Tired all the time at 60, is it B12?
Often, yes. It is the first thing Dr. Martin checks, and on this episode he opens with a study that backed him up.
Dr. Martin on how common it is:
Dr. Martin, The Doctor Is In, Episode 973And actually this study confirms that B12 deficiency is much more prevalent today than it used to be.
He spent his clinical years looking for deficiencies, and he says this was a very common one. It also used to be treated as one. In the 1950s and early 1960s, doctors handed out B12 shots without much fuss. His wife is a nurse and he says she gave more of them than you could count. His line about today is that you almost have to be dead before you get offered one.
Why it hides in plain sight
The title of the episode is the whole problem in three words, and it is worth understanding before you look at your own result.
Dr. Martin on what happens:
Dr. Martin, The Doctor Is In, Episode 973And so people walk around hiding in plain sight and they don't know their low in b12.
His explanation is the lab range. He calls it the hijacking of labs, and his point is that once a result sits anywhere above a couple of hundred, the report says normal and the conversation stops. His verdict on that floor is that it is enough B12 for a mouse.
Dr. Martin on how he reads the range:
Dr. Martin, The Doctor Is In, Episode 973And remember, if you're in the two hundreds, the three hundreds, the four hundreds, the five hundreds, you're literally deficient.
He does not stop there either. At six or seven hundred he says you are still low. Not deficient, not optimized.
The number he aims for
Dr. Martin on the target:
Dr. Martin, The Doctor Is In, Episode 973Now aim high, 800 to 1200 is optimized b12.
The reaction he gets to that is always the same, and he enjoys it. Someone rings up worried because their doctor called to say their B12 is high. His answer is that high is what they were aiming for.
His reasoning on the safety side is that B12 is water soluble, and he points out that emergency departments are not full of people who took too much of it. His reasoning on the benefit side is simpler. In practice, he says, when people optimized their B12 they felt better. That is what he is chasing, not a tick on a report.
Nothing here is a reason to start or stop anything a doctor has prescribed. Talk to your doctor first.
What drags B12 down
He asked the tired man he had been talking to one question before anything else: are you on any medication.
Dr. Martin on medications:
Dr. Martin, The Doctor Is In, Episode 973You know, you name the med, they knock your B12 down.
He singles out two. Metformin, which he says is extremely hard on B12. And anything for the stomach, the acid reducers, because stomach acid is what gets B12 out of your food in the first place. He adds blood pressure medication to the list. His words about what he saw in practice were almost no exceptions.
That is not a reason to stop anything. He does not tell people to come off their medication and neither does this page. It is a reason to have B12 checked, and to know what number you are looking for when you do.
Food and absorption
Dr. Martin on the second cause:
Dr. Martin, The Doctor Is In, Episode 973People don't eat enough steak and they don't get B12 in their food.
He calls it a double whammy, and the second half is the part people miss. Your stomach is meant to be very acidic, far more acidic than a cow's, because you were built to break down meat. Stop eating it and, in his words, you use it or you lose it. The pH drifts up, the stomach gets less acidic, and now you are absorbing less of whatever B12 you do eat.
Chicken, he says, is not steak. You still need acid to break it down, just not the same acid. And there is no B12 in the plant kingdom. If you eat little or no red meat, that is not a moral argument, it is an arithmetic one, and he covers it fully in why are people so low in B12.
If it is not B12
Tiredness at 60 is not always one thing, and it would be dishonest to pretend otherwise.
B12 is where he starts because it is cheap to check, common, and fixable. If the number comes back at 900 and you are still flattened, the two he goes to next are cortisol and the thyroid. Cortisol tiredness tends to be wired and tired, worst in the evening, with sleep that will not hold. Thyroid tiredness tends to be cold, slow, and comes with hair and skin changes. He has a whole episode on the thyroid one: the thyroid never acts on its own.
None of that is a diagnosis, and none of it replaces a blood test. It is just the order he works in.
Common questions
Why am I tired all the time at 60?
He checks B12 first, because he says deficiency is much more common now than it used to be and it is routinely missed behind a normal lab result.
What is a good B12 level for seniors?
He aims high, 800 to 1200. He calls anything from the two hundreds to the five hundreds deficient, and six or seven hundred still not optimized.
What medications lower B12?
He says you can name the med and it will knock B12 down. Metformin and stomach acid medication are the two he calls hardest on it, with blood pressure medication on the list too.
Can you get B12 from plants?
He says there is no B12 in the plant kingdom. Some of the other B vitamins are there, B12 is not.
Can you take too much B12?
He says B12 is water soluble and points out that emergency departments are not full of people who took too much of it.
Read next: How Much B12 Does A Woman Over 60 Actually Need? and What Supplements Should A 65 Year Old Woman Take?.
Rule B12 in or out
Martin Clinic's Vitamin B12 is a sublingual methylcobalamin, 4000 mcg in one daily serving, taken under the tongue rather than swallowed.
60-day money-back guarantee. If the tiredness is more wired than flat, he would look at Cortisol Control Formula next.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.
