It's not old age, stupid. It's B12

Updated: Apr 28, 2020, 07:09 IST | C Y Gopinath | Mumbai

Their hands tremble, they can't walk well, they forget. You call it old age. What if it was a deficiency that an injection could fix?

Eating meat and animal products like dairy products, milk and cheese provide your body with the 2.4 or so micrograms you need every day. Pic/Getty Images
Eating meat and animal products like dairy products, milk and cheese provide your body with the 2.4 or so micrograms you need every day. Pic/Getty Images

C Y GopinathYour mother gets more and more confused these days. She forgets names, does not recognise usually familiar faces and often starts speaking only to forget the rest of the sentence. She gets tired easily and slumbers a lot. Sometimes she drools like a baby while asleep on the easy chair. You feel a little sadness inside: she is 73, poor thing.

Old age sucks.

Your father, who ran marathons and stayed fit all his life, can hardly take a reliable step any more. His gait is unsteady, he seems wobbly and you constantly fear that he will fall. He has taken a couple of tumbles already and been injured. Poor man, he is 79.

This is how the end begins, you think, with halting steps and frequent falls. It will lead, you suppose, to dementia, forgetfulness, perhaps Alzheimer's, dignity pads, nannies and probably finally pneumonia through too much food going down the wrong way.

You realise both of them will need more care and probably more of your time. One day you might notice a tremor in his hand which makes it impossible for him to feed himself — and an ayah will be hired for the job. This will only get worse, you tell yourself, until the day they find release through death. With any luck, it will not be a lingering, painful one.

This, you tell yourself, is what ageing and senility look like. You don't look forward to the day it will come to you.

My mind has been on the elderly in our lives ever since COVID-19 entered our world. It has a particular appetite for taking away our senior citizens, particularly those over 60, we are told, and more especially if they have underlying conditions. No matter who you are, how young you are, you will one day watch a beloved parent or senior relative decline — and like the overwhelming majority of us, you will dismiss it as creeping old age.

What if you were very very wrong about the signs of old age? What if all the things we call ageing are the result of a single missing vitamin called B12?

My digging began around 2010 when my mother started falling forward every time she stood up. Her hands were unsteady, her once 20-20 vision was blurry, she misheard things, spoke disjointedly, frequently forgot names and faces and frequently dozed off while watching TV. She was then 77, and I thought — she's getting old.

I began reading and googling, meanwhile, and one day, I made a list of all the behaviours and symptoms that I naturally assumed were a part of normal ageing.

Clumsiness
Irregular gait, stumbling
Frequent falls
Forgetfulness
Depression and moodiness
Deteriorating vision
Disorganised speech
Tangential or incoherent thinking
Easily tired, needing more sleep
Being feeble, anaemic
Trembling
Being incontinent (not being able to hold pee in)

Guess what? Every one of these is a symptom of a deficiency of vitamin B12, otherwise known as cobalamin. It is one of the most complex vitamins, with a single cobalt atom in the centre, and the only one that your body does not synthesise. Vegetarians and vegans must get it through dairy or soy products. Eating meat and animal products like dairy products, milk and cheese provide your body with the 2.4 or so micrograms you need every day.

That microscopic amount, it seems, is all your body requires to maintain a healthy central nervous system, produce healthy DNA and make red blood cells.

And then old age starts creeping up on you. Unknown to you, your stomach starts producing less gastric juices, and this directly affects your body's ability to synthesise vitamin B12 from the food you eat. Some people turn into belch and fart factories as they age, struggling with acid reflux at night, popping proton pump inhibitors and antacids. These pills make it even harder for your body to synthesise and absorb vitamin B12.

Your near and dear see what they suppose are signs of senility but they're actually the first signs of a developing B12 deficiency in your ageing parents — weakness, fatigue, shakiness, unsteady gait, incontinence, low blood pressure, depression and other mood disorders, and cognitive problems like poor memory. Since B12 is water-soluble and stored by the body in the liver along with other B vitamins, the deficiency cannot be detected in a blood test until the level drops below 250 picograms per millilitre of blood serum.

There is no good estimate of how many senior citizens we label as aged without checking if they are actually only displaying signs of vitamin B12 deficit. Once detected, it can often be fixed with a single injection once or twice a year.

My mother did have a vitamin B12 deficiency. Injections restored her to a semblance of a more normal life for some years till she died of other causes.

Here, viewed from there. C Y Gopinath, in Bangkok, throws unique light and shadows on Mumbai, the city that raised him. You can reach him at cygopi@gmail.com
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