B-Cell Therapy for Multiple Sclerosis

What Is B-Cell Therapy?

B-cell therapy (also called B-cell depletion therapy) is a treatment for people with multiple sclerosis (MS). It targets cells called B cells that damage nerves in your brain and spinal cord.   

B-cell therapy isn’t a cure, but it can:

• Ease symptoms
• Help prevent relapses
• Slow the course of your disease

How B-Cell Therapy Works

B cells are a type of white blood cell. They make antibodies — proteins that fight viruses and bacteria. B cells normally can’t cross from your blood into your brain or spinal cord. If you have MS, some B cells enter your brain and spinal cord and attack the myelin sheath that protects your nerves.

B-cell therapy uses drugs called monoclonal antibodies to attack these cells. These meds stick to the surface of B cells. This kills the cells, helps ease inflammation, and plays a part in slowing down nerve damage.

B-cell therapy might affect other parts of your immune system as they fight MS. That’s because B cells affect other immune cells called T cells. T cells usually kill viruses and bacteria. But when you have MS, B cells recruit T cells into your brain. There, they cause inflammation.

When your number of B cells goes down, your amount of T cells that cause inflammation goes down, too. At the same time, your level of something called regulatory T cells goes up. Regulatory T cells turn off inflammation. They may even help slow your immune system’s attacks on your body.

B-Cell Therapy Types

The FDA has approved two B-cell therapy drugs.

Ocrelizumab (Ocrevus) treats relapsing forms of MS, including:

• Clinically isolated syndrome
• Relapsing-remitting MS
• Active secondary progressive MS in adults
• Primary progressive MS in adults

It may lower relapses and slow the disease. You get ocrelizumab through an infusion at a hospital or clinic. This puts the medicine directly into your bloodstream. You’ll receive two doses, 2 weeks apart. Then you’ll get one dose every 6 months.

Ofatumumab (Kesimpta) is a shot you give yourself at home. Your doctor will teach you how. You’ll have an injection once a week for 3 weeks, skip 1 week, and then inject one dose per month.

These drugs are new versions of the cancer med rituximab (Rituxan). Rituximab isn’t approved to treat MS, but doctors sometimes prescribe it as an “off-label” treatment. With rituximab, you’d get the medication through an IV in a doctor’s office. You’d get two doses, 2 weeks apart. Then, every 6 months, you’d have two more doses, 2 weeks apart.

B-Cell Therapy Side Effects

Infusions sometimes cause an allergic reaction. Your doctor might call it an infusion reaction. If it happens, it’s usually during your first dose.

You might have:

• Itching
• Rash
• Nausea
• Hives
• Headache  

These symptoms are often mild but can be severe. You usually get your first dose of these medicines across two sessions to make it less likely that you’ll have a reaction.

With any of these treatments, you could be more prone to infections like colds, bronchitis, and herpes. So it’s important to take steps to stay healthy.

Some researchers believe that these treatments can also give you a slightly higher chance of some cancers, especially breast cancer. But experts aren’t sure of the connection.

In very rare cases, they may lead to progressive multifocal leukoencephalopathy (PML), a rare brain infection that can be fatal.

Before you try B-cell therapy, your doctor will go over all the possible side effects to make sure you know the risks and benefits of treatment.

Vitamin B12 – Consumer

What is vitamin B12 and what does it do?

Vitamin B12 is a nutrient that helps keep your body’s blood and nerve cells healthy and helps make DNA, the genetic material in all of your cells. Vitamin B12 also helps prevent megaloblastic anemia, a blood condition that makes people tired and weak.

How much vitamin B12 do I need?

The amount of vitamin B12 you need each day depends on your age. Average daily recommended amounts for different ages are listed below in micrograms (mcg):

Life Stage	Recommended Amount
Birth to 6 months	0.4 mcg
Infants 7–12 months	0.5 mcg
Children 1–3 years	0.9 mcg
Children 4–8 years	1.2 mcg
Children 9–13 years	1.8 mcg
Teens 14–18 years	2.4 mcg
Adults	2. 4 mcg
Pregnant teens and women	2.6 mcg
Breastfeeding teens and women	2.8 mcg

What foods provide vitamin B12?

Vitamin B12 is found naturally in a wide variety of animal foods, and manufacturers add it to some fortified foods. Plant foods have no vitamin B12 unless they are fortified. You can get recommended amounts of vitamin B12 by eating a variety of foods including the following:

• Fish, meat, poultry, eggs, milk, and other dairy products contain vitamin B12.
• Clams and beef liver are some of the best source of vitamin B12.
• Some breakfast cereals, nutritional yeasts, and other food products are fortified with vitamin B12.

To find out if a food has added vitamin B12, check the Nutrition Facts label. Manufacturers are not required to list vitamin B12 on the label if a food naturally contains this vitamin.

What kinds of vitamin B12 dietary supplements are available?

Vitamin B12 is available in multivitamin/multimineral supplements, in B-complex supplements, and in supplements containing only vitamin B12. It is usually in a form called cyanocobalamin. Other common forms are adenosylcobalamin, methylcobalamin, and hydroxycobalamin. Vitamin B12 is also available in a form that’s dissolved under your tongue (called sublingual vitamin B12). Research has not shown that any form of supplemental vitamin B12 is better than the others.

The amount of vitamin B12 in supplements varies widely. Some provide doses of vitamin B12 that are much higher than recommended amounts, such as 500 mcg or 1,000 mcg, but your body absorbs only a small percentage of it. These doses are considered safe. Check the Supplement Facts label to see how much vitamin B12 a supplement contains.

A prescription form of vitamin B12 can be given as a shot. This is usually used to treat vitamin B12 deficiency. Vitamin B12 is also available by prescription as a nasal gel that’s sprayed into the nose.

Am I getting enough vitamin B12?

Most people in the United States get enough vitamin B12 from the foods they eat. But some people have trouble absorbing vitamin B12 from food. The body absorbs vitamin B12 from food in a two-step process. First, hydrochloric acid in the stomach separates vitamin B12 from the protein that it’s attached to. Second, the freed vitamin B12 then combines with a protein made by the stomach, called intrinsic factor, and the body absorbs them together.

Vitamin B12 in dietary supplements isn’t attached to protein and doesn’t require the first step. However, B12 in supplements does need to combine with intrinsic factor to be absorbed.

People with pernicious anemia, an autoimmune disease, can’t make intrinsic factor. As a result, they have trouble absorbing vitamin B12 from foods and dietary supplements.

Vitamin B12 deficiency affects between 3% and 43% of older adults. Your doctor can test your vitamin B12 level to see if you have a deficiency.

Certain groups of people may not get enough vitamin B12 or have trouble absorbing it:

• Many older adults don’t have enough hydrochloric acid in their stomach to absorb the vitamin B12 that’s naturally present in food. People over 50 should get most of their vitamin B12 from fortified foods or dietary supplements because, in most cases, their bodies can absorb vitamin B12 from these sources.
• People with an autoimmune disease called atrophic gastritis might not absorb enough vitamin B12 because they make too little hydrochloric acid and intrinsic factor in their stomach.
• People with pernicious anemia do not make the intrinsic factor needed to absorb vitamin B12. As a result, they have trouble absorbing vitamin B12 from foods and dietary supplements. Doctors usually treat pernicious anemia with vitamin B12 shots, although very high doses of vitamin B12 given by mouth might also be effective.
• People who have had some types of stomach or intestinal surgery (for example, to lose weight or to remove part or all of the stomach) might not make enough hydrochloric acid and intrinsic factor to absorb vitamin B12.
• People with disorders of the stomach and small intestine, such as celiac disease or Crohn’s disease, might not absorb enough vitamin B12.
• People who eat little or no animal foods, such as vegetarians and vegans, might not get enough vitamin B12 from their diets. Only animal foods have vitamin B12 naturally. When pregnant women and women who breastfeed their babies are strict vegetarians or vegans, their babies might also not get enough vitamin B12.

What happens if I don’t get enough vitamin B12?

Your body stores 1,000 to 2,000 times as much vitamin B12 as you’d typically eat in a day, so the symptoms of vitamin B12 deficiency can take several years to appear.

If you have a vitamin B12 deficiency, you may feel tired or weak. These are symptoms of megaloblastic anemia, which is a hallmark of vitamin B12 deficiency. You might also have pale skin, heart palpitations, loss of appetite, weight loss, and infertility. Your hands and feet might become numb or tingly, a sign of nerve problems. Other symptoms of vitamin B12 deficiency include problems with balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue.

In infants, signs of a vitamin B12 deficiency include failure to thrive, delays in reaching the typical developmental milestones, and megaloblastic anemia.

Vitamin B12 deficiency can damage the nervous system even in people who don’t have megaloblastic anemia, so it’s important to treat a deficiency as soon as possible.

What are some effects of vitamin B12 on health?

