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B12 Deficiency-Affects 43% of those over 65

Published June 18th, 2012 in Brain Body Connection

by Tammera J. Karr, PhD, BCHN, BCIH

In May of 2012 I attended the National Association of Nutritional Professionals (NANP) Conference in San Francisco. The first day of the conference I heard from an emergency room nurse- Sally Pacholok, RN, BSN and co-author of the book, Could it be B12? An epidemic of misdiagnosis. The information she shared was staggering on how a $36.00 vitamin treatment that is being overlooked by medical practitioners could save over 54.5 billion dollars a year in medical costs for fall related injuries only. The numbers only go up when you add dementia, depression, MS, hospitalization…..

Why aren’t doctors checking B12 levels? That is obviously the billion dollar question.

Part of the answer is doctors don’t think of the obvious anymore, An estimated 15% to 25% of older adults have a B12 deficiency, but many of them are never tested or diagnosed.  B12 deficiency causes suffering and serious injury—even death.  Yet many health care professionals mistakenly attribute signs and symptoms of B12 deficiency to aging;

Next comes no one wants to take responsibility, B12 awareness involves reeducating the health care community, educating the public, and holding health care professionals and health care institutions accountable to the patients they serve.

Healthcare providers like Sally are working hard to expose health care’s dirty little secret and putting an end to not screening symptomatic and at risk people.   Until the health care community is reeducated and up to date, the public is at great risk for unnecessary injury and poor health. The result of the healthcare community’s ignorance results in you the patient being passed from one doctor to another, and lab values are woefully out of date.  And the one answer with the strongest strangle hold is money. Why would a pharmaceutical company, hospital or doctor for that matter want to treat and cure your health challenges with a $36.00 yearly treatment when there are billions to be made with other designer drugs, therapies and tests?

Many of the case studies Sally went over with us are pending malpractice cases that she is on the review committee for. These cases involved a 26 year old male who will never be able to walk again, a young woman who had surgery with nitrous oxide without being tested for B12 deficiency before hand – she will need a walker or wheel chair for the rest of her life. As I said earlier the information was staggering, and now you see it was also infuriating to see what has been buried from public view.

Untreated B12 deficiency results in:

1.Fall-related trauma

2.Psychiatric illness


4.Use of other costly prescribed medications

5.Cognitive changes/dementia

6.Nursing home placement

Falls are the leading cause of death and disability for individuals over 65. Only 50% of those hospitalized for hip fractures are able to return home or live independently after injury. Seniors at high risk for misdiagnosis exhibit the following symptoms.

•Difficulty explaining symptoms

•Minimizing symptoms


•Dental problems


•Mobility limitations

•Already having a diagnosis for their symptoms

B12 deficiency mimics:

•Alzheimer’s disease


•Parkinson’s disease

•Essential Tremor



•Mental illness

•Diabetic neuropathy

Neurologic signs & symptoms


•Weakness of legs, arms, trunk

•Unsteady or abnormal gait

•Balance problems

•Difficulty walking




•Memory loss


•Impaired vibration

•Abnormal reflexes

•Restless legs


•Urinary or fecal incontinence

The 10 cent secret

•For < 10 cents per day—treatment for B12 deficiency for an entire year!

$36 divided by 365 days = 0.098

Injectable B12


•1,000 mcg/ml 1ml IM or SC qd or qod x 6 (I left in the dosing information for the many healthcare providers who have taken to reading this column)

•1ml q 2 wks for next 12 months

•$36.00 (cost/yr)

So before you think this is a deficiency of the elderly only – I want to stress the error of that thinking. Research supports this deficiency effects newborns, children, teens, adults as well as the population over 65. It is my opinion after hearing this lecture and following up with additional research after I got home that not only is this widely overlooked and miss diagnosed but it is a travesty and criminal that the American population is being denied this inexpensive and efficacious therapy.

Why Is B12 Deficiency So Frequently Misdiagnosed?

  • Most doctors and health care providers don’t know the facts about B12 deficiency.
  • Most patients who have B12 deficiency symptoms or are at risk for B12 deficiency never get tested.
  • The current standard for “normal” serum B12 levels is actually far too low.
  • Doctors frequently don’t diagnose B12 deficiency until the patient has enlarged red blood cells and/or macrocytic anemia—which are often late signs of advanced B12 deficiency.
  • People over 65 are frequently misdiagnosed because doctors blame their B12 deficiency symptoms on preexisting diseases and comorbid conditions.
  • The current Daily Required Intake (DRI) and Recommended Daily Allowance (RDA) for B12 health for adults, during pregnancy, and during child growth and development are grossly outdated.

B12 screening is not included for:

Older adults who fall or are at risk for falling.

Older adults who have cognitive changes or dementia.

Patients presenting depression or mental illness.

Patients who are pregnant or breastfeeding.

What tests to ask for?

  1. B12 serum test with
  2. Methylmalonic acid
  3. Homocysteine and
  4. Holotranscobalamin II which measures one of the blood binding proteins used to transport B12.

For more in-depth information on this epidemic I encourage you to read Sally’s book and go to her website –