What is the purpose of a vitamin B-12 level test. How is the procedure performed. What do the results indicate. Why is vitamin B-12 important for your health. Who is at risk for vitamin B-12 deficiency.

The Importance of Vitamin B-12 for Overall Health

Vitamin B-12 plays a crucial role in various bodily functions, including brain health, blood cell production, and proper nerve functioning. This essential nutrient is not produced naturally by the body and must be obtained through diet or supplements. Understanding the importance of vitamin B-12 and monitoring its levels can help prevent potential health issues and maintain optimal well-being.

Key Functions of Vitamin B-12

• Brain health maintenance
• Red blood cell production
• Proper nerve functioning
• DNA synthesis
• Energy metabolism

Given its vital role in numerous bodily processes, maintaining adequate levels of vitamin B-12 is essential for overall health and well-being. A deficiency in this nutrient can lead to various health problems, making it crucial to monitor B-12 levels through appropriate testing methods.

Methods for Testing Vitamin B-12 Levels

There are several ways to assess vitamin B-12 levels in the body. Healthcare providers may recommend one or more of the following tests to determine if an individual has a deficiency or excess of this essential nutrient:

• Blood draw for serum B-12 measurement
• Home urine test
• Methylmalonic acid (MMA) test
• Homocysteine test
• Holotranscobalamin (holoTC) test

Recent research suggests that MMA and holoTC tests may provide more accurate readings of low B-12 levels, as they represent active B-12 in the body. These tests can help healthcare providers determine if an individual requires supplementation or further investigation into the cause of abnormal B-12 levels.

Signs and Symptoms of Vitamin B-12 Deficiency

Recognizing the signs and symptoms of vitamin B-12 deficiency is crucial for early detection and treatment. Some common indicators include:

• Tingling in the hands and feet
• Balance problems
• Racing heart
• Confusion
• Dementia-like symptoms
• Weakness
• Loss of appetite
• Pale skin
• Inflamed red tongue or bleeding gums

If you experience any of these symptoms, it’s essential to consult with a healthcare provider who may recommend a vitamin B-12 level test to determine if a deficiency is present.

Risk Factors for Vitamin B-12 Deficiency

Certain individuals are at a higher risk of developing vitamin B-12 deficiency due to various factors. Understanding these risk factors can help identify those who may need regular monitoring of their B-12 levels:

• Older adults
• Children
• Vegans and strict vegetarians
• People with diabetes
• Individuals who have undergone gastric bypass surgery
• Those with conditions affecting nutrient absorption (e.g., celiac disease, Crohn’s disease)
• People taking certain medications (e.g., proton pump inhibitors, metformin)

If you fall into any of these categories, it’s advisable to discuss vitamin B-12 testing with your healthcare provider to ensure your levels are within the normal range.

The Vitamin B-12 Level Test Procedure

The vitamin B-12 level test is typically performed through a blood draw, which is a relatively simple and low-risk procedure. Here’s what you can expect during the test:

1. A healthcare professional will clean the area where the blood will be drawn, usually the inside of your elbow or the back of your hand.
2. An elastic band will be placed around your upper arm to increase blood flow in the veins.
3. A needle will be inserted into a vein to collect the blood sample.
4. The blood will be collected in a vial or tube.
5. The needle will be removed, and the puncture site will be covered with a bandage.

The entire process usually takes less than five minutes. You may feel a slight prick when the needle is inserted, but the discomfort is generally minimal and short-lived.

Interpreting Vitamin B-12 Test Results

After the test, your healthcare provider will interpret the results and discuss them with you. The normal range for vitamin B-12 levels can vary depending on the laboratory and the specific test used. Generally, results are interpreted as follows:

• Low B-12 levels: May indicate a deficiency that requires further investigation and possible treatment
• Normal B-12 levels: Suggest adequate intake and absorption of the vitamin
• High B-12 levels: Could be a sign of liver disease, certain types of leukemia, or diabetes

It’s important to note that B-12 levels alone may not provide a complete picture of your health. Your healthcare provider may consider other factors and tests to make an accurate diagnosis and recommend appropriate treatment if necessary.

Treatment Options for Vitamin B-12 Deficiency

If a vitamin B-12 deficiency is diagnosed, there are several treatment options available. The choice of treatment will depend on the underlying cause of the deficiency and the severity of the condition. Common treatment approaches include:

• Oral B-12 supplements
• Intramuscular B-12 injections
• Nasal B-12 gel
• Dietary changes to increase B-12 intake
• Treatment of underlying conditions affecting B-12 absorption

Your healthcare provider will work with you to determine the most appropriate treatment plan based on your individual needs and circumstances.