Scientists are studying vitamin B12 to understand how it affects health. Here are several examples of what this research has shown.

Cancer

Some research shows that people with high levels of vitamin B12 have a higher risk of cancer. But other research shows that the risk of cancer is higher in people with low levels of vitamin B12 or that vitamin B12 levels don’t affect cancer risk. More evidence is needed to understand whether vitamin B12 levels affect cancer risk.

Heart disease and stroke

Vitamin B12 supplements (along with other B vitamins) reduce blood levels of homocysteine, a compound linked to an increased risk of having a heart attack or stroke But despite reducing homocysteine, research shows that these vitamins don’t reduce the risk of developing cardiovascular disease or stroke.

Dementia and cognitive function

Most studies show that low blood levels of vitamin B12 don’t affect the risk of cognitive decline in older people, regardless of whether they have dementia or Alzheimer’s disease. More clinical trials are needed to better understand the effects of vitamin B12 supplementation on cognitive function in older adults.

Energy and Endurance

Manufacturers often promote vitamin B12 supplements for energy, athletic performance, and endurance. But vitamin B12 doesn’t provide these benefits in people who get enough B12 from their diet.

Can vitamin B12 be harmful?

Vitamin B12 has not been shown to cause any harm, even at high doses.

Does vitamin B12 interact with medications or other dietary supplements?

Yes. Vitamin B12 supplements can interact or interfere with some medicines that you take. Here are several examples.

Gastric acid inhibitors

People take gastric acid inhibitors to treat certain digestion problems, such as gastroesophageal reflux disease and peptic ulcer disease. These drugs can interfere with vitamin B12 absorption from food by slowing the release of hydrochloric acid into the stomach, leading to vitamin B12 deficiency. Gastric acid inhibitors include omeprazole (Prilosec®), lansoprazole (Prevacid®), cimetidine (Tagamet®), and ranitidine (Zantac®).

Metformin

Metformin is used to treat prediabetes and diabetes. Metformin might reduce vitamin B12 absorption and lower blood levels of vitamin B12.

Tell your doctor, pharmacist, and other healthcare providers about any dietary supplements and prescription or over-the-counter medicines you take. They can tell you if the dietary supplements might interact with your medicines. They can also explain whether the medicines you take might interfere with how your body absorbs or uses other nutrients.

Vitamin B12 and healthful eating

People should get most of their nutrients from food and beverages, according to the federal government’s Dietary Guidelines for Americans. Foods contain vitamins, minerals, dietary fiber, and other components that benefit health. In some cases, fortified foods and dietary supplements are useful when it is not possible to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy). For more information about building a healthy dietary pattern, see the Dietary Guidelines for Americans and the U.S. Department of Agriculture’s MyPlate.

Where can I find out more about vitamin B12?

• For general information on vitamin B12:
• For more information on food sources of vitamin B12:
• For more advice on choosing dietary supplements:
• For information about building a healthy dietary pattern:

Disclaimer

This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: July 7, 2021 History of changes to this fact sheet

Vitamin B12 Deficiency: Overview and More

Anemia

Vitamin B12 plays a role in the production of red blood cells (RBCs), which normally carry oxygen throughout the body. Since oxygen is a vital part of your body’s energy production, when RBCs are defective (which occurs with vitamin B12 deficiency), anemia develops.

Neuropathy

Vitamin B12 is also a vital part of a healthy nervous system, and its absence causes slow degeneration of the nerves in the brain, spinal cord, and peripheral nerves. The weakness and imbalance associated with neuropathy—impairment in nerve function—can be exacerbated when anemia is also present.

Myelopathy

Myelopathy, an impairment of spinal cord function, is produced when there is a deterioration of neurons in the posterior column of the spinal cord. This results in muscle weakness and deficits in detecting light touch, vibration, and proprioception (position sense). Some neuropathy-like symptoms are common as well.

Dementia

Vitamin B12 deficiency may cause dementia, resulting in memory loss and cognitive decline, behavioral changes, and problems with self-care. With severe and chronic vitamin B12 deficiency, psychosis may develop.

Other Symptoms

Other symptoms and signs of vitamin B12 deficiency may include:

• Low white blood cell count, which increases your risk for infection
• Low platelet count, which increases your risk for bleeding
• Headaches
• Weight loss
• Mood changes, especially depression
• Behavioral changes
• Walking problems
• Loss or diminished sense of smell
• Swollen tongue (called glossitis)

Symptoms of vitamin B12 deficiency typically develop gradually over the course of weeks or months and do not usually improve without treatment.

Causes

The two main causes of vitamin B12 deficiency are inadequate intake and impaired absorption in the intestines.

Inadequate Intake

Vitamin B12 is found in animal proteins such as fish, meat, and milk, as well as some fortified cereals. Longstanding vegetarians or vegans who don’t use supplements may develop a B12 deficiency due to inadequate nutritional intake of the vitamin. People who abuse alcohol and the elderly are also at risk for vitamin B12 deficiency.

Impaired Absorption

Since vitamin B12 is absorbed in the gut through a complex process that relies on a protein called intrinsic factor, impaired intestinal absorption may also result in this vitamin deficiency.

Causes of impaired vitamin B12 gut absorption include:

• Pernicious anemia, an autoimmune disorder in which antibodies attack the cells that release intrinsic factor
• Inflammatory gastrointestinal (GI) disorders like Crohn’s disease and celiac disease
• Prolonged use of certain medications like metformin and proton pump inhibitors (PPIs)
• Gastric bypass surgery, which involves resection of parts of the stomach and/or small intestine
• GI resection surgery, which is a treatment for serious medical problems such as bowel obstruction or cancer

Diagnosis

While the diagnosis of vitamin B12 may seem straightforward, it isn’t always very obvious. This is because many of the common symptoms of vitamin B12 deficiency overlap with those of other health conditions.

Your medical team may consider a number of diagnoses in addition to vitamin B12 deficiency when working to explain your symptoms.

History and Physical Examination

Besides a medical history, which may reveal symptoms like unexplained fatigue or numbness and tingling, your physical examination may identify signs of vitamin B12 deficiency.

For example, a weak, rapid pulse or pale fingers may be a sign of anemia. Diminished sensation in your feet and decreased reflexes can be a sign of neuropathy. Lastly, confusion or difficulty communicating are common signs of dementia and depression.

Laboratory Tests

Laboratory tests, specifically a complete blood count (CBC) and a vitamin B12 level, can confirm a diagnosis of vitamin B12 deficiency.

Moreover, often with vitamin B12 deficiency, a specific type of anemia called macrocytic anemia (not to be confused with pernicious anemia) can be identified with a blood smear.  The RBCs appear large and may have a varied shape and size.

Imaging and Specialized Tests

While certain imaging tests and nerve conduction studies (NCV) can be helpful in assessing the effects of vitamin B12 deficiency, they do not produce a specific pattern of results that corresponds with this deficiency. As such, if performed, results must be considered alongside other assessments.

Treatment

Vitamin B12 deficiency can be managed with oral (by mouth) or intramuscular (IM) injections of the vitamin. If decreased absorption is among the causes of your vitamin B12 deficiency, you may need to have an injection so that it will be absorbed directly into your body.

If possible, the cause of the B12 deficiency should be addressed, especially if you have not had a surgical resection or do not know why you are low in this vitamin.

Depending on the reason for your vitamin deficiency, you may need to continue to use lifelong supplementation with vitamin B12 even after your symptoms improve. 

Recovery from vitamin B12 deficiency takes time and you may not experience any improvement during the first few months of treatment. Improvement may be gradual and may continue for up to six to 12 months.

Rehabilitation

It is possible that you may continue to suffer from lasting deficits of vitamin B12 deficiency, such as numbness, tingling, and weakness. These effects can impair your balance. Working with a physical or occupational therapist may help you optimize your abilities despite these lingering problems.

In addition, memory problems can improve as your vitamin B12 levels are corrected, but you may continue to experience some deficits in cognitive (thinking) skills for a long time.

Cognitive rehabilitation and therapy is a challenging process, but it can help you maximize and improve your thinking and problem-solving skills.

A Word From Verywell

Vitamin B12 deficiency can be a fairly complicated diagnosis because the effects and symptoms are so varied. You might not experience sudden effects of the vitamin deficiency, but instead go through periods of gradual or intermittent declines in your vitamin B12 level that result in subtle or off-and-on symptoms.

If you have an inflammatory GI condition or if you have had a gastric resection, you may need to use a preventative treatment such as regularly scheduled vitamin B12 injections to avoid becoming deficient in this vitamin.

Vitamin B12 oral

What is this medicine?

