Vitamin B12, also called cobalamin, is a type of B vitamin that is essential in the human diet. Vitamin B12 plays a role in DNA production, the functioning of the nerves and blood cells, immune health, and cell metabolism. People with B12 deficiency experience a type of anemia called megaloblastic anemia that causes fatigue, weakness, and dizziness. Read on to learn more about vitamin B12, its benefits, and how you can meet your daily B12 needs.
About Vitamin B12
Vitamin B12 is an essential nutrient for the nerves, blood cells, metabolism, DNA, immune system, cognitive function, and much more.
Most people get enough B12 from their diet, but certain groups—including older adults and strict vegetarians—are at risk of deficiency. People who have low levels of stomach acid or digestive issues are also at risk, because stomach acid breaks down B12 and helps the body absorb it.
These groups may benefit from a B12 supplement. Supplements come in two main forms: methylcobalamin and cyanocobalamin. Although cyanocobalamin is the most common form of B12, methylcobalamin is rapidly gaining in popularity as the body may absorb it more easily.
Untreated, vitamin B12 deficiency can cause anemia, weakness, fatigue, nerve damage, cognitive decline, and intestinal problems.
Vitamin B12 Benefits
Research into B12 is still ongoing, although experts know it affects many areas in the body. To date, research has explored the following health benefits of vitamin B12:
Vitamin B12, along with folic acid and vitamin B6, may help the heart. These vitamins reduce levels of homocysteine in the blood, a substance that increases the risk of heart disease, stroke, and other health issues.
However, research is limited and vitamin B12 supplements have not been shown to reduce heart disease risk. However, eating a diet rich in B12 foods may still be beneficial for heart health and other areas of well-being.
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Low levels of vitamin B12 in the body may increase the risk of cognitive issues, including dementia. That’s because people with dementia and related conditions often have high homocysteine levels.
Supplementation with vitamin B12 (in the form of methylcobalamin) lowers homocysteine levels and could potentially prevent dementia. More research is needed in this area, but it can’t hurt people who have a low B12 status to increase their dietary intake of B12, or take supplements.
Energy and Athletic Performance
Having a B12 deficiency saps your energy and leaves you lethargic. Taking vitamin B12 supplements is a surefire way to increase your energy levels again, so you can get back to the activities you enjoy.
That said, there’s no evidence to suggest that people without a B12 deficiency can enjoy improved energy or athletic performance from taking supplements.
Vitamin B12 Deficiency
People with a vitamin B12 deficiency develop a form of anemia called megaloblastic anemia. This blood disorder results in larger-than-normal red blood cells. Because they are bigger, there are not enough of them.
Without enough red blood cells, the body struggles to transport oxygen to its tissues and organs. Also, the cells may be too big to leave the bone marrow to make their way into the bloodstream and deliver oxygen around the body.
Sometimes, people are unaware they have vitamin B12 deficiency because they take in large amounts of folic acid through diet or supplements. High levels of folic acid masks B12 deficiency symptoms by correcting anemia, but not the neurological damage it causes. To avoid this situation, do not take in more than 1,000 micrograms (mcg) of folic acid daily from fortified foods and supplements.
Vitamin B12 deficiency is typically treated with vitamin B12 injections or high-dose oral supplements. If you have a deficiency, your doctor will decide if you can absorb enough B12 for oral supplements to be effective. If not, you may need vitamin B12 shots.
Vitamin B12 Deficiency Symptoms
Signs and symptoms of megaloblastic anemia and a B12 deficiency include:
- Balance issues
- Difficulty maintaining balance
- Loss of appetite
- Numbness and tingling in the hands and feet
- Poor memory
- Soreness of the mouth or tongue
- Weight loss
In infants, signs of a vitamin B12 deficiency include:
- Delays in development
- Failure to thrive
- Megaloblastic anemia
- Mobility and movement issues
If you are at risk of vitamin B12 deficiency, monitor your health carefully and look for signs and symptoms of low vitamin B12. For example, you may notice the pounds dropping off you thanks to your digital bathroom scale.
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Or, you might find yourself relying more and more on your folding cane to address your newly acquired balance issues.
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You should be aware that the neurological symptoms of B12 deficiency can occur even in people who don’t have anemia. Early intervention is crucial to prevent long-term damage.
Causes of Vitamin B12 Deficiency
Most people get enough vitamin B12 from their diet, but some people have problems absorbing it. Other people eat diets that are low in, or devoid of, vitamin B12. It is estimated that up to fifteen percent of Americans have a B12 deficiency.
The following are risk factors for B12 deficiency:
Older adults are more likely than young people to become deficient in vitamin B12. That’s because stomach acid production declines with age, and stomach acid is necessary for B12 absorption. Experts recommend that people over the age of 50 get most of their vitamin B12 from fortified foods and supplements, as they are less able to absorb it from food sources. Some older adults need doses higher than the RDA to avoid deficiency.