Preventing Vitamin B-12 Deficiency

While treatment options are available for vitamin B-12 deficiency, prevention is always preferable. Here are some strategies to help maintain healthy B-12 levels:

• Consume a balanced diet rich in B-12 sources (e.g., meat, fish, dairy products, fortified cereals)
• Consider B-12 supplements if you follow a vegan or vegetarian diet
• Discuss B-12 monitoring with your healthcare provider if you have risk factors for deficiency
• Address any underlying health conditions that may affect B-12 absorption
• Be aware of medications that may interfere with B-12 levels and discuss alternatives with your doctor if necessary

By taking these preventive measures and staying informed about your B-12 status, you can help ensure optimal health and well-being.

The Role of Vitamin B-12 in Pregnancy and Breastfeeding

Adequate vitamin B-12 levels are particularly important during pregnancy and breastfeeding. Pregnant women with low B-12 levels may be at increased risk for neural tube defects in their developing fetuses. Additionally, breastfeeding mothers with B-12 deficiency may pass on insufficient amounts of the vitamin to their infants, potentially leading to neurological damage and developmental problems.

If you are pregnant or breastfeeding, it’s crucial to discuss vitamin B-12 testing and supplementation with your healthcare provider to ensure both you and your baby receive adequate amounts of this essential nutrient.

Vitamin B-12 and Cognitive Function

Research has shown a potential link between vitamin B-12 deficiency and cognitive decline, particularly in older adults. Low B-12 levels have been associated with:

• Memory problems
• Difficulty concentrating
• Increased risk of dementia
• Depression

Maintaining adequate B-12 levels throughout life may help support cognitive function and potentially reduce the risk of age-related cognitive decline. Regular monitoring of B-12 levels, especially in older adults, can help identify and address deficiencies before they lead to significant cognitive issues.

The Impact of Vitamin B-12 on Energy Levels

Many people associate vitamin B-12 with increased energy levels. While B-12 does play a role in energy metabolism, it’s important to understand the relationship between this vitamin and perceived energy levels:

• B-12 is involved in the production of red blood cells, which carry oxygen throughout the body
• Adequate B-12 levels support proper nerve function, which can affect overall energy and well-being
• B-12 deficiency can lead to fatigue and weakness, which may be mistaken for low energy levels

While supplementing with B-12 may not provide an immediate energy boost for those with normal levels, addressing a deficiency can help alleviate fatigue and improve overall energy levels in individuals with low B-12 status.

Vitamin B-12 and Cardiovascular Health

Emerging research suggests that vitamin B-12 may play a role in cardiovascular health. Some studies have found associations between low B-12 levels and increased risk of cardiovascular disease. This connection may be related to the vitamin’s role in:

• Regulating homocysteine levels, an amino acid linked to heart disease when elevated
• Supporting the formation of red blood cells, which are crucial for oxygen delivery to the heart and other organs
• Maintaining proper nerve function, including those that control heart rate and blood pressure

While more research is needed to fully understand the relationship between vitamin B-12 and cardiovascular health, maintaining adequate B-12 levels may contribute to overall heart health as part of a balanced diet and healthy lifestyle.

Vitamin B-12 and Bone Health

Recent studies have explored the potential connection between vitamin B-12 status and bone health. Some research suggests that low B-12 levels may be associated with:

• Decreased bone mineral density
• Increased risk of osteoporosis
• Higher fracture risk, particularly in older adults

The exact mechanisms behind this relationship are not fully understood, but it’s believed that B-12 may play a role in bone formation and maintenance. While more research is needed to establish definitive conclusions, ensuring adequate B-12 intake may contribute to overall bone health, especially when combined with other bone-supporting nutrients like calcium and vitamin D.

Vitamin B-12 and Athletic Performance

Athletes and fitness enthusiasts often wonder about the potential benefits of vitamin B-12 for athletic performance. While B-12 supplementation is unlikely to enhance performance in individuals with adequate levels, addressing a deficiency may have positive effects on:

• Endurance and stamina
• Recovery from intense exercise
• Overall energy levels during physical activity

Athletes following restrictive diets, such as vegetarian or vegan regimens, may be at higher risk for B-12 deficiency and should pay particular attention to their B-12 status to support optimal athletic performance.

The Relationship Between Vitamin B-12 and Anemia

Vitamin B-12 plays a crucial role in the production of red blood cells. A deficiency in this vitamin can lead to a specific type of anemia known as pernicious anemia or vitamin B-12 deficiency anemia. This condition is characterized by:

• Large, immature red blood cells
• Decreased oxygen-carrying capacity of the blood
• Symptoms such as fatigue, shortness of breath, and pale skin

Identifying and treating B-12 deficiency anemia is essential to prevent potential complications and improve overall health. Regular monitoring of B-12 levels, especially in at-risk individuals, can help detect and address this type of anemia early on.

