Toggle Health Problems and D

Vitamin B12

Vitamin B12 is not a cofactor of Vitamin D, but it is often needed with Vitamin D
Started this page March 2018
Had been aware of B12 for years
Surfing the web finds

  • B12 deficiency increases with age
  • B12 appears to have no toxic upper limit
  • Some people get frequent B12 injections or I.V, to restore levels
    • Injection may not be needed
  • Only a small portion of B12 taken orally gets into the bloodstream
    • Sublingual B12 may not have that problem
  • B12 is stored in the liver – half life of > 2 years - Dr. Greger says take it weekly or daily
  • B12 can be supplemented via pills, sublingual, transdermal patch, injection, emulsion, and spray
    • As with Vitamin D, a massive (loading) dose can restore levels quickly
42 items in Vitamin B12 category on Vitamin D Life

Table of contents

WARNING: High intake of B12 and B6 found to increase risk of hip fracture by 47 percent - 2019

Association of High Intakes of Vitamins B6 and B12 From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study - May 2019
Combination of B6 >35 mg/d and B12 >20 micrograms/d increased hip fracture risk 47%
Note: My wife had been taking Life Force supplements for decades and got a hip fracture
Recommended daily serving of 4 tablets contains 48 mg of B6 and 200 micrograms of B12
No data in the study, but perhaps this much of B6 and B12 might increase the risk of hip fracture by > 2X
 Download the Study PDF from Vitamin D Life
Details on Vitamin D Life at Warning - High intake of Vitamin B12 and B6 found to increase risk of hip fracture by 47 percent - 2019

Here are all of the Vitamin B12 articles on Vitamin D Life

Vitamin B12 on the web

Lower 30% of range of B12 blood test can hide big problems - Dr. Greger Aug 2020

How to Test for Functional Vitamin B12 Deficiency 5 minute Video

  • "Most physicians tend to assume that if the B12 level in your blood is “normal”, there is no problem. But, within the lower range of normal, 30% of patients could have metabolic B12 deficiency, with high homocysteine levels."
  • "...10%-40% of the general population, and more than 40% in vegetarians..."

B12 supplemtation improved cognition (MMSE) in 3 months - Feb 2020

Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia
Cureus, 12 (2), e6976 2020 Feb 13, DOI: 10.7759/cureus.6976
Shazia Jatoi 1, Abdul Hafeez 2, Syeda Urooj Riaz 3, Aijaz Ali 1, Muhammad Ishaq Ghauri 3, Maham Zehra 1

Background Vitamin B12 deficiency is linked to impaired cognition and memory along with a sensation of tingling and numbness, an outcome of poor myelination. Elevated methylmalonic acid and serum homocysteine levels are markers of Vitamin B12 deficiency. Elevated homocysteine levels are also often associated with Alzheimer's disease and stroke. We conducted this study to determine the effect of vitamin B12 replacement therapy on vitamin B12-deficient patients with noted cognitive impairment.

Methods We conducted a cross-sectional, multicenter study of patients with minimal cognitive impairment (MCI) to assess for Vitamin B12 and homocysteine levels. All patients found to be deficient in vitamin B12 underwent replacement therapy and were assessed again after three months via the Mini-Mental State Examination (MMSE) and a review of symptoms.

Results A total of 202 patients were included in the study. Of those, 171 (84%) patients reported marked symptomatic improvement after vitamin B12 replacement while MMSE scores improved in 158 (78%) patients. Of the remaining 44 patients who reported no symptomatic improvement, MMSE scores improved in 26 while 18 patients showed no MMSE score improvements.

Conclusions Vitamin B12 deficiency is linked to cognition, and replacement therapy may be an option to improve patient cognition outcomes. Further studies are needed to confirm and refine the observed associations over a larger scale and to determine whether these findings will translate to a reduction in cognitive decline.
 Download the PDF from Vitamin D Life
Conclusions from the end of the PDF
We found a clear association between low vitamin B12 levels and progressive cognitive
impairment; therefore, further studies are needed to confirm and refine the observed
associations over a larger scale and to determine whether this change will translate to a
reduction in cognitive decline. Moreover, we are in favor of screening for vitamin B12
deficiency, at least in the elderly population, to find and prevent the possible causes of this
deficiency state, as this can be an easily preventable cause of impending dementia before the
cognitive decline becomes irreversible.