CYANOCOBALAMIN (sye an oh koe BAL a min) is a man made form of vitamin B12. Vitamin B12 is essential in the development of healthy blood cells, nerve cells, and proteins in the body. It also helps with the metabolism of fats and carbohydrates. It is added to a healthy diet to prevent or treat low vitamin B-12 levels.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• anemia
• kidney disease
• Leber’s disease
• malabsorption disorder
• an unusual or allergic reaction to cyanocobalamin, cobalt, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the package or prescription label. If you are taking the tablets, do not chew, cut, or crush this medicine. If using an vitamin solution, use a specially marked spoon or dropper to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. For best results take this vitamin with food. Take your medicine at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

• alcohol
• aminosalicylic acid
• colchicine
• medicines that suppress your bone marrow like chemotherapy, chloramphenicol

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Follow a healthy diet. Taking a vitamin supplement does not replace the need for a balanced diet. Some foods that have vitamin B-12 naturally are fish, seafood, egg yolk, milk and fermented cheese.

Too much of this vitamin can be unsafe. Talk to your doctor or health care provider about how much is right for you.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• chest pain, tightness

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 85 degrees F). Protect from heat and light. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What are the Side Effects of Vitamin B12? (with pictures)

The side effects of vitamin B12 can range from the very minor, like brief nausea or mild headache, to the very serious, including heart palpitations and breathing difficulties. A lot depends on how the vitamin is taken, as well as how much is consumed. Most people experience no side effects whatsoever when taking only small doses via oral capsules. Problems are more common when people overdose, or if they receive large doses via injection. Side effects of injection often include swelling and tenderness, skin rash, and fluid retention. People sometimes also experience digestive troubles, and there have been a few studies that link prolonged B12 supplementation with weight gain — but this can vary a lot from person to person. In general, anyone who experiences concerning side effects while taking this supplement should consult a medical care provider.

Understanding Vitamin Supplementation

Vitamin B12 is a water soluble vitamin that’s considered essential for human cell growth, particularly brain cell growth. Humans can’t synthesize it themselves, though, which means that it must be acquired through the diet. Many foods are good sources, but not all are, and it can be hard for people to get enough each day; certain medical conditions and pharmaceuticals can impede absorption, too.

In these cases, people often look to supplements. Pills and daily vitamin capsules are usually the most common. In cases of extreme deficiency, intramuscular injections may be required; some people also take the vitamin sublingually, which involves injections into the delicate tissues beneath the tongue. Side effects usually vary depending on how the vitamin entered the body and how much of it there was. Differences in individual absorption and tolerance can play a role, too.

Swelling and Tenderness

The most common side effects of vitamin B12 injections aren’t usually particularly serious. Some individuals who receive an injection may experience tenderness, or feel a burning sensation in the vicinity of the injection site. In many cases this is due to the shot itself rather than the contents. Leg tenderness has also occurred, and swelling of the legs, feet, ankles, arms, and hands is common, too. Joint stiffness and creakiness can happen as well. All of these symptoms are usually temporary and tend to go away on their own after a day or so.

Skin Rashes

People may also develop a skin rash. The rash often starts near the injection site, but can quickly spread up and down the limbs and often extends up to the face. Hives and boils can also happen in rare cases. Sometimes this is related to allergic reaction, but it could also be a result of high dosing or just basic body chemistry.

Headaches and Digestive Issues

Some individuals may also experience headaches related to B12 supplementation. Digestive issues, including upset stomach, diarrhea, and intestinal discomfort, have been reported as well. In most cases these sorts of problems happen when a person is taking more of the supplement than his or her body can process. It isn’t an overdose per se, but stresses the body’s systems just the same.

Heart Palpitations and Breathing Problems

Other side effects can be more serious, but are not as common. Those who receive injections have a slight chance of experiencing symptoms similar to those of a cardiac event, such as heart palpitations, a more rapid heartbeat, chest tightness, or chest pains. Side effects of vitamin B12 can also include symptoms similar to those of a cold, such as coughing, low energy, wheezing, and breathing difficulties after minor physical exertion or after lying down. Other rare reactions involve the muscles, including muscular cramps, muscle weakness, muscle soreness, and tingling. People who experience these serious side effects are usually advised to see a physician right away.

Concerns Related to Fluid Retention

It is possible for individuals to gain weight rapidly after vitamin B12 treatment. They may also need to urinate frequently, feel exceptionally thirsty, have difficulties swallowing, and experience confusion, numbness, dizziness, and tingling. It is not entirely known whether these side effects occur due to high doses of this vitamin or due to other ingredients that may be added to the supplement formula. People who are worried about their symptoms might think about switching to a different brand or concentration, usually on the recommendation of their care provider.

Possible Interactions

Vitamin B12 can interact with a variety of different drugs, including over the counter medications, herbal supplements, and prescription-only compounds. For instance, folic acid and vitamin B12 work together in the body and are commonly taken together, but a reaction can occur if too much of one is taken. Other drugs vitamin B12 may interact with include certain kinds of antibiotics, phenobarbital, potassium supplements, and alcohol.

When to Get Help

Most of the side effects of this vitamin are minor enough that people don’t need to get care; most will also go away all on their own, usually once the person’s body gets adjusted to the supplementation. Even still, people who are worried about the things they’re feeling are usually smart to get a professional opinion. Most health care providers recommend that patients continue taking the vitamin unless they’re told to stop, particularly if it’s needed for some specific condition. Switching to a lower dose or changing the delivery method may be all that’s needed.

Vitamin B12: Benefits, Dosage, Side Effects & More

Vitamin B12 is a compound essential to human health. If you’re not getting enough B12 there’s a strong chance you don’t feel as good as you could. Understanding the role b12 plays in our body, common forms in foods and supplements, and the associated health benefits can help you ensure optimal health.

Highlights

• Vitamin B12 is a water-soluble vitamin
• Not found in plant-based foods unless they’ve been fortified
• The most common form in foods and supplements is Cyanocobalamin
• Methylcobalamin and other forms are more bioavailable
• Essential for early brain development
• B12 deficiency could impact health in many unforeseen ways
• Vegan diets put people at high-risk for B12 deficiency

Overview

Vitamin B12 describes several different types of cobalt-containing compounds. Together, these are known as cobalamins. Vitamin B12 helps our bodies produce new cells, protects and repairs nerves, and plays a critical role in early childhood brain development.

Different Names

Vitamin B12 may be referred to as cobalamin, methylcobalamin, cyanocobalamin, adenosylcobalamin, hydroxocobalamin, or a handful of others. Cyanocobalamin is a synthetic form, not found naturally in the human body. Research suggests that supplementation with the bioidentical forms offers the best absorption (R). Oddly enough, the synthetic cyanocobalamin (bound with cyanide) seems to be the preferred form used in food fortification (R).

Note: Product counts from Dietary Supplement Label Database

Bioavailability

Methylcobalamin is often discussed as the superior form of B12 due to its “superior absorption. ” There isn’t much research to describe which form of Vitamin B12 is best absorbed.

What little research there is suggests that any of the natural forms, particularly Adenosycobalmin and Methylcobalamin, are absorbed equally-well (R)(R).Limited human trials have shown sublingual and oral (taken as a pill) are absorbed almost equally-well (R).

I’ve heard that Vitamin B12 is better absorbed orally, through liquids, sprays, or sublingual tablets (dissolved under the tongue.) This may be specifically true for those with genetic mutations or digestive conditions affecting cobalamin absorption. I haven’t seen convincing research to suggest the same can be said for the majority of people.

Genetic Factors

Vitamin B12 is absorbed through pathways very specific to cobalamin. It’s first broken down in the stomach, absorbed through the intestines, transported through the bloodstream, and absorbed into cells. Each step of this process involves cobalamin-specific compounds such as intrinsic factor, pepsin, or haptocorin. A hitch involving any such compound can cause poor b12 absorption.

Mutations of the TC (TCN1) gene limit the amount of cobalamin absorbed. This can be particularly hard to spot since it doesn’t impact the amount of cobalamin measured in the bloodstream (R). Related SNPs are rs526934 and rs34324219.

Health Benefits

Vitamin B12 plays a critical role in many aspects of human health and essential to optimal health. B12 supplementation won’t guarantee any particular benefits but a deficiency is almost certain to negatively influence your health and wellbeing. Below are some of the benefits of Vitamin B12.

Blood Cells

Vitamin B12 is essential to the formation of new red blood cells. B12 deficiency can cause red blood cells to improperly develop. This usually results in larger-than-normal red blood cells that are unable to move from the bone marrow into the bloodstream at an appropriate rate (R).

This is measured via the Mean Corpuscular Volume (MCV) test common to most blood panels. Higher MCV values indicate a larger average red blood cell size. This is one indicator used to diagnose vitamin b12 deficiency, among other health conditions such as certain infections, kidney disease, liver disease, or HIV.

Brain Health

Vitamin B12 plays a critical role in the development of our brains. Infants are particularly sensitive to b12 deficiency and low levels may result in stunted brain growth (R). Additionally, low b12 during early childhood has also been associated with higher risks of depression in adulthood (R).