Vitamin B-12 and Digestive Health

The relationship between vitamin B-12 and digestive health is complex and bidirectional. While B-12 is essential for proper digestive function, certain digestive conditions can impair B-12 absorption. Understanding this relationship is crucial for maintaining optimal B-12 levels and digestive health:

• B-12 supports the health of the digestive tract lining
• Adequate B-12 levels may help reduce inflammation in the gut
• Conditions like Crohn’s disease, celiac disease, and atrophic gastritis can impair B-12 absorption
• Prolonged use of certain medications, such as proton pump inhibitors, can affect B-12 absorption

If you have a digestive condition or are taking medications that may affect B-12 absorption, it’s important to work closely with your healthcare provider to monitor your B-12 levels and ensure adequate intake or supplementation.

The Future of Vitamin B-12 Research

As our understanding of vitamin B-12’s role in human health continues to evolve, ongoing research is exploring new areas of potential impact and improved testing methods. Some promising areas of future research include:

• Development of more accurate and accessible B-12 testing methods
• Investigation of B-12’s role in neurodegenerative diseases
• Exploration of potential benefits for mental health and mood disorders
• Examination of B-12’s impact on longevity and healthy aging
• Research into novel delivery methods for B-12 supplementation

As new findings emerge, our approach to vitamin B-12 testing, supplementation, and treatment may evolve, potentially leading to improved health outcomes and quality of life for individuals affected by B-12 deficiency or related conditions.

Vitamin B-12 Level Test: Purpose, Procedure & Results

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What is a vitamin B-12 deficiency?

Vitamin B-12 is an important vitamin for many bodily functions, such as brain health, blood cell production, and proper nerve functioning. There are several ways to test your B-12 levels. You can get your blood drawn or take a home urine test. These tests will look at the levels of your:

• overall vitamin B-12
• methylmalonic acid (MMA)
• homocysteine
• holotranscobalamin (holoTC)

Research suggests that MMA and holoTC may be more accurate at reading low B-12 levels because they represent active B-12. Low B-12 levels can lead to:

• permanent nerve damage
• deteriorating brain functions
• memory loss
• temporary infertility in women

People who are obese or eat a lot of meat also tend to have higher-than-normal levels. High levels of vitamin B-12 can be a sign of liver disease, certain types of leukemia, or diabetes.

Vitamin B-12 deficiency is a common condition. Between 1.5 and 15 percent of Americans have low levels of vitamin B-12, according to the National Institutes of Health. Many people, especially older adults and people with intestinal disorders, have trouble absorbing vitamin B-12 from food and oral supplements.

Can vitamin B-12 boost your energy levels? »

Your doctor might recommend a B-12 test if you have:

• tingling in the hands and feet
• problems with balance
• a racing heart
• confusion
• dementia
• weakness
• loss of appetite

You may also take this test if your doctor suspects you might have pernicious anemia. Pernicious anemia is a reduction in red blood cells. It occurs when your intestines can’t absorb vitamin B-12, which is necessary for red blood cell production. Symptoms are not often seen in people younger than 30 years old. The average age of diagnosis is 60.

Symptoms of this condition include:

• diarrhea or constipation
• exhaustion
• loss of appetite
• pale skin
• inflamed red tongue, or gums that bleed

High serum folate levels

Your doctor might also test your vitamin B-12 levels if you have high serum folate levels. High serum folate levels may mask vitamin B-12 deficiency and worsen the symptoms, according to the National Institutes of Health (NIH). Serum folate measures the level of folic acid in the blood. Folic acid is necessary for your body’s growth and development and the production of red and white blood cells and platelets.

Read more about the symptoms of vitamin B-12 deficiency »

Your body doesn’t naturally produce vitamin B-12. It comes from animal products like fish, meat, and dairy. People who are at risk for vitamin B-12 deficiency are:

• older adults
• children
• vegans
• strict vegetarians
• people with diabetes
• people who’ve had gastric bypass surgery

New mothers who are breastfeeding may want to test their vitamin B-12 levels if they have symptoms or are in the at-risk group above. If a breast-feeding mother has low levels of B-12, her infant is at increased risk for neurological damage and developmental problems, according to Harvard Health Publications.