5X difference in B-12 bioavailability (emulsion best)

Note: Does not appear to mention sub-lingual tablets
 Download the PDF from Vitamin D Life

B12 use both before and during Breast Cancer chemotherapy decreased survival by 1.8 X - 2019

Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221)

11 symptoms of B12 deficiency - Jan 2019

__MedNewsToday has detailed description
1. Tingling hands or feet
2. Trouble walking
3. Pale skin
4. Fatigue
5. Fast heart rate
6. Shortness of breath
7. Mouth pain
8. Problems thinking or reasoning
9. Irritability
10. Nausea, vomiting, and diarrhea
11. Decreased appetite and weight loss

Brain Shrinkage 6X more likely if low B-12 - 2008

Vitamin B12 status and rate of brain volume loss in community-dwelling elderly.
doi: 10.1212/01.wnl.0000325581.26991.f2

Misconceptions about a B12 deficiency - 2017?

Misconceptions about a B12 deficiency
Summary points
1. Serum B12 is a conclusive test
2. A B12 deficiency always causes anemia
3. A B12 deficiency is rare and only occurs in older people
4. There is only one cause for a B12 deficiency, auto-immune pernicious anemia.
5. Serum B12 can be used to monitor treatment:
6. B12 can be toxic in high doses

Seniors needed 1000 ug of B12 tablet form (which is the least bio-available) - 2005

Older Adults May Need B12 Dose More Than 200 Times the RDA to Normalize Mild Vitamin Deficiency Medscape 2005

  • Randomized Controlled trial using 2.5, 100, 250, 500, and 1,000 µg
  • “To achieve 80% to 90% of the estimated maximum reduction in the plasma methylmalonic acid concentration, daily doses of 647 to 1,032 µg of cyanocobalamin were required”



B12 - a huge resource of information

Anyone, at any age, can become B12 deficient. However, certain people are at an elevated risk

  • that are vegetarians, vegans and people on macrobiotic diets
  • aged fifty and over
  • who've undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (gastric bypass)
  • who regularly use proton-pump inhibitors, H2 blockers, antacids, Metformin and related diabetes drugs, or other medication which can interfere with B12 absorption
  • Nitrous oxide administration or abuse
  • with a history of eating disorders (anorexia or bulimia)
  • with a history of alcoholism
  • with a family history of pernicious anaemia
  • diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia, and thalassemia)
  • with Crohn's disease, ulcerative colitis, irritable bowel syndrome, coeliac disease, or any other disease that causes malabsorption of nutrients
  • with autoimmune disorders (especially thyroid disorders such as Hashimoto's thyroiditis and Graves' disease), type 1 diabetes, vitiligo, lupus, Addison's disease, ulcerative colitis, rheumatoid arthritis, acquired agammaglobulinemia, or a family history of these disorders
  • with neurologic or motor symptoms
  • with Downs syndrome
  • with Phenylketonuria (PKU)
  • with psychiatric disorders, including depression, bipolar etc
  • with elevated MCV (mean corpuscular volume)
  • with occlusive vascular disorders (MI, CVA, DVT, PE)
  • Orthostatic hypotension / Postural hypotension
  • Transient ischemic attacks (TIAs, or 'mini stroke')
  • Cerebral vascular accident (CVA or 'stroke')
  • Myocardial infarction ('heart attack')
  • DVT - Deep vein thrombosis (blood clot to the leg or arm)
  • with Gastroesophageal reflux disease (GERD)
  • who've undergone neck or back surgery
  • Who've undergone Chemo or radiation therapy

Women . . .