Folate (folic acid, Vitamin B-9), often recommended during pregnancy, is also largely attributed to brain development and later-in-life cognitive function. Vitamin B12 is an essential co-factor in the production of tetrahydrofolate (activated folic acid). There is solid research showing the beneficial impact of folate supplementation and its impact on b12 levels during pregnancy (R)(R).

Many of the case studies I’ve read where emergency B12 therapy was required involved infants. These are cases typically involve infants who were fed b12-deficient diets (usually Vegan). In most cases, short-term IV therapy seems to fix things in a matter of months.

Bone Health

There is strong scientific evidence supporting the fact that Vitamin B12 deficiency is related to lower bone density (R)(R). Older people and women are at a particularly higher risk of bone-related illness.

Studies among these demographics have highlighted the paramount relationship between B12 levels and bone-related illnesses. Even with the amount of supportive evidence, the exact nature of Vitamin b12’s relationship to bone health is still unclear.

Leading theories hint at the issue being related to the formation of new bone-forming cells, known as osteoblasts (R).

Energy & Metabolism

Vitamin B12 has long been regarded as playing a pivotal role in metabolism and cellular energy production. It’s required for folate metabolism, methionine production, and ubiquinone synthesis (R). Recent research has only strengthened the case for B12’s role in metabolism.

Recent lab-based studies identified over 40 microbial proteins and enzymes that were B-12 dependant. This is far more than previously recognized and suggestive of B12 being heavily utilized by microbial communities.

Chronic B12 or folate deficiency has been associated with lower levels of energy and athletic performance (R). However, I’ve not seen overwhelming science to suggest that those having sufficient B12 would gain any particular energetic benefits from B12. That is; taking B12 might not give you an energy boost if you’ve already got enough.

Heart Health

The role Vitamin B12 plays in cardiovascular health is complicated. There is research that shows lower Vitamin B12 levels are related to a higher risk of certain vascular diseases (R).

On the other hand, there are several studies that conclude there is no direct relationship between Vitamin B12 deficiency and cardiovascular health (R)(R). To further complicate things, some argue that some reported lower-than-expected benefits of vegetarian diets for cardiovascular health may be explained by lower dietary b12 amounts (R).

Signs of Deficiency

It’s hard to pin down all the symptoms of Vitamin b12 deficiency since it’s used indirectly in many processes. Immediate symptoms are often characterized by tiredness and weakness while a chronic deficiency can cascade into immune dysfunction, memory impairment, and even neuropathy (R)(R)(R). Below are symptoms commonly attributed to b12 deficiency:

• Anemia
• Fatigue
• Weakness
• Constipation
• Loss of Appetite
• Weight loss
• Numbness or Tingling
• Depression
• Confusion
• Memory Impairment
• Burning Tongue/Mouth

Dosages

A 2015 paper published by the EFSA Panel on Dietetic Products considered 8 separate studies on Vitamin B12 ranging in dosages of 1.5-3.0 mcg/day. The average dosage is calculated as 2.2375 mcg/day (PDF).

This is slightly below the 2.4 mcg/day for men and women ages 18-50 recommended by the US-based Dietary Reference Intakes for Vitamin B12 (R). There is not a currently defined Tolerable Upper Limit for b12.

Side Effects

There is no Tolerable Upper Intake (UL) for vitamin b12 because it’s considered relatively safe in just about any dose. The RDA is 2.4mcg/day though I’ve seen (and taken) supplements containing 5000mcg per dose. I took one of those every day for a year and didn’t have any issues. My b12 levels came up quickly too!

B12 doses are all smiles and sunshine though. Research shows that b12 supplementation can negatively affect those with certain health conditions. Specifically, it can have negative effects on those with diabetic neuropathy (R).

Strangely enough, many of the cases of early-childhood b12 deficiency detail unfavorable reactions. When given b12, common symptoms of deficiency begin to resolve but unexplainable muscle twitching and spasms pop up. From the very limited number of case reports on the subject, it seems this issue resolves in a matter of weeks or months. In some cases, these spasms are reported as being severe enough to warrant anti-convulsant medication (R).

More Reading

For anyone that wants a deep dive into Vitamin B12 I recommend reading the Following Publication:

Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline.

That publication covers the research and data used to establish the RDA, EAR, and AI amounts for Vitamin B12. Those are the numbers many doctors and/or nutritional professionals are going to reference.

Review

There’s no doubt that Vitamin B12 is one of the most essential compounds for sustaining optimal health. Whether your body is producing energy, churning out new blood cells, or working your brain overtime—B12 plays an important role. I suggest reading our Buyer’s Guide for Supplements as well as List of Best Supplement Brands if you are considering taking a Vitamin B12 supplement. Between those two resources, you should be able to get a good handle on how to find a good brand as well as some personal recomendations.

Vitamin B12 Deficiency Anemia | HealthLink BC

Topic Overview

What is vitamin B12 deficiency anemia?

Having vitamin B12 deficiency means that your body does not have enough of this vitamin. You need B12 to make red blood cells, which carry oxygen through your body. Not having enough B12 can lead to anemia, which means your body does not have enough red blood cells to do the job. This can make you feel weak and tired. Vitamin B12 deficiency can cause damage to your nerves and can affect memory and thinking.

What causes vitamin B12 deficiency anemia?

Most people get more than enough B12 from eating meat, eggs, milk, and cheese. Normally, the vitamin is absorbed by your digestive system—your stomach and intestines. Vitamin B12 deficiency anemia usually happens when the digestive system is not able to absorb the vitamin. This can happen if:

• You have pernicious anemia. In this anemia, your body destroys the cells in your stomach that help you absorb vitamin B12.
• You have had surgery to remove part of the stomach or the last part of your small intestine, called the ileum. This includes some types of surgery used to help very overweight people lose weight.
• You have problems with the way your body digests food, such as sprue (also called celiac disease), Crohn’s disease, bacteria growth in the small intestine, or a parasite.

This anemia can also happen if you don’t eat enough foods with B12, but this is rare. People who eat a vegan diet and older adults who don’t eat a variety of foods may need to take a daily vitamin pill to get enough B12. Other causes include drinking alcohol and taking some prescription and nonprescription medicines.

What is the recommended daily amount of vitamin B12?

The amount of vitamin B12 you need depends on your age.

What are the symptoms?

If your vitamin B12 deficiency is mild, you may not have symptoms or you may not notice them. Some people may think they are just the result of growing older. As the anemia gets worse, you may:

• Feel weak, tired, and light-headed.
• Have pale skin.
• Have a sore, red tongue or bleeding gums.
• Feel sick to your stomach and lose weight.
• Have diarrhea or constipation.

If the level of vitamin B12 stays low for a long time, it can damage your nerve cells. If this happens, you may have:

• Numbness or tingling in your fingers and toes.
• A poor sense of balance.
• Depression.
• A decrease in mental abilities.

How is vitamin B12 deficiency anemia diagnosed?

Your doctor will examine you and ask questions about your past health and how you are feeling now. You will also have blood tests to check the number of red blood cells and to see if your body has enough vitamin B12.

The level of folic acid, another B vitamin, will be checked too. Some people whose vitamin B12 levels are too low also have low levels of folic acid. The two problems can cause similar symptoms. But they are treated differently.

How is it treated?

Vitamin B12 deficiency anemia is treated with supplements of vitamin B12. Taking supplements brings your level of vitamin B12 back to normal, so you do not have symptoms. To keep your level of vitamin B12 normal, you will probably need to take supplements for the rest of your life. If you stop taking them, you’ll get anemia again.

Your vitamin B12 supplements might be pills or shots. If you use shots, you can learn to give them to yourself at home. For many people, pills work just as well as shots. They also cost less and are easier to take. If you have been getting shots, ask your doctor if you can switch to pills.

You can take steps at home to improve your health by eating a varied diet that includes meat, milk, cheese, and eggs, which are good sources of vitamin B12. Also, eat plenty of foods that contain folic acid, another type of B vitamin. These include leafy green vegetables, citrus fruits, and fortified breads and cereals.

Can vitamin B12 deficiency anemia be prevented?

Most people who eat animal products like milk or cheese will not get this B12 deficiency anemia. People who follow a vegan diet can prevent it by taking a daily vitamin pill or by eating foods that have been fortified with B12.

Babies born to women who eat a vegan diet should be checked by a doctor to see whether they need extra vitamin B12.

If you have pernicious anemia or another reason you cannot absorb enough vitamin B12, your doctor will give you vitamin B12 shots or pills to prevent deficiency.

90,000 Can you take large amounts of vitamin B12

Vitamin B12, which is of great importance to the body, is one of the water-soluble nutrients that do not accumulate in the human body. This is why many people believe that consuming large amounts of this vitamin is more beneficial than taking the recommended doses.

Such behavior of people made many researchers think about how much of this vitamin is harmful to human health.

