Vitamin B12 and Menopause

Vitamin B12 is an essential micronutrient that is needed for more bodily processes than you probably realised.

Many of its deficiency signs match those of the menopausal transition so it’s important to determine if your symptoms are deficiency-related or not. 

Here are the main signs and symptoms of B12 deficiencies that show up at this stage of life:

• Tiredness and fatigue
• Difficulty thinking or memory issues
• Low moods such as apathy, depression, or irritability
• Digestive complaints
• Issues staying asleep
• Feeling like your heart is racing and pounding

Other common complaints include

• Numbness, tingling, or other altered nerve like sensations in your body such as burning feet
• Clumsiness, balance, or gait problems
• Development of tremors
• Vision changes
• Feeling light-headed, weak, or dizzy
• Feeling short of breath
• Having an inflamed red tongue
• Loss of appetite
• Cardiovascular complications
• Bone loss

You can assess your B12 levels in a few different ways

You can test B12 on its own and depending on where you live in the world this range varies significantly, which is insane. In some parts of the world, they consider it ok to have levels as low as 200 to be ok and others consider anything under 500 to be a blatant deficiency. I take a global view and want this number to be right at the top end of your range. But I also back this up with other tests that look at how your body utilises B12 to check you have enough.

If you have abnormal results in any of these tests you need to reconsider if you have adequate B12 for you as an individual.

• Issues with the size, shape, and number of your red blood cells
• an elevated fasting homocysteine level

When it comes to correcting a vitamin B12 deficiency it's important to first consider why your level was low in the first place. Here are a few common examples of how this can occur.

• Digestive issues, such as lower digestive acid production. This is, unfortunately, a common occurrence as we age
• Vegan or vegetarian diet as most B12 foods are from animal sources
• Excessive alcohol consumption
• Toxic metal exposure 
• Some Auto-immune conditions 
• Certain genetic polymorphism
• Some medications like antacids, anti-histamines, and some blood-sugar-lowering drugs.

If supplementing is the next step for you, you need to consider which form of B12 is the right choice for your symptom picture.

There are 4 different forms of B12.

• Cyanocobalamin is a form of vitamin B12 derived from cyanide and should be avoided. It has low biological activity and needs to be converted to a more active form by the liver. Long-term supplementation with cyanocobalamin can have systemic toxic effects. I don’t use or recommend this form.
• Hydroxycobalamin is more bioavailable than cyanocobalamin and is recommended for people with known methylation issues, smokers and is the best B12 form for anyone living with low blood pressure. It has cell protective as well detoxifying qualities.
• Methylcobalamin is another form of vitamin B12 and it is my most recommended form. Methylcobalamin is often taken to improve cardiovascular problems, cognitive impairments, behavioral issues, and circadian rhythm disturbances such as insomnia.
• Adenosylcobalamin is great to take alongside methylcobalamin to obtain the full spectrum of benefits that can be derived from vitamin B12 supplementation. Due to its role in myelin sheath production, it's the preferred form for women with nerve or spinal cord problems. Adenosylcobalamin is the form of vitamin B12 associated most closely with improving energy levels. 

 Once you know your form you need to consider which delivery method is best suited to you as there are also options here. Such as intramuscular injections, transdermal creams, drops, sublingual tablets, or capsules.

I bet you didn’t realise there are so many factors to consider with this essential vitamin. And it's just one of the many essential nutrients that keep our body running smoothly.  If you need help interpreting test results, reassessing your supplement intake or you would like a second opinion considering booking a consultation.