24/05/2026
I couldn’t agree more with the comment about the importance of understanding a patient’s markers for B12, for cognitive decline.
And the fact that this is no longer a funded blood test in NZ – unless you meet certain criteria – blows my mind.
B12 is such an important nutrient to consider for brain function in all population. And we just don’t consume enough from our diet. Let’s be honest, here in NZ the majority do not eat organ meat, shellfish or enough seafood, DAILY, to have optimal B12 intake.
Also, I love the statement “this does not mean everyone should start taking high dose supplement…..” this is certainly true! Understanding a person’s methylation is fundamental in knowing if B12 is even the issue, it could be another B vitamin or other nutrient altogether, that is needed. Even working out which type of B12 should be taken.
And the serum B12 test reference is so wide, it is important to understand if we are actually dealing with a true B12 deficiency, in the context of presenting symptoms.
So yes, I feel we need to bring back funded B12 testing, and to understand where on the reference range someone falls in the context of risk for dementia, but also for children and teenage brain health.
But we should also be considering methylation as part of this picture and this is where I tend to ask patients to consider Active B12 and methylmalonic Acid, plus nutrigenomic testing.
If you have any questions around this, please make sure to reach out! 🤓
https://www.facebook.com/share/p/1DyKNQNchR/
We may have misunderstood vitamin B12 — and the brain could be paying the price.
A new study led by researchers at the University of California, San Francisco suggests that older adults with vitamin B12 levels considered “normal” may still show signs of subtle neurological decline.
The research focused on 231 healthy older adults with no dementia or mild cognitive impairment. Even though their average B12 levels were well above the current U.S. deficiency cutoff, those with lower levels of active B12 — the form the body can actually use — performed worse on tests of thinking speed and visual response.
The most concerning finding came from brain scans. MRI results showed that people with lower active B12 had more white matter lesions, a type of brain change linked to cognitive decline, dementia, and stroke risk. White matter acts like the brain’s communication network, helping different regions send signals to each other quickly and efficiently.
Researchers say this raises an important question: are current B12 deficiency cutoffs too low to protect brain health, especially in older adults?
Vitamin B12 is essential for making red blood cells, supporting DNA production, and maintaining healthy nerves. But this study suggests that simply being “not deficient” on a lab report may not always mean the brain is getting enough.
The researchers believe future guidelines may need to look beyond total B12 levels and include functional biomarkers that better reflect how much B12 is actually available to the nervous system.
This does not mean everyone should start taking high-dose supplements without medical advice. But it does highlight the need for better testing, earlier detection, and more attention to B12 status in older adults with memory, nerve, or thinking-speed concerns.
Source: University of California, San Francisco / Annals of Neurology — “Vitamin B12 Levels Association with Functional and Structural Biomarkers of Central Nervous System Injury in Older Adults.”