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B12 for Menopause: What does the research say?

Vitamin B12: An essential nutrient

The role of B12 in the body

Vitamin B12 is an essential nutrient that is important for a healthy nervous system, formation of red blood cells and helps your body make DNA.

B12 can be found naturally in foods but it is bound to protein and needs to be released from the protein in order to be absorbed. This process occurs throughout the digestive tract, starting in the mouth. Fortified foods, like milk and nutritional yeast contain unbound B12 and is easily absorbed.

Food sources of Vitamin B12

The main food sources of Vitamin B12 are meat and animal products. These include red meat, poultry, seafood, eggs, milk and other dairy products. 

The only non-animal foods that contain significant B12 are those that are fortified. These include some plant-based milk, nutritional yeast, yeast spreads (Reduced salt Vegemite or Marmite) and vegetarian plant-based sausages, burgers etc. 

Mushrooms contain some natural B12 however the amount is very small and is unlikely to contribute significantly to B12 intake.

Infographic of foods high in B12

Recommended daily intake for menopausal women

The recommended daily intake for adult women, including those in perimenopause and menopause, is 2.4 micrograms per day.

Signs of Vitamin B12 deficiency

Vitamin B12 deficiency can be caused by a lack of absorption, certain medications or a diet low in high B12 foods. People who suffer from gastritis (inflammation of the stomach lining) may have decreased absorption of B12. Gastritis is more common in people over the age of 50 and therefore is important to consider for menopausal women.

Deficiency in B12 can cause anemia. Symptoms include:

  • Fatigue
  • Swollen, inflamed tongue
  • Palpitations
  • Loss of appetite
  • Headaches
  • Neurological issues like tingling in arms and legs, difficulty thinking/memory loss, weakness

Similar symptoms may also be a result of iron deficiency anemia. For more information see this blog post.

Menopause and Vitamin B12

What the research says about Vitamin B12 levels and menopause

Research about the link between Vitamin B12 and menopause is currently limited. There have been some studies that have looked at the relationship between B12 and bone density and its role in brain function. Bone and brain health are significant in menopause as we know that they can be affected by a decrease in estrogen. 

B12 has a role to play in converting homocysteine (an amino acid) into other amino acids, therefore lowering the levels of homocysteine in the blood. Many studies have shown that homocysteine levels are higher in people with cardiovascular disease, stroke, cognitive decline, Alzheimer’s disease and osteoporosis.

Currently, studies have been inconclusive in showing whether reducing homocysteine levels can reduce the risk of the diseases mentioned above.

Let’s look more closely at research on Vitamin B12 and its role in bone and brain health? 

Vitamin B12 and bone density

Vitamin B12 doesn’t have a direct effect on bone density. Its role in bone health is related to reducing homocysteine levels which can negatively affect bone formation. 

A literature review of studies that looked at B vitamins and bone health showed that many studies have reported an association between B12 and bone health. 

Intervention studies, where researchers looked at whether supplementing with B12 improved bone health, have shown mixed results. Some have had positive results, many have shown a reduction in homocysteine levels, however, no studies were able to show a significant improvement. 

Vitamin B12 and the brain

A review of 16 studies that looked at supplementation of Vitamin B12 on cognitive function in older adults without any neurological disease. It concluded that there was no evidence that vitamin B12 supplementation in people with and without deficiency improved cognition or reduced symptoms of depression.

Dietary strategies to ensure adequate Vitamin B12 intake

Vegan/Vegetarian diets

SInce vitamin B12 is found in animal foods, people who follow a vegan or vegetarian diet may become deficient.

Vegetarians who consume dairy products have a lower risk of deficiency whereas, vegans will need to ensure they consume fortified foods or take a supplement to meet the daily requirements for B12.

Foods fortified with B12

Many foods designed for people following a vegan diet are fortified with vitamin B12 and can be an excellent source of this essential nutrient.

Foods commonly fortified include plant-based milk, yeast spreads, nutritional yeast and vegan meat alternatives.

How to include vitamin B12- rich foods at each meal

If you eat meat, poultry, seafood and dairy, you can easily meet your Vitamin B12 requirements by including one or more of these foods at each meal.

If you are following a vegan/vegetarian diet, try these tips to ensure you are consuming adequate B12:

  • Use yeast spreads like Vegemite/Marmite* on toast or add them to soup or casseroles for extra flavour
  • Sprinkle nutritional yeast on pasta and other dishes
  • Include some fortified vegan meat alternatives into your meals
  • Add plant-based milk to cereal/oats and smoothies or use to make creamy sauces for pasta
  • If you eat dairy, include at least 3 serves a day

Note: * Check nutritional information of yeast spreads for vitamin B12 as some only contain other B vitamins

Summary

Vitamin B12 is an essential nutrient found in animal products like meat and dairy. Women following vegetarian and vegan diets may be at risk of deficiency as well as those with certain medical conditions or taking some medications. 

The need for vitamin B12 does not change once a woman reaches menopause. There is currently not enough evidence that supplementation with vitamin B12 improves bone density or cognitive function. Recent review papers have recommended further studies are needed to understand the role of B12 in prevention of diseases related to ageing.

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