What to watch with B12 and Wechseljahre?

During menopause, vitamin B12 needs can shift due to hormonal changes affecting absorption. Deficiency may present as fatigue, brain fog, or elevated homocysteine – a cardiovascular risk marker. Consumer DNA tests (e.g., MTHFR, FUT2) can indicate genetic predispositions for lower B12 absorption, but they do not measure actual B12 status. Evidence for actionable B12 guidance from genetics alone is weak (mechanistic/GWAS). A blood test (holotranscobalamin, homocysteine) is essential. Supplementation of 50–100 µg/day is typically sufficient; higher doses are water-soluble and safe but unnecessary. Safety note: Do not rely solely on genetic results; consult a clinician for personalized advice.