In this article, we look at the health benefits of vitamin B12, as well as the possible side effects caused by consuming large amounts of it.

Vitamin B12 is essential for a number of bodily functions, including the generation of red blood cells, energy production, the maintenance of the nervous system, and the formation of DNA, according to scientists.

Although this vitamin is found in many foods, such as chicken, beef, eggs, dairy products and grains, some people do not get enough of this substance, which can cause a deficiency.It is worth noting that acute vitamin B12 deficiency can be caused by inflammation, aging, genetic mutations, and dietary restrictions.

In most cases, a deficiency of this substance can lead to a number of complications, such as impaired functioning of the nervous system, increased levels of fatigue and anemia. Therefore, many experts recommend the use of nutritional supplements to avoid acute deficiencies of this vitamin.

It should be noted that people who receive a sufficient amount of vitamin B12 through the use of natural foods absorb this microelement much better, and their body uses it more efficiently.However, such people do not need to take nutritional supplements.

However, scientists have found that vitamin B12 supplementation may be beneficial for people who are not deficient in this micronutrient. So, during the experiment, it was found that supplements of B complex vitamins with a high content of vitamin B12 have the following effect on the body of a healthy person:

improves mood;

reduces stress levels;

improves brain function;

eliminates symptoms of depression and anxiety.

In addition, the researchers note that the use of vitamin B12 with a deficiency of this element allows, in addition to all of the above, to increase the amount of energy in the body. However, in healthy people, the latter effect is not observed.

Peculiarities of taking large amounts of vitamin B12

Due to the fact that this vitamin is one of the water-soluble nutrients, its use in large quantities is considered absolutely safe. It is important to note that scientists have not established the maximum allowable intake of this substance, which does not cause side effects, since this vitamin is considered harmless.

Another reason that vitamin B12 does not have a maximum allowable dose is that when an excessive amount of this element is consumed, its excess is excreted by the body through urine.

However, despite all this, the researchers still managed to find several side effects that can be caused by the use of large doses of this vitamin. So, during one of the experiments, it was found that large amounts of vitamin B12 can cause skin rashes and the development of rosacea – a condition of the skin, in which purulent bumps are formed.However, it should be noted that a similar effect was caused by injections of this vitamin, and not by tablets.

Scientists also report that large amounts of this trace element can worsen the condition of people suffering from kidney disease and diabetes. So, during the research, it was found that the inclusion of 1 mg of vitamin B12 in the diet significantly impairs the functioning of the kidneys in persons with diabetic nephropathy, a disease associated with deterioration of the kidneys due to diabetes.In the same experiment, researchers found that high intake of this trace element significantly increases the risk of heart attack and stroke.

Studies in pregnant women have shown that high-volume B12 supplementation significantly increases the risk of children developing autism spectrum disorders.

Despite all the above negative consequences of taking high doses of this microelement, scientists have established that the use of up to 2 mg of vitamin B12 per day is absolutely safe.Moreover, this volume is most effective in treating a deficiency of this element.

The recommended daily intake of this vitamin is 2.4 mcg for women and men. However, pregnant women have a higher need for this substance.

What you need to know about the absorption and intake of vitamin B12

The needs of absolutely healthy people who do not have a deficiency of this microelement can be fully met through regular consumption of foods high in vitamin B12.These products include:

eggs;

beef;

poultry meat;

milk;

yogurt;

nutritional yeast;

fortified cereals and non-dairy products.

However, people who use certain medications that interfere with the absorption of this vitamin, vegetarians, pregnant women and women who are breastfeeding should take B12 supplements. Suitable supplements are also recommended for people over 50 years of age, for whom this vitamin deficiency is common.

Despite the fact that large volumes of up to 2 mg are absolutely safe for the human body, experts recommend avoiding such doses, especially if they are not needed.

For those who wish to use vitamin B12 supplements to exclude the possibility of developing a deficiency, experts recommend contacting a doctor who can accurately determine the individual recommended intake of this substance.

When using appropriate supplements, it is also important to take into account that the human body assimilates only the amount of vitamin that it really needs. Recently, scientists have found that when a healthy person consumes 500 mcg of vitamin B12, the body absorbs only 10 mcg of the substance. That is why the inclusion of large amounts of vitamin B12 in the diet does not provide any additional benefit for people who do not feel the need for this element.

Output

Vitamin B12 is one of the most important nutrients, supplements of which are often used even by people who are not deficient in this element.

Despite the fact that doses up to 2000 mcg of this substance are considered completely safe, it is recommended to consult with your doctor before using such volumes, who will determine the need to include vitamin B12 supplements in the diet.

In most cases, a balanced diet is sufficient to meet the body’s requirements for this vitamin. However, some categories of people, such as pregnant women and the elderly, need supplementation.

Research references

1. Vitamin B12 in Health and Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257642/

2. Vitamin B12 deficiency.

https://www.ncbi.nlm.nih.gov/pubmed/28660890

3. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885294/

90,000 biological value, ways to eliminate deficiency

Hypovitaminosis b12 is a fairly common phenomenon, especially among the elderly, since over the years the percentage of animal food in their diet decreases significantly, and the ability to assimilate it from food worsens.Risk groups include those who have had surgery to remove the part of the intestine that is responsible for absorbing this trace mineral, who are taking metformin for diabetes, long-term antacids for heartburn, and who are following a strict vegan diet.

Symptoms of a deficiency in the “red vitamin” may appear over the years with various diseases or clinical symptoms, but the diagnosis is not always successful. For example, cyanocobalamin deficiency is often mistaken for a lack of folate in the body.

Symptoms may include hematological, neurological, gastroenterological, mental and cardiac disorders. This is often expressed by chronic fatigue, glossitis, lack of appetite and sense of taste, bad mood, persistent headaches, dizziness, impaired cognitive and intellectual functions, blurred vision, dysphagia, unsteadiness of gait, speech difficulties. Persistent vit12 deficiency can even lead to mental disorders: depression, memory loss, dementia, psychosis.External signs of its lack by the body are also ulcers on the mucous membranes and seborrheic dermatitis.

The main symptoms of B12 deficiency include:

1. Pale or jaundiced skin

People who do not get enough of this vitamin often look pale or have a slight yellow tinge on the skin and whites of the eyes. Pallor is caused by problems with the production of red blood cells – red blood cells, and yellowness – by excess bilirubin, which is generated by the liver when old blood cells are destroyed and gives the skin and eyes a yellowish tint.

2. Weakness and fatigue

These symptoms occur due to insufficient amount of vitamin B12 in the body for the formation of red blood cells, which carry oxygen throughout the body. In the elderly, this type of anemia is often caused by an autoimmune condition known as pernicious anemia.

3. Tingling sensations all over the body

One of the most serious side effects of long-term B12 deficiency is nerve damage. This can happen over time, since this compound is an important member of the metabolic pathway that produces the fatty substance myelin.

Myelin surrounds the nerves as a form of protection and isolation. Without B12, myelin is produced differently and the nervous system cannot function properly. One of the common signs of impaired myelin production is paresthesia – a tingling sensation in the limbs with small needles. It has been established that these neurological symptoms very often occur together with anemia. Thus, vitamin B12 plays an important role in the production of myelin, which insulates the nerves and is critical for the nervous system.

4. Changes in mobility

If left untreated, damage to the nervous system due to B12 deficiency leads to impairment of musculoskeletal functions. This can affect balance and coordination, making the person more prone to fall. This symptom is often observed with undetected B12 deficiency in the elderly, since people over 60 are more prone to vitamin deficiency. This symptom may also be present in young people with severe, untreated deficiency. Preventing or eliminating a deficiency in cobalamin can improve mobility.

5. Glossitis, oral ulcers and loss of appetite

Glossitis is a term used to describe an inflamed tongue that changes color and shape, becoming painful, red and swollen. Glossitis can also make the tongue smooth, as all the tiny bumps that contain taste buds stretch out and disappear. This disease not only causes pain, but also affects the process of eating and speaking.

Studies have shown that a swollen and sore tongue with long straight injuries and loss of appetite may be an early sign of vitamin B12 deficiency.In addition, some people with vitamin deficiencies may experience other oral symptoms, such as ulcers, a burning and itching sensation in the mouth, or the feeling of pins and needles in the tongue.

6. Shortness of breath and dizziness

In case of anemia caused by a lack of cobalamin, a person may feel shortness of breath and dizziness, especially with exertion. This is due to the fact that the body lacks red blood cells necessary to obtain a sufficient amount of oxygen in the cells of the body. However, these symptoms can have many other reasons that require a detailed analysis by the attending physician.

7. Impaired vision

One of the symptoms of vitamin B12 deficiency is blurred or impaired vision caused by damage to the nervous system of the optic nerve. Due to the deficiency of the trace element, the nerve signal passing from the eyes to the brain is impaired, and vision deteriorates. This condition is known as optic neuropathy and is treated with vitamin B12 supplementation.