Being Vegan or Vegetarian
Vitamin B12 only occurs naturally in animal products such as meat and eggs. Those who avoid animal products are therefore more at risk of B12 deficiency. The babies of pregnant or breastfeeding vegetarians or vegans are also at risk unless the mother supplements or eats fortified foods.
Having a Digestive Issue
People with digestive problems such as celiac disease or Crohn’s disease may have vitamin B12 malabsorption issues. These conditions reduce the amount of B12 the body absorbs. Learn more about causes of poor digestion.
Having Pernicious Anemia
Those with pernicious anemia have less intrinsic factor in their stomachs. Intrinsic factor is a substance that, along with stomach acid, is necessary for the breakdown of vitamin B12. People with pernicious anemia—approximately one to two percent of older adults—often require B12 shots or high-dose supplements.
History of Stomach Surgery
If you have had weight loss surgery or another type of gastrointestinal surgery, you may struggle to absorb B12 as well as you once did. This is because you have fewer cells that secrete stomach acid and intrinsic factor. Your doctor should monitor your B12 status carefully following these types of surgery.
Sources of Vitamin B12
Sources of B12 include certain foods—namely animal products and fortified products, supplements, and B12 shots.
Foods with vitamin B12 in them include:
- Meat, including beef liver, beef, ham, and chicken
- Seafood, such as clams, trout, salmon, tuna, and haddock
- Fortified breakfast cereals
- Fortified plant-based drinks such as soy, almond, and rice milks
- Dairy products such as milk, yogurt, and cheese
- Fortified vegan dairy alternatives
- B12-fortified nutritional yeast
Taking a vitamin B12 spray or capsule is an excellent way to meet your daily needs. You can also get vitamin B12 sublingual supplements, which you can dissolve under your tongue.
If you already take a good multivitamin with B12, you may be getting enough from that—check the label to confirm it contains 100 percent of your daily needs. Alternatively, you can take a single B12 supplement or a B-complex that also contains other B vitamins including B6 and folic acid. Make sure you take your supplements every day by keeping them in your pill organizer.
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Vitamin B12 Injections and Gels
If you are severely B12 deficient or have issues absorbing B12, your doctor may recommend a course of vitamin B12 shots. These injections are given into the muscle and help treat or prevent megaloblastic anemia and pernicious anemia.
A vitamin B12 gel is also available as a prescription medication. This gel is applied in the nose and may be just as effective as shots at increasing levels of B12, although more research is necessary to say for sure. If you are B12 deficient and don’t like injections, ask your doctor if an intranasal gel is right for you.
Vitamin B12 Dosage
The amount of B12 a person need depends on their age. Adults and teenagers aged fourteen and over require 2.4 micrograms daily, while children require less. Pregnant and breastfeeding women need 2.6 mcg and 2.8 mcg, respectively, of B12 each day.
You can safely take higher doses than this. Being a water-soluble vitamin, the body absorbs what B12 it needs and excretes the rest through the urine. Therefore, it is extremely difficult to achieve a vitamin B12 overdose.
Vitamin B12 Side Effects
Research suggests that vitamin B12 does not cause any harm. After all, it is an essential nutrient that our body requires.
However, very high doses of B12 may cause:
Another of vitamin B12’s effects is that it can interact with some medications. In some cases, medicines can interfere with how the body uses B12. Medications that interact with B12 in some way include:
- Aminosalicylic acid, a drug used to treat digestive problems
- Chloramphenicol, an antibiotic for bacterial infections such as conjunctivitis and meningitis
- Colchicine, an anti-inflammatory drug used to treat gout
- Histamine H2 receptor antagonists, such as cimetidine, famotidine, and ranitidine, for peptic ulcers
- Metformin, a diabetes medication
- Proton pump inhibitors, to reduce stomach acid (such as omeprazole and lansoprazole), which can reduce B12 absorption
Also, vitamin C (ascorbic acid) supplements can reduce the amount of B12 available. To avoid this, take vitamin C at least two hours after taking a vitamin B12 supplement or eating foods fortified with B12.
If you are taking other medications, ask your doctor or pharmacist if they interact with vitamin B12 or other supplements you may be taking. If they do, your doctor may recommend using an alternative medication or taking B12 supplements at a different time to your medication.
Ensuring Optimal B12 Levels for Health and Wellbeing
Clearly, vitamin B12 is an incredible nutrient that does so much for the functioning of our bodies and our overall health. Reduce your risk of neurological issues by ensuring you get enough vitamin B12 every day. If you are vegetarian or are over 50 years of age, take a B12 supplement and eat plenty of B12-fortified foods. Speak to your doctor if have a health condition that may inhibit absorption, as they may recommend you get regular B12 shots or take high-dose oral supplements.