  • with a history or infertility or multiple miscarriages
  • with post natal depression
  • Nitrous oxide administration (laughing gas)

Infants . . .

  • born to and/or breast-fed by women who are symptomatic or are at risk for B12 deficiency
  • Infants and children with developmental delay


B12 Deficiency

B12 infographics from the web


A Proven Sign Of Vitamin B12 Deficiency June 2019


  • "Around one-quarter of people may have a vitamin B12 deficiency."
  • "One study of Colombian children found that children deficient in vitamin B12 were at more than twice the risk of repeating a grade"
    • "Deficient children were also almost twice as likely to be absent from school as those who were not" 10.1016/j.jsbmb.2018.09.005

Low B12 in 55% of Diabetics getting Metformin

B12 oral seems as good as an injection, and much lower cost - Cochraine March 2018

Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency 10.1002/14651858.CD004655.pub3

B12. - March 2018

Adv Food Nutr Res. 2018;83:215-279. doi: 10.1016/bs.afnr.2017.11.005. Epub 2018 Feb 2.
Smith AD1, Warren MJ2, Refsum H3.

The biosynthesis of B12, involving up to 30 different enzyme-mediated steps, only occurs in bacteria. Thus, most eukaryotes require an external source of B12, and yet the vitamin appears to have only two functions in eukaryotes: as a cofactor for the enzymes methionine synthase and methylmalonylCoA mutase. These two functions are crucial for normal health in humans, and in particular, the formation of methionine is essential for providing methyl groups for over 100 methylation processes. Interference with the methionine synthase reaction not only depletes the body of methyl groups but also leads to the accumulation of homocysteine, a risk factor for many diseases. The syndrome pernicious anemia, characterized by lack of intrinsic factor, leads to a severe, sometimes fatal form of B12 deficiency.
However, there is no sharp cutoff for B12 deficiency; rather, there is a continuous inverse relationship between serum B12 and a variety of undesirable outcomes, including

  • neural tube defects,
  • stroke, and
  • dementia.

The brain is particularly vulnerable; in children, inadequate B12 stunts brain and intellectual development.
Suboptimal B12 status (serum B12<300pmol/L) is very common, occurring in 30%-60% of the population, in particular in pregnant women and in less-developed countries. Thus, many tens of millions of people in the world may suffer harm from having a poor B12 status. Public health steps are urgently needed to correct this inadequacy.

KEYWORDS: Brain; Children; Cobalamin; Cognition; Elderly; Homocysteine; Memory; Methylmalonic acid; Pregnancy

PMID: 29477223 DOI: 10.1016/bs.afnr.2017.11.005

3X as many headaches in children with low B12 - March 2018

The association between serum vitamin B12 deficiency and tension-type headache in Turkish children.
24% vs 8% were < 200 pg/ml

Singers believe B12 reduces voice tremors - Jan 2018

The Singer's and the Clinician's Perspective on Vitamin B12 Treatment for Vocal Benefits
but laryngologists have not seen any studies

Nineteen B12 genes - Feb 2018

An update on vitamin B12-related gene polymorphisms and B12 status

5 co-factors or regulators for the transport of vitamin B12
1 membrane transporters
3 involved in the catalysis of enzymatic reactions
1involved in cell cycle regulation
3mitochondrial proteins
4 unknown function

 Download the PDF from Vitamin D Life

B12 deficiency - from Pintrest


B12 injections increase acne

Why Most People Need Vitamin B12 Supplementation - Mercola April 2018, 50 minute video

Why Most People Need Vitamin B12 Supplementation

  • 40 % have marginal vitamin B12, 9 % are deficient
  • "Animal foods have become a questionable source of B12 thanks to modern farming practices ,,,"
  • "B12 Deficiency Mimics Many Serious Neurological Disorders and Diseases"
    such as multiple sclerosis, Alzheimer’s disease and autism
  • "Low B12 Implicated in Migraines"
  • especially for "Adults over 50, because as you grow older, your ability to produce intrinsic factor decreases."
  • also "People who have taken antibiotics, as these drugs have been shown to induce vitamin B12 deficiency.26"
  • Methylcobalamin is more absorbable than the cyanocobalamin form of B12