8. Changes in mood

People with B12 deficiency often report mood changes.Low vitamin levels have been linked to mood and brain disorders, including depression and dementia. As a potential explanation for this association, the “Homocysteine ​​Depression Hypothesis” has been proposed, which suggests that high homocysteine ​​levels caused by low B12 levels can damage brain tissue and interfere with the movement of signals into and out of the brain, leading to mood changes.

Research shows that for some people with B12 deficiency, taking the vitamin can reverse symptoms and improve mood.However, it does not replace other proven medical treatments for depression or dementia.

9. Fever

A very rare but occasional symptom of cobalamin hypovitaminosis is high fever. It is unclear why this happens, but some doctors have reported cases of fever that returned to normal after treatment with low levels of vitamin B12. It is important to remember, however, that high temperatures are most often caused by illness and not by B12 deficiency.

10.Memory loss and difficulty thinking

It has been established that a decrease in cognitive abilities in old age occurs against the background of a long-term deficiency of b12. Very often, diseases such as Alzheimer’s disease, schizophrenia and bipolar disorder can be associated with this. Studies of people who have died as a result of these diseases have shown a significant deficiency of this compound in the brain. Severe hypovitaminosis of cobalamin can lead to profound depression, paranoia and delirium, memory loss, and urinary incontinence.

11. Frequent constipation and unreasonable weight loss

One of the significant causes of B12 hypovitaminosis is atrophic gastritis against a background of chronic Helicobacter pylori infection or autoimmune origin. With this disease, the gastric mucosa sharply becomes thinner, and the glands atrophy. All can be accompanied by constipation, diarrhea, weight loss, even with a normal diet.

Due to the disruption of the internal factor of the stomach, vitamin B12 is not absorbed, which leads to its deficiency and the development of megaloblastic anemia.At the same time, the risk of gastric adenocarcinoma increases by 3 times. Treatment is carried out by parenteral administration of vitamin B ₁₂ .

When vitamins are bad. Scientists warn people don’t believe

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When vitamins are bad. Scientists warn people don’t believe

When vitamins are bad. Scientists warn people do not believe – RIA Novosti, 05.04.2019

When vitamins are harmful. Scientists warn people do not believe

Almost a third of Russians take dietary supplements to make up for the lack of nutrients in their bodies.However, according to several scientific … RIA Novosti, 05.04.2019

2019-04-05T08: 00

2019-04-05T08: 00

2019-04-05T08: 11

science

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vitamins

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MOSCOW, April 5 – RIA Novosti.Almost a third of Russians, replenishing the lack of nutrients in the body, take dietary supplements. However, according to several scientific studies at once, the abuse of vitamins can be harmful to health. Nutrition needs to be balanced. Unhealthy and not so “According to the Federal State Statistics Service, only 14 percent of adults in the country are provided with all the necessary vitamins. At the same time, Russians rarely encounter vitamin deficiency – a critical lack of vitamins. The real problem is hypovitaminosis, a lack of one or more nutrients at once.Thus, one fifth of the adult population of Russia suffers from polyhypovitaminosis – a deficiency of three or more vitamins. Most often these are A, B1, B2, PP, D and beta-carotene (provitamin A). Of this group of nutrients, the human body can independently synthesize only vitamins PP and D. For example, D3 is produced under the influence of ultraviolet radiation. The rest of the substances can only be obtained from food. As shown by a large-scale study of Canadian scientists, you should not rely on vitamin-mineral complexes – their benefits are limited.Researchers analyzed 113 scientific papers on the relationship of popular dietary supplements and multivitamin complexes (vitamins C and D, multivitamins, calcium, beta-carotene, and others) with the risk of cardiovascular disease and premature death, and did not find a significant effect from their intake. The only exception is folic acid in combination with some vitamins of group B. It really reduces the likelihood of stroke. According to the authors of the work, while the most optimal way to fill the deficiency of some nutrients in the body remains a balanced diet with a lot of vegetables, fruits and nuts, and not intake multivitamin complexes.Together is bad, apart too Taking vitamins separately also does not give a significant effect. Despite the fact that the health of the heart, blood vessels, the condition of bones and the ability to withstand prolonged physical activity are associated with the content of vitamin D in the body, its deficiency can be replenished only with the help of sunbathing, fish oil, mushrooms and seafood. According to scientists from the University of Auckland and Aberdeen. (They analyzed the results of 81 studies involving more than 50,000 people), regular vitamin D pill form does not prevent fractures and does not increase bone mineral density, regardless of the dose of the drug.However, Japanese researchers believe that the artificially synthesized vitamin has an effect. For six months, they regularly gave 167 children a supplement with vitamin D3 and a placebo. In the group receiving the vitamin preparation, a little more than ten percent fell ill with the flu (18 people). Among the participants taking placebo, there were already 18 percent (31 children). In addition, of those who had asthma and had the flu during the study, only two in the vitamin D3 group and 12 in the placebo group had seizures more frequent.The authors of the work attribute this to the fact that vitamin D activates innate immunity. When vitamins are dangerous Vitamin C has long been considered a good remedy for strengthening the immune system. However, the debate about whether taking it can really protect against colds does not subside until now. Finnish scientists who analyzed the data of 67 studies, the object of which was a total of more than 20 thousand people, came to conflicting conclusions. On the one hand, vitamin C has been shown to be effective in preventing colds, but only for professional athletes and only during intense training.This effect did not apply to ordinary people. On the other hand, vitamin C supplementation reduced the duration of illness by about eight percent in adults and 14 percent in children. But seven studies studied by the researchers did not confirm this connection. Vitamin C had no effect on the health of three thousand people who fell ill with colds. The situation is similar with other important nutrients – vitamins A, E and beta-carotene. Large-scale placebo-controlled studies (that is, studies in which neither the scientists nor the participants know whether they are consuming a vitamin or a placebo) have not confirmed the benefits of taking these antioxidants.Moreover, Danish scientists have shown that an addiction to artificially synthesized vitamins may be associated with the development of certain diseases. For example, according to American experts, smokers who take beta-carotene and vitamin A are more likely to get lung cancer than those who do not take antioxidant supplements. … These findings were confirmed by Swedish researchers who showed in mice at increased risk of developing lung cancer how antioxidants can stimulate the onset of malignant tumors.These substances (in the study it was about vitamin E and N-acetylcysteine) inhibit the work of a protein that regulates the cell cycle and prevents the appearance of cancer cells. Vitamins and genetics According to American geneticists, the key role is not played by the substances themselves, but by the genetic predisposition of a person. The same vitamins affect different people in different ways. In particular, vitamin E can protect against cancer or, conversely, contribute to the formation of a malignant tumor, depending on which variant of the catechol-O-methyltransferase (CMT) gene a person possesses.A decade of research showed that women with the Met / Met variant who took vitamin E had a 14 percent lower risk of cancer than those who received a placebo. With the owners of the Val / Val variant, the situation is the opposite – the use of vitamin E increased the chance of developing a malignant tumor by 15 percent compared to those taking placebo. The authors of the work suggest that a similar principle may apply to other vitamins. Therefore, large-scale studies of the effectiveness of taking these substances can give opposite results.

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cancer, vitamins, genetics

MOSCOW, April 5 – RIA Novosti. Almost a third of Russians take dietary supplements to make up for the lack of nutrients in their bodies.However, according to several scientific studies at once, the abuse of vitamins can be harmful to health. You need to have a balanced diet.

Useless and not so good

According to Rosstat, only 14 percent of adults in the country are provided with all the necessary vitamins. At the same time, Russians rarely encounter vitamin deficiency – a critical lack of vitamins. The real problem is hypovitaminosis, a lack of one or more nutrients at once.Thus, one fifth of the adult population of Russia suffers from polyhypovitaminosis – a deficiency of three or more vitamins. Most often these are A, B1, B2, PP, D and beta-carotene (provitamin A). Of this group of nutrients, the human body can independently synthesize only vitamins PP and D. For example, D3 is produced under the influence of ultraviolet radiation. The rest of the substances can only be obtained from food. As shown by a large-scale study of Canadian scientists, you should not rely on vitamin-mineral complexes – their benefits are limited.

Researchers analyzed 113 scientific papers on the relationship of popular nutritional supplements and multivitamin complexes (vitamins C and D, multivitamins, calcium, beta-carotene, and others) with the risk of cardiovascular disease and premature death, and did not find a significant effect from their intake … The only exception is folic acid in combination with some B vitamins. It really reduces the likelihood of stroke.

According to the authors of the work, the most optimal way to replenish the deficiency of some nutrients in the body is a balanced diet with a large amount of vegetables, fruits and nuts, and not taking multivitamin complexes.

