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I’ve written about the importance of vitamin B12 severaltimes before. A large new study suggests that having healthy vitamin B12 levelsin midlife may help your brain age more slowly. That’s also encouraging newsfor people living with chronic headaches, who often worry about “brain fog” andlong-term memory problems. People who have migraines with aura are more likelyto have a vitamin B12 deficiency.
What did researchers find?
Scientists followed almost 2,000 adults who were around 60years old and did not have dementia at the start of the study. Over more than adecade, they measured vitamin B12–related markers in the blood and repeatedlytested memory, language, and higher-level thinking skills like planning andorganizing.
People whose B12 status stayed higher over time had slightlyslower decline in these thinking skills. The effect for any single person wasmodest, but across the whole group it was clear enough that the researcherscould measure it. Even a small delay in cognitive decline can translate intoextra years of good function at the population level. The study was funded byNIH and published in Alzheimer’s and Dementia.
“Normal” B12 may not be good enough
A key point many patients don’t know: what labs call“normal” B12 is very different from country to country. In the United States,the usual reference range runs from about 200–250 up to 1,100 pg/mL. If yourlevel is 280, it will typically be reported as normal.
In Japan, however, the lowest level considered normal isabout 500 pg/mL. A B12 of 280 would be clearly labeled as low and treated. Someresearchers believe this higher cutoff could be one of several reasons Japanhas lower rates of Alzheimer’s disease than the U.S., although it is unlikelyto be the only factor. Diet, lifestyle, and other medical care differences alsoplay important roles.
For practical purposes, it means that a “borderline” B12level on an American lab report should not be reassuring—especially if you havesymptoms like fatigue, numbness or tingling, balance problems, or new memoryissues.
Why this matters for people with headaches
Migraine and other headache disorders often come withcomplaints of poor concentration, word‑finding trouble, and mental fatigue. Atthe same time, many patients are on medications (such as acid‑reducing drugs ormetformin), follow restricted diets, or have medical conditions that make B12deficiency more likely.
Because B12 is crucial for keeping nerves healthy andmaintaining the “insulation” around nerve fibers, even a mild deficiency canworsen brain fog and mood. Supporting B12 status is one simple, low‑risk way tostack the odds in favor of a clearer, sharper brain over time—on top of sleep,exercise, blood pressure control, and good headache management.
Do you need to talk to a doctor first?
For most people, especially vegetarians and vegans, olderadults, and those with intestinal or other chronic illnesses, it is reasonableto start a B12 supplement without waiting to see a doctor. B12 is water‑soluble,and your body gets rid of the extra in urine; toxicity from typical over‑the‑counterdoses is extremely rare.
I check the B12 level in most of my patients. If your levelis below 500 or you are at risk of deficiency, I recommend 500–1,000 mcg of B12daily in a tablet or sublingual form. Of course, you should seek medical adviceif you have significant neurological symptoms, very high B12 levels on testing,or complex medical problems—but for most readers, B12 is very safe.
The bottom line
The emerging research on B12 and cognition fits a largerstory: brain aging is shaped by many small, modifiable factors rather than asingle magic bullet. Keeping your B12 comfortably above the bare minimum—closerto the Japanese “normal” than the American cutoff—is a simple step you can takeyourself. For people with headaches who already invest so much effort inmanaging pain, this is one more way to quietly protect your brain for the longrun and can improve migraines.