B12 Mercola Nov 2018

Mercola is selling a B12 energy boost product - methylcobalamin
It apparently has better bioavailability, but the article does not appear to state by how much

FDA has lowered the Daily Value for B-12 to just 2.5 mcg for adults

but this won't be reflected on most supplement labels until 2018 or 2019

Tested German pregnancies for 27 deficiencies, B-12 deficiency was found most frequently - June 2018

High incidence of maternal vitamin B12 deficiency detected by newborn screening: first results from a study for the evaluation of 26 additional target disorders for the German newborn screening panel.
DOI: 10.1007/s12519-018-0159-1

B12 notes - Bill Sardi July 2018


80 % of those within eurological abnormalities were B12 deficient - June 2018

Vitamin B12 deficiency neuropathy: A clinical and electrophysiological study
Neurophysiologie Clinique. Volume 48, Issue 3, June 2018, Page 130. https://doi.org/10.1016/j.neucli.2018.05.00

Vitamin B12 deficiency is a metabolic disorder with many causes. The neurological features of vitamin B12 deficiency are heterogeneous [2]. Peripheral neuropathy often described [3], but its frequency and its type is controversial [1[]. The present study was conducted to describe electro-clinical presentations of peripheral neuropathy in patients with vitamin B12 deficiency.

A Retrospective review of 32 subjects with neurological abnormalities due to vitamin B12 deficiency, were subjected to a detailed motor and sensory nerve conduction studies of median, ulnar, external popliteal sciatic, internal popliteal sciatic and sural nerves. Patients that have another reason for neuropathy or another disease that can effect nerve conduction studies were excluded.

The median age of the patients was 51 (± 16.57) years old, (range 18–84 years old), sex ratio (M/F) was 1.66 (20/12).
Clinical features of neuropathy:

  • paraesthesia,
  • hyporeflexia
  • ataxia and limb weakness

were present in 20 (62.5%) patients.
Electromyography showed abnormal nerve conduction in

  • 25 (78.12%) patients and it was normal in 7 (21.88%) patients.

On nerve conduction study: 16 (50%) had axonal impairment, 3 (9.3%) had demyelinating neuropathy and 6 (18.75%) had mixed features. Eleven patients (34.37%) presented a pure sensory impairment and 14 (43.75%) presented mixed pattern sensory and motor impairment.
All cases underwent treatment with intramuscular hydroxocobalamin treatment (daily injection of 1000 μg cyanocobalamin for 4 weeks, followed by injections of 1000 μg each month) with marked clinical and haematological improvement.

Conclusion: We conclude that nearly 80% patients with neurologic manifestations of vitamin B12 deficiency had evidence of peripheral neuropathy which is mainly axonal with some demyelinating features.
Sensory and motor nerve conduction were affected.
Evolution is generally good if the treatment was initiated early.

Images from the web


Evolutionary Quirk- Discover Magazine Aug 2018

The Evolutionary Quirk That Made Vitamin B12 Part of Our Diet
B12 made in the human gut is further down than it can be absorbed

Vitamin B-12 – little extra benefit if more than 5 micrograms at a time

  • I had been taking 50,000 micrograms every couple of days – in the form of a little pill
  • I just learned that the gut become far less efficient at taking in more than about 5 micrograms at a time.
  • So I had been supplementing with about 1,000 X more than could be absorbed
  • I have been taking many of my supplements in bulk form
    This greatly reduces the cost and the number of pills I take weekly.
  • Bulk Vitamin B12 costs only $18 for 500,000 micrograms Amazon
  • I will be adding 5 micrograms of B-12 to my daily bulk supplements – at a cost of $0.0002 per day
    Had cost $0.06/day so the bulk form will be 300 X lower cost
  • I am unaware of any limitation on daily intake of Vitamin D by any form nor of Vitamin B-12 by injection