Together is bad, apart too

Taking vitamins separately does not give a significant effect either. Despite the fact that the health of the heart, blood vessels, the condition of bones and the ability to withstand prolonged physical activity are associated with the content of vitamin D in the body, its deficiency can be replenished only with the help of sunbathing, fish oil, mushrooms and seafood. According to scientists from the University of Auckland and Aberdeen. (They analyzed the results of 81 studies involving more than 50,000 people), regular vitamin D pill form does not prevent fractures and does not increase bone mineral density, regardless of the dose of the drug.October 12, 2018, 11:15 a.m. InfographicsVitamin hungerWhat are the reasons for the deficiency of vitamins and minerals and how to deal with it – see the infographic ria.ru.However, Japanese researchers believe that the effect of artificially synthesized vitamin is. For six months, they regularly gave 167 children a supplement with vitamin D3 and a placebo. In the group receiving the vitamin preparation, a little more than ten percent fell ill with the flu (18 people). Among the participants taking placebo, there were already 18 percent (31 children).In addition, of those who had asthma and had the flu during the study, only two in the vitamin D3 group and 12 in the placebo group had seizures more frequent. The authors of the work attribute this to the fact that vitamin D activates innate immunity.

When vitamins are dangerous

Vitamin C has long been considered a good remedy for strengthening the immune system. However, the debate about whether its intake can really protect against colds does not subside until now. Finnish scientists who analyzed the data of 67 studies, the object of which was a total of more than 20 thousand people, came to conflicting conclusions.On the one hand, vitamin C has been shown to be effective in preventing colds, but only for professional athletes and only during intense training. This effect did not apply to ordinary people.

On the other hand, vitamin C supplementation reduced the duration of illness by about eight percent in adults and 14 percent in children. But seven studies studied by the researchers did not confirm this connection. Vitamin C had no effect on the condition of three thousand people who fell ill with colds.

October 30, 2018, 15:59 Large-scale placebo-controlled studies (that is, studies in which neither the scientists nor the participants know whether they are consuming a vitamin or a placebo) have not confirmed the benefits of taking these antioxidants. Moreover, Danish scientists have shown that the fascination with artificially synthesized vitamins may be associated with the development of certain diseases.So, according to the work of American experts, smokers taking beta-carotene and vitamin A are more likely to get lung cancer than those who do not use antioxidant supplements. These findings were confirmed by Swedish researchers who showed in mice at increased risk of developing lung cancer how antioxidants can stimulate the onset of malignant tumors. These substances (in the study it was about vitamin E and N-acetylcysteine) inhibit the work of a protein that regulates the cell cycle and prevents the appearance of cancer cells.

Vitamins and genetics

According to American geneticists, the key role is played not by the substances themselves, but by the genetic predisposition of a person. The same vitamins affect different people in different ways.

In particular, vitamin E can protect against cancer or, conversely, promote the formation of a malignant tumor, depending on which variant of the catechol-O-methyltransferase (CMT) gene a person possesses. A decade of research showed that women with the Met / Met variant who took vitamin E had a 14 percent lower risk of cancer than those who received a placebo.With the owners of the Val / Val variant, the situation is the opposite – the use of vitamin E increased the chance of developing a malignant tumor by 15 percent compared to those taking placebo.

The authors of the work suggest that a similar principle may work for other vitamins. Therefore, large-scale studies of the effectiveness of taking these substances can give opposite results.

December 18, 2018, 15:24

Vitamin B 12 is especially popular in the group of B vitamins.It can often be found in doctors’ appointments for a variety of diseases. What is this vitamin, what is it for and how justified is its use in cats?

Vitamin B12 (Vitamin B12, cyanocobalamin) is actually a whole group of cobalt-containing biologically active substances, but the main amount of vitamin B12 enters the body in the form of cyanocobalamin.

Sources of vitamin B12 are animal liver and fish (especially cod), eggs, cottage cheese and milk.This vitamin is absent in plant feed.

It is the only water-soluble vitamin that can accumulate in the body, accumulating in the liver, kidneys, lungs and spleen. The liver contains the main depot of vitamin B 12, from which it is consumed when there is a shortage.

What is vitamin B 12 for?

First of all, it is necessary for normal hematopoiesis, maturation of erythrocytes and the formation of hemoglobin, for the effective functioning of the nervous system and liver.It also stimulates the formation of antibodies.

Symptoms of vitamin B 12 deficiency (hypovitaminosis) in animals.

Various forms of anemia, stunted growth and development. In females – a decrease in fertility, the birth of weak offspring. Pale mucous membranes, inelastic or flaky skin that may develop dermatitis or worsen the symptoms of pre-existing dermatitis. From the digestive system: poor appetite and increased thirst, constipation, colic, increased gas production, enlarged liver and spleen.

One of the specific symptoms in cats is appetite perversion, manifested in the eating of their own feces.

With a strong vitamin deficiency, neurological disorders can develop (unsteadiness of gait, seizures, loss of coordination of movements, paralysis).

When is B 12 prescribed?

Veterinarians prescribe this drug for the treatment of anemia caused by various causes (including chronic renal failure), for many types of liver pathologies and liver failure, as well as other digestive organs.The role in the treatment of neurological pathologies is very important: neuralgia, paresis, neuritis. Used in the complex therapy of dermatitis. It is prescribed before operations, as it activates the blood coagulation system, and after them – to increase hemoglobin, improve tissue regeneration. Also, this vitamin is used to eliminate the symptoms of poisoning with salts of heavy metals in animals. Among other things, it promotes the growth and development of the animal.

The main indication for the use of vitamin B 12 is anemia (anemia) – a term meaning a decrease in erythrocytes and hemoglobin in the blood, as a result of which oxygen delivery to organs and tissues worsens.The appointment of vitamin B 12 for anemia should be carried out after assessing the condition of the animal and confirming that it is caused precisely by its deficiency. A similar picture of anemia has a deficiency of folic acid (vitamin B9 – vitamin B9) and other pathologies, therefore, it is important to diagnose and establish the true cause. Often prescribed in combination with iron preparations and folic acid.

Application of Vitamin B for animals.

There are injectable forms and tablets.Injectables are absorbed faster and better, however, a pure solution of cyanocobalamin is one of the most painful vitamins when administered intramuscularly. Some animals may even limp for a while after injection. If an intravenous catheter is in place, intravenous administration is the best option – it is painless and most effective.

Currently, complex preparations that include several B vitamins at the same time are especially popular.

In Russia “Milgamma ” is widely used, in Europe and America the pharmaceutical company produces “ Neurobion complex”, and there are also local analogues of these drugs in almost every country. The ampoule includes vitamins B1, B6, B12, some additionally contain lidocaine for painless administration. These drugs are injected deeply intramuscularly once a day.

Veterinary Cyanocobalamin

There is also veterinary Cyanocobalamin in large 100 ml bottles.

The usual dose for a cat up to 5 kg is 250 mcg. If this is a standard ampoule of cyanocobalamin (500 μg in 1 ml), then this is half of it. If the vitamin is in the composition of a complex preparation, then the dose should be calculated individually in each case, since the content in different preparations may differ. The dose and course should be determined by the veterinarian, since they may differ for different pathologies. The shortest courses are for the prevention and treatment of mild forms of anemia; for neurological disorders, the use of vitamin is required more.The course is usually long, at least 2 weeks, usually up to a month.

B12 also contains a complex veterinary drug Hemobalance , which contains, in addition to B12, L-lysine hydrochloride, DL-methionine, glycine, ammonium iron citrate, cobalt sulfate, copper sulfate, vitamin B2, vitamin B4, vitamin B6, inositol (vitamin B8 ), nicotinamide – 100 mg / ml, D-panthenol – 15 mg / ml, biotin (vitamin H) – a whole complex of biologically active substances, thanks to which it optimizes metabolic processes in the body (protein, vitamin and mineral).The components of the drug are involved in hematopoietic processes, stimulate hematopoiesis, and normalize the blood count.

Also B12 is a part of the veterinary drug “ Catosal ” – The drug contains two active ingredients: butaphosphamide and cyanocobalamin. Butafosfan is an organic phosphorus compound. With metabolic disorders of various etiologies. It is used to reduce the productivity and performance of animals, for the prevention and treatment of infertility and postpartum complications, in the treatment of secondary anemias, to restore animals after stress, to stimulate the growth of young animals.

Doses of complex preparations are calculated according to the instructions, based on the weight of the animal.

The use of vitamin B 12 during pregnancy in cats.

Penetrates through the placental barrier and into breast milk, therefore, B 12 is prescribed with caution and carefully calculating the amount, since there is evidence of toxic effects on the fetus when using high doses. Vitamins of this group are often included in special supplements for pregnant women, their amount there is usually small and safe.

Contraindications:

– Hypersensitivity to the drug,
– thromboembolism,
– benign and malignant neoplasms,
accompanied by megaloblastic anemia.

Application notes:

Many B vitamins are known to be intolerant of each other.It is forbidden to mix them in one syringe. In complex preparations, their stability is maintained by certain excipients. Poorly combined with ascorbic acid.

