiovascular health. He applies pharmaceutical standards to nutrient science and has developed a unique ability to translate complicated concepts into simple promotional messages that resonate with practitioners and consumers. He has developed dozens of innovative nutritional products, of which many are category leaders in the US. Jonathan obtained his medical degree from the University of the Witwatersrand Medical School in South Africa and did his fellowship in Endocrinology at Washington University in St. Louis, MO.

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