The signs of low B12 in a woman over 60
The trouble with low B12 is that nothing on the list sounds like a vitamin problem. Every one of the signs Dr. Martin names has an easier explanation sitting next to it, and the easier explanation is usually age.
Here is his list from episode 779. Short of breath going up a flight of stairs. Yawning, sucking for air. Heart palpitations. Memory trouble. A burning mouth. Add fatigue, which he has put at the top of the hit parade for decades.
Read them again as a group. Individually they are nothing. Together they are one thing.
Breathless on the stairs, and yawning for air
Dr. Martin on the stairs:
Dr. Martin, The Doctor Is In, Episode 779You go up a flight of stairs and you're short of breath, it's usually a sign you're low in B12.
The mechanism is the same one behind everything else on this page. Without B12 you do not make enough red blood cells. He describes red blood cells as FedEx trucks on the highways of your blood vessels, carrying hemoglobin and oxygen. Fewer trucks, less oxygen delivered, and a flight of stairs feels like a hill.
Yawning belongs to the same story, and it is the sign nobody connects. Yawning is sucking for air, he says. Not tiredness. Air.
Then the part women over 60 hear most often, which is that their level came back normal. His answer is to not wait for the blood test. When someone tells him their number is 300 and their doctor is satisfied, his position is that the body is starving for B12 anyway, and so is the microbiome.
Heart palpitations
Palpitations frighten people, and the usual first thought is magnesium. He does not dismiss that.
Dr. Martin on palpitations:
Dr. Martin, The Doctor Is In, Episode 779One of the reasons, okay, you can have a magnesium deficiency, but heart palpitations are often, often, often, often a shortage or a deficiency in B12.
Four times. That is not a man hedging. He backs it with his own office rather than a paper, and says to ask Nicole, who worked with him for years, how often they found B12 deficiencies. Incredible, is his word for it.
Palpitations always deserve a proper look from your own doctor. His point is only that B12 belongs on the list of things to check, and it usually is not on it.
Memory and the nerves
Your brain needs B12. Your nervous system needs B12. He says both flatly, and then explains what for.
Dr. Martin on the nerves:
Dr. Martin, The Doctor Is In, Episode 779The myelin sheath of your nerves that cover your electrical grid in your brain and the central nervous system absolutely need B12.
Myelin is the coating on the wire. Strip the coating on any wire in your house and the current still runs, badly, until it does not. That is the picture he wants you holding when a woman in her sixties says her memory is not what it was.
He is not dramatic about the consequences. You are not going to croak right away, he says. You just will not be at the top of your game, and for a lot of women that describes the last five years exactly.
Digestive problems mean absorption problems
This is the question he gets after every list: I eat well, so why would I be low?
Dr. Martin on digestion:
Dr. Martin, The Doctor Is In, Episode 779If you put your hand up, if you have digestive problems, you just about figured that you're low in B12.
And then the reason, which is physical rather than dietary.
Dr. Martin on why it is hard to absorb:
Dr. Martin, The Doctor Is In, Episode 779It's one of the reasons a lot of people are low, because they don't absorb it properly because it's such a big vitamin compared to other vitamins.
He calls B12 a finicky vitamin, and the molecule is large next to the others. So a woman can be eating steak and still not be getting much of it across, because the gut doing the work is not doing it well.
It also explains where it comes from in the first place. Cows eat grass and you get B12 from the cow. You do not eat grass. Salad, as he puts it, is glorified grass.
The medications that drain it
He used to measure B12 in the office, which is why this list is his own rather than a label warning.
- Metformin, for diabetes.
- Acid reflux medication, because lowering stomach acid lowers what you release from food.
- Blood pressure medication.
- Antidepressants.
He goes further and says almost any medication, including everyday painkillers when someone lives on them, and that he used to surprise people in the office with the result.
Now the part that has to be said as clearly as he says it. This is an observation about B12 levels. It is not a reason to stop anything you have been prescribed, and he does not tell anyone to. If something on that list is in your cupboard, the useful move is to have your B12 checked, not to change your medication.
One test worth asking for
Besides a B12 level, he names one more on this episode: homocysteine, an amino acid test.
High homocysteine means high inflammation, in his reading. And what lowers homocysteine? B12. That is why he likes the test, because it shows the shortage doing damage rather than just sitting on a chart.
Both are requests you can make at your next appointment.
What to do about it
His preference is a daily sublingual methylcobalamin, which dissolves under the tongue and goes into the bloodstream instead of taking its chances in the digestive tract. Given that the whole problem in this episode is absorption, that is the consistent choice.
He is not against the B12 shot at all. He gave plenty. The comparison is laid out in sublingual B12 versus the B12 shot, and the reasons so many people are low in the first place are in why are people so low in B12.
And the food answer stays the same as it has always been with him. Red meat, because that is where it is.
Common questions
What are the symptoms of B12 deficiency in a woman over 60?
The ones Dr. Martin names in this episode are being short of breath going up a flight of stairs, yawning and sucking for air, heart palpitations, memory trouble and a burning mouth.
Can low B12 cause heart palpitations?
He says yes, and that this gets missed. You can have a magnesium deficiency, but palpitations are often a shortage of B12.
Why am I low in B12 if I eat well?
Because it is an absorption problem more than an intake problem. B12 is a large molecule and hard to absorb, and digestive problems plus several common medications make it harder.
Which medications lower B12?
He names Metformin for diabetes, acid reflux medication, blood pressure medication and antidepressants, and adds that he saw it with everyday painkillers taken constantly. He is clear he is not telling anyone to stop a prescription.
What causes a burning mouth?
He puts burning mouth on his list of signs of low B12. It has other causes too, so get a persistent one looked at.
Read next: Tired All The Time At 60: B12 Or Something Else and How Much B12 Does A Woman Over 60 Actually Need?.
B12, from the clinic shop
Martin Clinic's Vitamin B12 is a sublingual methylcobalamin, the form he says he prefers because it goes in under the tongue rather than through a stomach that may not be absorbing well.
60-day money-back guarantee. Talk to your practitioner about your own levels and about anything you are prescribed. Nothing here is a reason to stop a medication.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
