Should I take vitamin B12 supplements as I get older?
Getting older increases the risk of a B12 deficiency, even if you eat healthily. A tablet of 1000 µg per day is safe and restores blood levels effectively; discuss this with your doctor. In addition to your B12 blood value, ask for your methylmalonic acid (MMA) level to be measured for a reliable picture.
Yes, as you get older a B12 supplement is worth considering. In 10 to 15 percent of people over 60, the stomach lining gradually wears down, causing less stomach acid to be produced and making it harder for B12 from food to be released. On top of that, a small protein in your gut and kidneys that absorbs and recycles B12 works less efficiently with age. This happens insidiously, without clear symptoms.
The good news is that a tablet largely solves the problem. B12 from tablets does not need stomach acid to be released. Studies in older adults show that 1000 µg per day restores blood levels just as effectively as injections1. This goal falls under medical advice: if you want to try it, discuss it with your doctor. On the label, look for 'Vitamin B12 1000 µg', as cyanocobalamine, methylcobalamine or hydroxocobalamine; which of the three it is matters less than the amount. Take it for at least one month, then continue long term as maintenance. If you have serious neurological symptoms, an injection is safer: that has not yet been sufficiently studied with oral tablets. Note: a high intake of folic acid through fortified foods can worsen neurological damage in an untreated B12 deficiency. That is a reason to have your status checked, not a reason to avoid supplements.
For memory and cognition, the picture is less clear. B12 alone is not demonstrably linked to a lower risk of dementia. A combination of B vitamins slowed decline slightly in older adults without dementia, but only when taken for longer than 12 months; in people with existing dementia it had no effect. For this purpose the evidence is too limited to make a recommendation.
At the cellular level, studies suggest that a B12 deficiency contributes to DNA damage and impaired energy production2. A rat study showed protection of the kidneys3. Interesting, but not yet translated into proven effects in humans. If you are unsure whether you have a deficiency, ask for your methylmalonic acid (MMA) level to be measured alongside your B12 blood value: that gives a more reliable picture.
The claims are based on 10 unique PMIDs, including a meta-analysis of 25 randomised studies (PMID 34432056), multiple guideline articles and observational studies. The evidence for absorption problems in older adults and the effectiveness of supplementation on blood levels is the strongest. The evidence that B12 alone slows cognitive decline is limited and contradictory. Mouse studies (PMID 41100656) and cell research (PMID 38732262) are promising but not yet directly applicable to humans.
Do older adults need more protein than younger people?
Older adults likely need more protein than the standard guideline of 0.8 grams per kilogram suggests. As a healthy older adult, aim for 1.0 to 1.2 grams per kilogram per day, spread well across meals, and combine this with resistance training where possible.
Is taking extra vitamin C worthwhile?
Extra vitamin C offers little benefit for most people. Intensive athletes and people following a carnivore diet do have a good reason to supplement, and those who take it daily tend to have slightly milder symptoms when they catch a cold.
Does the time you eat affect your ageing?
The time at which you eat does appear to matter, although the evidence in humans is still associative. A nightly fasting window of 10 to 12 hours and concentrating your meals during the day are the most concrete guidelines that current research offers.
Can you get too much vitamin D?
Too much vitamin D is genuinely harmful, but that risk only arises at blood levels far above the recommended values. Stick to the dose on the packaging, and if you are unsure about your level, have it measured by your GP.
Does eating a high-fibre diet help against constipation as you get older?
Eating more fibre helps with constipation in older adults, but the overall dietary pattern matters at least as much as fibre grams alone. Always drink enough water when taking fibre supplements, and consult your doctor if you use medications or are unable to drink sufficient fluids.
Which screenings and check-ups are recommended for my age?
Which screenings apply at your age depends on the individual, but a few anchor points are well supported: annual mammography from age 40, bowel cancer screening from age 45, and genetic prenatal tests for all pregnant women.