Vitamin B12 deficiency is strongly associated with cognitive impairment, including problems with memory, attention, and executive function, and is considered a reversible cause of dementia when caught early. Low or borderline B12 levels are more common in older adults, particularly those with atrophic gastritis, long-term use of acid-suppressing medications, or vegetarian/vegan diets, and studies show that deficient individuals often perform worse on cognitive tests than those with adequate status. Clinically, correcting B12 deficiency can lead to measurable improvements in cognition and mood in some patients, which is why B12 levels are routinely checked in the evaluation of cognitive decline and suspected dementia. This medication is commonly used for Pain Management.
Jatoi S, Hafeez A, Riaz SU, Ali A, Ghauri MI, Zehra M. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus. 2020 Feb 13;12(2):e6976. Ueno A, Hamano T, Nagata M, Yamaguchi T, Endo Y, Enomoto S, Kimura H, Ikawa M, Yamamura O, Yamanaka D, Kimura Y, Nakamoto Y, Nishiyama Y. Association of vitamin B12 deficiency in a dementia cohort with hippocampal atrophy on MRI. J Prev Alzheimers Dis. 2025 Sep;12(8):100265. Issac TG, Soundarya S, Christopher R, Chandra SR. Vitamin B12 deficiency: an important reversible co-morbidity in neuropsychiatric manifestations. Indian J Psychol Med. 2015 Jan-Mar;37(1):26-9. Moore E, Mander A, Ames D, Carne R, Sanders K, Watters D. Cognitive impairment and vitamin B12: a review. Int Psychogeriatr. 2012 Apr;24(4):541-56.
Some side effects may be linked to nutrient depletion caused by this medication.
Regular use of aspirin (acetylsalicylic acid) can increase how much vitamin C your body gets rid of through urine, potentially leading to deficiency. If you take aspirin regularly, consider supplementing with vitamin C supplementation.
Research found that individuals hospitalized with heart disease and a history of aspirin use were nearly twice as likely to have low or borderline vitamin B12 levels compared to non-aspirin users. While this doesn't definitively prove aspirin causes B12 deficiency, it raises a potential link. Aspirin can irritate the stomach lining in some individuals. This is concerning because the stomach plays a crucial role in vitamin B12 absorption by producing hydrochloric acid and intrinsic factor. Both are essential for proper B12 uptake.