Normal B12 Levels by Age, Plus Symptoms of a Deficiency Women Over 50 Need To Know

Vitamin B12 may be last on the numerical list of B vitamins, but it’s highly important for health and vitality. And according to Fred Pescatore, MD, a vitamin B12 deficiency is surprisingly common—in fact, he estimates that at least two-thirds of us suffer from B12 deficits to some degree. Diets low in the vitamin, medical conditions and common medications can be to blame. Plus, age can impact B12 absorption to make women over 50 vulnerable to shortfalls. Wondering if your B12 levels are high enough? Here we break down normal B12 levels by age, plus what to do if yours need a lift.

Why healthy B12 levels matter

“Vitamin B12 (cobalamin) is essential for producing red blood cells, maintaining a healthy nervous system, synthesizing DNA and converting food into energy,” notes Laura Binder, LAc, of Santa Monica Acupuncture and Wellness. And as Dr. Pescatore notes, B12 also keeps a lid on homocysteine, an amino acid that can increase the risk of heart disease.

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Vitamin B12 deficiency symptoms to watch for

According to Leigh Erin Connealy, MD, medical director of the Center for New Medicine, severe deficiencies in vitamin B12 can cause the following symptoms:

• Numbness, burning or shooting pains in extremities 
• Difficulty walking or poor balance
• Glossitis (a smooth, red and sore tongue)
• Shortness of breath and/or heart palpitations
• Memory loss or mood changes
• Megaloblastic anemia (large, abnormal red blood cells)

But less-dramatic B12 deficits can also cause symptoms, she warns. Among them: Fatigue, brain fog, mild depression or irritability and tingling in the hands or feet. 

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Normal B12 dietary levels by age

The body can’t make B12 on its own, so it relies on sources such as animal products (meats, poultry, fish, shellfish, eggs and dairy) and vitamin B12 supplements. The normal daily dietary levels of B12 recommended by the NIH—based on age and life stage—are as follows:

Normal B12 blood levels by age

You can get your levels of vitamin B12 checked through a simple serum or plasma blood test. While doctors don’t typically screen for B12 deficiencies as part of routine exams, they may order testing if you’re experiencing symptoms of low B12 levels. Healthy ranges may vary slightly from one lab to another depending on the testing method, but according to Yale University experts, here’s what’s considered normal B12 blood levels across most ages:

Note: A blood test measures circulating levels of vitamin B12, not the amount being used by the body. “For more accurate insight, check methylmalonic acid (MMA) and homocysteine,” Dr. Connealy urges. “These markers can detect functional B12 deficiency, where the cells are not properly using the B12 that’s already there.” 

What causes a vitamin B12 deficiency?

Stomach acid is needed to properly absorb vitamin B12, and acid production drops naturally over time in older adults. The result: “After 50, reduced stomach acid is the most common cause of decreased B12 absorption,” Binder says. Plus, research in the Journal of the American Medical Association shows that long-term use of acid-suppressors such as H2 blockers and proton pump inhibitors (PPIs) can impede B12 absorption to increase the risk of a B12 deficiency.

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Other reasons for a B12 deficiency, according to Binder:

• Medical conditions such as pernicious anemia, celiac disease or Crohn’s disease
• Bariatric or stomach surgeries
• Prolonged use of the diabetes drug metformin
• Vegetarian or vegan diets

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How to boost your B12 levels

Unless you’re following a strict plant-based diet, Dr. Pescatore advises eating two to three servings of B12 sources such as lean beef, chicken, salmon, eggs and Greek yogurt daily. And to supplement, he recommends a baseline dose of 1,000 mcg of methylcobalamin (a biologically-active form of B12) per day. Also smart: Opting for a sublingual supplement, which helps to offset gastrointestinal absorption problems by delivering B12 via blood vessels under the tongue.

But bear in mind that ideal dosages can differ depending on your degree of deficiency. That’s why it’s smart to ask your doctor to check your B12, MMA and homocysteine levels. Based on the results, he or she can advise you on taking different amounts or investigating other options such as vitamin B12 shots.