Approximately 5.8 million people in the United States have Alzheimer’s disease and related dementias, and these life-altering diseases have a widespread impact across the United States. But while it can be shocking to see signs of forgetfulness in a loved one, doctors say it shouldn’t be automatically assumed they have dementia.
Several factors, including vitamin B12 deficiency, can lead to typical dementia symptoms. “Vitamin B12 deficiency can lead to cognitive impairment, including thought disorders,” says Scott Kaiser, a geriatrician and director of the Division of Geriatric Cognitive Health at the Pacific Neuroscience Institute in Santa Monica, California. says the doctor. “It could definitely mimic the symptoms of dementia.”
Combine this with the fact that older adults are more likely to have difficulty fully absorbing vitamin B12, putting them at risk for vitamin B12 deficiency, and doctors believe that at least those who have older loved ones states that people should be careful about vitamin B12 deficiency. Unlike dementia, this is a reversible health problem.
But what is vitamin B12 deficiency and how can you tell it from dementia? Doctors explain.
What is vitamin B12?
According to the National Institutes of Health (NIH), vitamin B12 is a water-soluble vitamin that occurs naturally in some foods, but is also available as a dietary supplement and prescription drug. This vitamin helps the body produce DNA and also plays a role in the development and function of the central nervous system, including the brain and spinal cord.
The human body cannot produce vitamin B12, so we must get it from external sources such as meat, dairy products, eggs, fortified foods, and supplements, the NIH says. Most adults need 2.4 micrograms of vitamin B12 per day, but during pregnancy and breastfeeding the value is slightly higher.
Causes of vitamin B12 deficiency
There are several reasons why vitamin B12 deficiency can develop. “It’s difficult to maintain a vegan diet for years,” says Deborah Cohen, an associate professor in the Department of Clinical and Preventive Nutrition Sciences at Rutgers University School of Health Professions. “Humans can store small amounts of vitamin B12,” she says, so it can take a while for a deficiency to appear.
But Cohen says there are many other risk factors for vitamin B12 deficiency, including long-term use of certain drugs for gastroesophageal reflux disease (GERD), such as the diabetes drug metformin and proton pump inhibitors. “These drugs reduce the secretion of intrinsic factor, a protein secreted by cells in the stomach that transports vitamin B12 from the stomach to the last part of the small intestine, where it is absorbed. ,” Professor Cohen explains.
People who have had stomach surgery to lose weight, older adults, and people with gastrointestinal diseases such as Crohn’s disease or celiac disease are also at risk for B12 deficiency, she says.
Symptoms of vitamin B12 deficiency
According to doctors, vitamin B12 deficiency has several characteristic symptoms.
- lack of energy
- mental fatigue
- nausea, vomiting, or diarrhea
- Anorexia
- weight loss
- yellowish skin
“Vitamin B12 is essential for energy production,” says Dr. Amit Sachdev, medical director of the Department of Neurology at Michigan State University. “The most common symptom of B12 deficiency is fatigue.” That fatigue and related symptoms can be confused with symptoms of depression or dementia, he says.
Kaiser said people with vitamin B12 deficiency can be forgetful and confused, making it difficult to concentrate and complete tasks. In more severe vitamin B12 deficiency, delusions and paranoia may develop. “It can mimic dementia,” Kaiser says.
How to distinguish vitamin B12 deficiency from dementia symptoms
Doctors say it’s difficult to tell whether a person has vitamin B12 deficiency or dementia just by doing a physical exam. “There’s no way to tell the difference based on this.” [cognitive] says Parul M. Goyal, M.D., assistant professor at Vanderbilt University Medical Center and director of geriatric medicine at Vanderbilt One Hundred Oaks.
But if you have gastrointestinal symptoms that started around the same time as your cognitive problems, your doctor may suspect vitamin B12 deficiency, Sahadev says. “The combination of physical and cognitive changes is a big clue that a treatable cause, such as vitamin B12 deficiency, may be the problem,” he says.
How is vitamin B12 deficiency detected?
If a doctor suspects a vitamin B12 deficiency, they will typically order blood tests to check a patient’s levels, Kaiser says. However, low vitamin B12 levels do not automatically mean that someone’s symptoms are caused by a vitamin B12 deficiency.
“B12 deficiency is also common in Alzheimer’s patients, so two things could be going on,” Kaiser says. As a result, doctors usually recommend taking vitamin B12 supplements and seeing what happens. “Treatment of vitamin B12 deficiency and improvement of symptoms can help determine the cause,” Kaiser says.
But things shouldn’t get to this point if your loved one visits the well regularly and gets blood tests done, Sahadev says. “Monitoring his B12 in the lab regularly with well testing is the most common way to detect a deficiency,” he says.
What to do if a loved one develops dementia-like symptoms
If your loved one is showing signs of dementia, doctors emphasize the importance of seeing a health care provider for a diagnosis. “Many people avoid being evaluated because of the common misconception that these memory changes are normal with age, but that’s not a helpful assumption,” Kaiser says. “There’s a misconception that there’s nothing we can do about it, but that’s not true.”
Once diagnosed, doctors typically order blood tests to check for vitamin B12 deficiency and other potential factors that can cause dementia-like symptoms, Sahadev says. In fact, if your loved one has a vitamin B12 deficiency, an oral or intramuscular supplement will likely be prescribed, Sahadev says. If you’re taking a drug that may be causing the deficiency, such as a proton pump inhibitor or metformin, your doctor may recommend trying a different type of drug, Goyal says.
Ultimately, doctors emphasize that vitamin B12 deficiency and its associated symptoms are reversible. “The effects of supplements are often seen within a few weeks,” Sachdev says.
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