Vitamin news: B12 and E

B12Two vitamins made the news in the past month, but thanks to the holidays, the stories didn’t get much attention.  Let’s remedy that.

Vitamin B12

Thanks to the obesity epidemic and poor diets, lots of people are taking medications for gastro-esophageal reflux disease, or GERD.  The basic problem is stomach contents, including acid, backing up into the esophagus.  It’s not good, because the acid can damage esophageal tissue.  But the stomach is made to withstand acid.  Stomach acid is essential to digestion.  Vitamin B12 absorption depends absolutely on stomach acid, which initiates the chain of metabolic reactions that moves B12 from the food you eat to your blood.

Unfortunately, those anti-GERD medications have been interfering with B12 absorption.  A new study found that people who had been taking proton-pump inhibitors or histamine inhibitors were much more likely to have a B12 deficiency after 2 years of medication use.  And more unfortunately: the people most likely to be taking these medications are older people already at higher risk for problems linked to B12 deficiency:nerve and cognitive function and bone mineralization.  Pernicious anemia is also caused by B12 deficiency.

So what should you do?  If you’re taking a GERD mediation, loading up on B12 supplements isn’t likely to help at all.  The problem is not the amount of B12; it’s the lack of stomach acid to facilitate absorption.  The best first step is a conversation with your physician about your medications, as well as a test for B12 status.  GERD isn’t an inevitable sign of aging.  If you’re obese (especially with significant abdominal fat), losing weight can help.  Large high fat meals that sit in your stomach are more likely to cause reflux problems, especially if you go to bed soon after eating.

Vitamin E and Alzheimer’s disease

This study did NOT show that:

  • vitamin E cures Alzheimers
  • vitamin E prevents Alzheimers

Instead, this new study reported that high doses of vitamin E seemed to help older people with existing Alzheimer’s disease retain some functionality a bit longer.  The subjects had mild-to-moderate Alzheimers disease and were already taking medication.  2000 IU of vitamin E a day helped them maintain the ability to perform some daily activities like getting dressed, while memory declined a bit less than subjects on placebo.  But it still declined.  And the benefit only lasted 6 months.

What to do with this information?  For Alzheimer’s patients with mild to moderate disease, on certain medications, vitamin E might help prolong functionality for a few months, but it will not cure the disease.   Patients and family members should discuss this with the physician before starting any regimen.  Taking high doses of vitamin E to prevent Alzheimer’s disease is not recommended since there’s no evidence it’s an effective strategy.  Worse, high dose vitamin E supplements have been linked to increased risk for hemorrhagic stroke, which has its own severe adverse effects on cognition and functionality.  So taking high doses of vitamin E could backfire.

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