It is forbidden to use it with drugs that increase blood clotting, since it itself has a similar effect. The absorption of cyanocobalamin can be hampered by potassium. Corticosteroid hormones, as well as antipsychotics, promote the leaching of cyanocobalamin. Vitamin C in large amounts can interfere with the ability to absorb vitamin B 12 from food.

Supplements and vitamin complexes for cats:

Vitamin B 12, along with the rest of the B group, is part of many complex vitamin preparations, dietary supplements and growth stimulants. Their use for prophylactic purposes is recommended for growing and elderly animals, as well as for sick and convalescent animals.

Health to you and your pets!

Network of veterinary clinics “Vasilek”

90,000 Vitamins B6 and B12 are associated with an increased risk of hip fracture

Vitamins are known to be an integral part of good health.However, consuming too much of certain vitamins may be associated with the risk of side effects, including cancer. A recent study examined the relationship between B vitamins use and the risk of hip fracture.

Vitamin and mineral supplements are becoming increasingly popular in the United States. According to a 2011–2012 study, 52% of US adults use some form of nutritional supplement.

Against this trend, there is concern that some people are taking supplements in excess of recommended dosages.In this context, the authors of the new study explain that both insufficient and excessive intake of nutrients can have a negative impact on human health.

In a new study, scientists have paid particular attention to the use of vitamins B ₆ and B ₁₂ , which perform a variety of functions in the human body.

New study results are based on data from 75,864 postmenopausal women who participated in the Nursing Health Study program.

Along with information on diet and supplementation, the researchers also had access to a wide range of other data on participants, including resting preferences, medication intake, smoking status, and body mass index (BMI).

Research results q studies

During the 20-year study, 2,304 hip fractures were reported that were not related to cancer or serious injuries such as those from a traffic accident.

Scientists have found that these fractures are associated with the use of supplements containing B vitamins.

« Women who consumed high doses of vitamins B ₆ and B ₁₂ , p claim femoral neck fracture was 50% higher than women with low levels of these vitamins , ”the researchers report in the publication of their findings in JAMA Network Open.

However, scientists also explain that among women with an average intake of both vitamins, the risk of hip fracture was not significantly increased.

The researchers also note that some people do need to take vitamin B supplements ₁₂ , and that there is no evidence that taking B ₁₂ alone increases the risk of hip fracture.

How do B vitamins increase the risk of fractures?

Exactly how vitamins B ₆ and B ₁₂ may increase the risk of hip fractures is unknown.The study authors suggest that this may be due to side effects of vitamin B ₆ , which occur if the dose is exceeded.

For example, some experts believe that high doses of vitamin B ₆ cause neurological symptoms such as ataxia and also lead to decreased muscle tone.

Another theory, which the authors describe, is that high levels of vitamin B ₆ may “accelerate bone loss by counteracting the modulating effect of estrogen on steroid receptors.”

As for the role of vitamin B ₁₂ in these relations, the authors do not yet have any specific theories.

Based on materials from www.medicalnewstoday.com

Information for you:

90,000 Caffeine 100 mg with vitamin B12 No. 25 tab.

Scope: as a biologically active food supplement – an additional source of caffeine, vitamin B12.

Recommendations for use: adults 1 tablet in the morning, with meals.Duration of admission is 1-2 months. If necessary, the reception can be repeated.

Daily dose contains:

* does not exceed the upper permissible level of consumption

1 – in accordance with the requirements of TR CU 022/2011 “Food products in terms of their labeling”, (Appendix 2)

2 – according to “Unified sanitary-epidemiological and hygienic requirements for goods subject to sanitary-epidemiological supervision (control)” (Chapter II , section 1, Appendix 5), approved by the Decision of the Customs Union Commission dated 28.05.2010 No. 299

Contraindications: individual intolerance to the components, pregnancy, breastfeeding, increased nervous irritability, insomnia, hypertension, cardiac dysfunction, severe atherosclerosis, admission in the evening. It is recommended to consult a doctor before use.

Shelf life – 3 years.

Nutritional and energy value per 100 g: dietary fiber 41 g, fats 2.5 g.Caloric content 420 kJ (100 kcal).

Country: Russia

Manufacturer: LLC “Kvadrat-S”

Too much vitamin B12 – what you need to know

Some people worry that supplements containing high amounts of vitamin B12 might be harmful. However, while supplements such as vitamin A or D can be harmful in excess, vitamin B12 is safe in high doses.

Vitamin B12 is vital to humans for its role in the production of red blood cells (erythrocytes) and in supporting brain and nerve function.

If a person does not have enough vitamin B12 in their diet, their doctor may suggest taking supplements that contain more than the recommended daily intake. The body does not store vitamin B12, so supplementation is safe.

Daily Value for Vitamin B12

The researchers do not provide an upper limit for vitamin B12. This is because people generally tolerate vitamin B12 well without unwanted side effects. According to an article in the American Family Physician magazine, supplements containing 1,000 times the RDA are safe.The body absorbs vitamin B12 poorly and absorbs only 9.7 mcg out of a 500 mcg dose, which is only 2%.

The dose of vitamin B12 by age is as follows:

• 0-6 months: 0.4 μg
• 7-12 months: 0.5 μg
• 1-3 years: 0.9 μg
• 4-8 years: 1.2 μg
• 9-13 years: 1.8 μg
• 14 years and older: 2.4 μg

During pregnancy, the norm of vitamin B12 is 2.6 μg. A woman needs 2.8 mcg during lactation.

Can excess vitamin B12 cause side effects?

At this time, experts are not aware of any side effects associated with taking higher than recommended levels of vitamin B12. Some researchers have even looked at the potential side effects of taking high doses of vitamin B12 for 5 years. However, no studies to date have identified any adverse symptoms or causes of harm.

Experts divide vitamins into two categories: water-soluble and fat-soluble.Water-soluble vitamins dissolve in water and are excreted in the urine. Vitamin B12 is water soluble and this is one of the reasons high levels of vitamin B12 are not toxic.

There is currently no evidence of any side effects from:

• Vitamin B12 taken orally up to 2 mg
• Vitamin B12 taken by injection up to 1 mg

Doctors generally are prescribed high doses to treat conditions associated with very low vitamin B12 levels, such as pernicious anemia.

Although vitamin B12 appears to be safe for the most part even at high dosages, more is not necessarily better.

It is not necessary to take very high doses of vitamin B12. There is no evidence that very high levels of supplementation are more effective in strengthening the immune system or body functions of a person who is not deficient in vitamin B12.

High level of vitamin B12

Doctors have not determined the upper limit for the level of vitamin B12 in the blood.The body secretes excess vitamin B12, which a person gets from food or supplements. The body does not absorb vitamin B12 supplements very efficiently. This means that even if a person takes a very large amount of vitamin B12, his body still does not absorb a significant amount. In addition, taking certain medications can impair the body’s ability to absorb vitamin B12. Examples of these drugs include:

• chloramphenicol (chloromycetin), which is an antibiotic
• H2 receptor antagonists
• Metformin proton pump inhibitors

Pregnancy and vitamin B12

Vitamin B12 supplements are safe to take during pregnancy.

In fact, doctors recommend that women who follow a strict vegetarian or vegan diet take vitamin B12 supplements, as a deficiency can seriously affect the fetus. For example, low vitamin B12 levels in pregnant women can lead to an increased risk of neural tube defects, premature birth, preeclampsia, and pregnancy loss. On average, about 25% of pregnant women are vitamin B12 deficient in all trimesters. Children of women with vitamin B12 deficiency who are breastfeeding are more likely to develop poorly, with developmental delays, anemia, and weakness.Taking a vitamin supplement or injecting vitamin B12 can protect against side effects that doctors associate with vitamin B12 deficiency.

Low Vitamin B12

A person with low B12 levels may experience weakness, loss of appetite, or problems with balance. Many people don’t get enough vitamin B12 from their diet.

Vitamin B12 is found naturally in many animal products, including meat, fish, dairy products and eggs.Plant-based sources of vitamin B12 include fortified milk and cereals, nutritional yeast, and vegan spreads. However, doctors recommend taking vitamin B12 supplements.

Low vitamin B12 levels can lead to a number of health problems, including:

• decreased appetite
• balance problems
• constipation
• fatigue
• mouth or tongue ulcers
• weakness
  

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Conclusion 9000

Although there is currently no evidence to indicate any adverse side effects from excess vitamin B12 supplementation, it is not necessary to take excessive amounts of the vitamin.Most doctors do not recommend exceeding the daily multivitamin, unless the person has a condition that causes vitamin B12 deficiency.

Scientific article on the topic: Vitamin B12 deficiency can weaken the body when infected with pathogenic microorganisms.

Before using the tips and advice on the website “Medical Insider” , , be sure to consult your doctor!

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