By Trisha McBride Ferguson
Mornings start the same for many older adults: coffee or juice, breakfast, and then the process of taking the day’s medicines and vitamins. Yet according to Chris Patterson, MD, CMD, Medical Director of CarePartners Program of All-inclusive Care for the Elderly (PACE), many seniors are missing adequate amounts of two critical vitamins: D and B12. And, even “normal” levels for these key vitamins may be too low for some patients, resulting in large populations unknowingly missing essential supplements.
Why Vitamin D?
Known as the source of strong bones, vitamin D offers more. “It turns out that vitamin D also has benefits to your muscles, colon, brain and immune system,” said Dr. Patterson. “Not getting enough vitamin D can also cause muscle weakness and lead to falls.”
“The revised minimum requirement for a senior is now considered to be 1,000 units a day,” said Dr. Patterson. “Unfortunately, you’d need to drink 80 ounces of whole milk a day to get this amount in your diet, and sun exposure poses a cancer risk. This is why we prescribe vitamin D supplements for all our patients.”
Nearly every patient Dr. Patterson sees tests low or deficient in vitamin D. “We really don’t know what an optimal vitamin D level is, so I prefer to keep people in the higher end of the range and I typically prescribe at least 2,000 units a day. I recommend the D3 over the D2, as it is better absorbed,” said Dr. Patterson.
Why Vitamin B12?
Vital for balanced health, vitamin B12 is only found in animal products, such as meat and eggs, and is considered one of the most difficult vitamins to absorb. “Medications that neutralize acid can cause a B12 deficiency; other medications, such as metformin, also cause B12 to not get absorbed,” said Dr. Patterson.
Frequently associated with anemia, a B12 deficiency can also cause many neurologic problems, including depression, dementia, incontinence, balance problems and falls from damage to the spinal cord. “The nerve damage is typically permanent, so it is important to prevent becoming deficient in the first place,” said Dr. Patterson.
Patients without anemia can still develop neurological damage from a B12 deficiency. “If folic acid (B9) is adequate, they will not become anemic from low B12,” said Dr. Patterson.
Another concern is that patients will stop taking B12 after seeing improvement. “This person will once again have their level fall low enough to cause further permanent neurologic damage,” said Dr. Patterson, who recommends keeping B12 levels over 500 pg/ml.
Christopher Patterson, MD, CMD, is Medical Director of CarePartners Program of All-inclusive Care for the Elderly (PACE).