How common is vitamin B-12 deficiency? - 2009

Am J Clin Nutr 2009;89(suppl):693S-6S. Printed in USA. © 2009 American Society for Nutrition
Lindsay H Allen
In considering the vitamin B-12 fortification of flour, it is important to know who is at risk of vitamin B-12 deficiency and whether those individuals would benefit from flour fortification. This article reviews current knowledge of the prevalence and causes of vitamin B-12 deficiency and considers whether fortification would improve the status of deficient subgroups of the population.
In large surveys in the United States and the United Kingdom, '6% of those aged >60 y are vitamin B-12 deficient (plasma vitamin B-12 < 148 pmol/L), with the prevalence of deficiency increasing with age.
Closer to 20% have marginal status (plasma vitamin B-12: 148-221 pmol/L) in later life.
In developing countries, deficiency is much more common, starting in early life and persisting across the life span. Inadequate intake, due to low consumption of animal-source foods, is the main cause of low serum vitamin B-12 in younger adults and likely the main cause in poor populations worldwide; in most studies, serum vitamin B-12 concentration is correlated with intake of this vitamin. In older persons, food-bound cobalamin malabsorption becomes the predominant cause of deficiency, at least in part due to gastric atrophy, but it is likely that most elderly can absorb the vitamin from fortified food. Fortification of flour with vitamin B-12 is likely to improve the status of most persons with low stores of this vitamin. However, intervention studies are still needed to assess efficacy and functional benefits of increasing intake of the amounts likely to be consumed in flour, including in elderly persons with varying degrees of gastric atrophy.

 Download the PDF from Vitamin D Life

From PDF

  • “Although >70% of the vitamin is absorbed when intake is in the range of 0.1-0.5 ug, the ileal receptors for the vitamin B-12-intrinsic factor complex become saturated with higher intakes such that absorption falls to '50% of a 1-ug dose, 15% of a 10-ug dose, and 3% of a 25-50-ug dose”

B Vitamins at Mercola Sept 2018

“The Power of Bioavailable B Vitamins – What Could Your Life Look Like If You Had More?”

B Vitamin Recommended Adult Daily Intake Susceptibility to damage during processing and storage Important Functions
Thiamine (Vitamin B1) 1.2 mg; 1.4 mg (pregnant and lactating women) Sensitive to heat, oxygen, humidity, and light, and very sensitive to alkaline pH Essential for metabolism of fats and carbohydrates, energy metabolism for nervous system and muscles*
Riboflavin (Vitamin B2) 1.3 mg; 1.6 mg (pregnant and lactating women) Sensitive to humidity and light Essential for growth and muscle development, eye health, and healthy skin*
Niacin (Vitamin B3) 16 mg; 18 mg (pregnant and lactating women) Stable Essential for the proper function of enzymes and a healthy nervous system, skin, nails and GI function*
Pantothenic Acid (Vitamin B5) 5 mg; 7 mg (pregnant and lactating women) Sensitive to heat and humidity A structural element of many coenzymes, plays a central role in energy metabolism and the synthesis of sex hormones*
Pyridoxine (Vitamin B6) 1.7 mg; 2 mg (pregnant and lactating women) Very sensitive to heat, and sensitive to humidity, light and acid pH Essential for the body’s utilization of protein and the synthesis of neurotransmitters*
Folate (Vitamin B9) 400 mcg; 600 mcg (pregnant and lactating women) Very sensitive to heat, acid pH and light, and sensitive to humidity Required for the production of red blood cells in bone marrow*
Biotin 30 mcg; 35 (pregnant and lactating women) Sensitive to humidity and light Supports healthy normal growth, digestion, muscle function, healthy skin and hair, and cellular health*
Cobalamin (Vitamin B12) 2.4 mcg; 2.8 mcg (pregnant and lactating women) Sensitive to heat, oxygen, humidity, and contact with iron or copper Supports protein, carbohydrate and fat metabolism, GI and nervous system health, immune function and the healthy production of red blood cells*


