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Low Vitamin B12 Levels: An Underestimated Cause Of Cognitive Impairment

Up to 40% of the population in Western countries is affected by a vitamin B12 deficiency, as they often eat too little vitamin B12-rich foods. This can lead to neurological and hematological disorders and symptoms in extreme cases.

Vitamin B12 levels that are too low or borderline (200–300 pg/ml or 148–221 pmol/l) are common in people with discrete symptoms or completely asymptomatic patients.

However, screening all adults at average risk for vitamin B12 deficiency is not recommended.


Vitamin B12 deficiency is seen relatively often in older people due to poor diet and lack of medical monitoring. Additionally, low vitamin B12 levels are often associated with regular medication like METFORMIN (for diabetes) and PROTON PUMP INHIBITORS ( often taken for heartburn or acid reflux gastritis, etc.)

Also, all patients who have undergone bariatric surgery should receive oral vitamin B12 supplementation (1 mg daily) indefinitely.



Why do we discuss vitamin B12 at IHEALTHY.IO; Brain Health?


Vitamin B12 is essential for our nerve function. Low levels can lead to peripheral neuropathy, headache, and neuropsychiatric disorders.

Experts worldwide investigate the link between low vitamin B12 levels and dementia—for example, a study from Pakistan included 202 patients.

One hundred seventy-one of those (84%) reported marked symptomatic improvement after vitamin B12 replacement, while MMSE (MINI MENTAL STATUS EXAM used to diagnose dementia) scores improved in 158 (78%) patients. Of the remaining 44 patients who reported no symptomatic improvement, MMSE scores improved in 26, while 18 patients showed no MMSE score improvements.


Vitamin B12 deficiency is linked to cognition, and supplemental therapy may support patients' cognitive performance. Certainly, it is not a cure for dementia. It is a small puzzle piece of what our brains require to perform at their best.




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