3 out of 4 Vegans are deficient, 1 out of 4 elderly


Very large doses do result in more getting into the blood

   Source of chart

Females may have less B12 if older than 12 years, especially Black females

   Buce Aimes

B-12 and Vitamin D reduce cardiovascular mortality - Dec 2018

Recent Insights into the Role of Vitamin B12 and Vitamin D upon Cardiovascular Mortality: A Systematic Review
 Download the PDF from Vitamin D Life

Oral B12 was 1.8X better than Injection - Jan 2019


B12 needed to fight pathpgens (in roundworms) March 2019

Rice University Press Release
Roundworms and humand both need B-12 in diet, both suffer from the same pathogen
Will soon be at PLOSONE

B12 eliminated canker sores in 74% of people - RCT 2009

Effectiveness of Vitamin B12 in Treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial
sublingual 1000 mcg of vitamin B12 for 6 months
[https://scholar.google.com/scholar?cites=14000970951237221541&as_sdt=5,48&sciodt=0,48&hl=en||Google Scolar - 119 citations of this study as of Feb 2019]
 Download the PDF from Vitamin D Life

Low B12 sometimes ==> Dementia - May 2019

"Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B12 deficiency" doi: 10.1136/bcr-2018-229044

B12 deficiency and clinical laboratory: Lessons revisited and clarified in seven questions - Sept 2017

 Download the PDF from Vitamin D Life

5 5 minute B12 videos by Dr. Greger Oct 2020

Created by admin. Last Modification: Monday October 26, 2020 21:19:24 GMT-0000 by admin. (Version 80)
Vitamin B12        
10872 visitors, last modified 26 Oct, 2020,
(Cached) Printer Friendly PDF this page! Follow this page for updates

Attached files

ID Name Comment Uploaded Size Downloads
13685 B12 Dimentia Feb 2020.pdf PDF 2020 admin 25 Mar, 2020 12:09 112.84 Kb 205
12862 5X difference in B12 response.jpg admin 25 Oct, 2019 20:35 47.29 Kb 1283
12861 B12 types.pdf admin 25 Oct, 2019 20:35 1.62 Mb 361
12860 B12 7 questions.pdf admin 25 Oct, 2019 19:45 624.97 Kb 327
11965 Excess B12 and B6 increases risk of hip fracture by 50 percent.pdf PDF 2019 admin 16 May, 2019 01:47 861.78 Kb 362
11426 canker sores 2009.pdf admin 18 Feb, 2019 17:49 123.21 Kb 428
10945 ASPS-02-0173.pdf PDF 2018 admin 01 Dec, 2018 15:51 290.74 Kb 518
10629 female deficiency.jpg admin 30 Sep, 2018 23:48 12.87 Kb 2282
10628 B12 females.jpg admin 30 Sep, 2018 23:43 30.24 Kb 2418
10627 B12 absorption.jpg admin 30 Sep, 2018 22:49 19.66 Kb 2195
10626 B12 vegan elderly.jpg admin 30 Sep, 2018 22:38 22.67 Kb 2163
10625 B12 lifetime.jpg admin 30 Sep, 2018 22:31 14.58 Kb 3150
10494 How common is vitamin B-12 deficiency.pdf admin 06 Sep, 2018 22:00 138.13 Kb 533
10493 B12 percent.jpg admin 06 Sep, 2018 22:00 26.31 Kb 2424
10105 B-12 infographic.jpg admin 03 Jul, 2018 21:27 97.94 Kb 2415
10104 B12 symptoms.jpg admin 03 Jul, 2018 21:26 44.50 Kb 2266
9547 B12 genes.pdf PDF 2018 admin 19 Mar, 2018 13:05 1.07 Mb 647
9470 B12 warning signs.jpg admin 09 Mar, 2018 00:27 52.59 Kb 7598
See any problem with this page? Report it (FINALLY WORKS)