Some conditions may also affect your body’s ability to absorb B-12. Talk to your doctor if you have:

• pernicious anemia
• celiac disease, where your body’s immune system reacts to gluten by damaging the lining of the intestine
• Crohn’s disease, an autoimmune condition that causes persistent inflammation of the gastrointestinal tract
• atrophic gastritis, a condition where your stomach lining narrows and limits stomach acid production

Medications that may also affect the body’s vitamin B-12 levels include:

• chloramphenicol, or Chloromycetin
• proton pump inhibitors, such as Prilosec and Prevacid
• h3 receptor blockers, such as Tagamet, Pepcid, and Zantac 360
• metformin, for diabetes

You might feel a pricking when your healthcare provider inserts the needle into your arm. But a blood draw is low risk and generally painless. It’s also possible to feel a little sore or observe bruising on your arm for a few days after. Alert your healthcare provider if the pain is throbbing or if your arm swells after the test.

Talk to your doctor before the test if you have a bleeding disorder, such as hemophilia, or if you’ve had problems with blood clotting in the past. It’s possible to experience excessive bleeding where the needle punctures your skin.

It’s also important to tell your doctor about any medications or over-the-counter drugs you’re taking, as certain drugs may interfere with the test results.

Preparing for a blood test

Your healthcare provider will tell you not to eat or drink for about six to eight hours before your test. You’ll want to make sure you’re well hydrated on the days before the test.

During the test, your healthcare provider will clean a small area of your arm or elbow with an antiseptic wipe or alcohol pad. They might wrap an elastic band around the top of your arm to increase the flow of blood. Your healthcare provider will then insert the needle into your vein and collect your blood.

Once enough blood is drawn, your healthcare provider will remove the needle and apply a bandage. Your blood sample is then taken to a lab to measure for vitamin B-12 or other markers, like holoTC.

Preparing for the home tests

It’s possible to test your B-12 levels at home. Home test kits cost about $50.00 each and can be purchased online. Most home kits test your urine for the presence of MMA, which is linked to early stages of a vitamin B-12 deficiency.

You may need to send your urine sample to a laboratory. These kits will include a jar and mailing instructions. Others will include test strips that you dip into your urine sample yourself, allowing you to read your results right away.

Both high and low levels of vitamin B-12 may indicate an underlying problem. Low levels of B-12 can suggest anemia, an internal parasite, and hyperthyroidism. High levels of B-12 may increase your risk for cancer, according to Medical Daily.

High levels of B-12 can also be a sign of:

• liver disease
• certain types of leukemia
• diabetes
• kidney failure

It’s also possible to have low or high levels of vitamin B-12 without other health concerns. Most health conditions will have additional symptoms other than abnormal vitamin B-12 levels.

Normal ranges can also vary from laboratory to laboratory, so it’s important to discuss your results with your doctor.

Vitamin B-12 results

For urine tests, a normal range for MMA is under 3.8 mcg/mC. If you have higher levels, you may have B-12 deficiency.

The normal range for holoTC is 23–100 pmol/L. Low holoTC is an early indicator of low B-12.

For people with high levels of B-12, treatment involves adjusting your diet. This may mean eating less animal products like meats, dairy, and seafood.

If you’re diagnosed with a B-12 deficiency, the goal of treatment is to increase your level of vitamin B-12. Your treatment may include:

• vitamin B-12 injection, with more frequent injections for those with severe deficiencies
• daily vitamin B-12 supplements, such as Cyanocobalamin, which is a manmade vitamin B-12
• regular administration of liquid B-12 through the nose
• adhering to a diet rich in vitamin B-12

If your B-12 deficiency is the result of an underlying medical condition, your doctor will treat that condition first.

Many cases of B-12 deficiency are rooted in underlying health problems, but it’s possible to take preventative measures. Preventative measures include paying close attention to your diet, especially if you’re vegetarian or vegan.

One serving of fortified breakfast cereal may fulfill 25 to 100 percent of your daily intake value, depending on the brand. Three ounces of cooked salmon has about 80 percent of your daily intake value.

You can also find B-12 in:

• seafood
• liver, pork, and beef
• chicken and poultry
• fortified soymilk
• dairy, such as milk, yogurt, cheese
• vitamin supplements

Vegetarians and vegans may also find some soy products, miso, and sea vegetables with B-12, but these don’t contain significant amounts of B-12.

How much vitamin B-12 do you need?

How much B-12 you need depends on your age and if you are pregnant or breastfeeding. The table below shows how much

birth to 6 months old	0.4 mcg
7 to 12 months old	0.5 mcg
1 to 3 years old	0.9 mcg
4 to 8 years old	1.2 mcg
9 to 13 years old	1.8 mcg
14 to 18 years old	2.4 mcg
adults, 19 and older	2.4 mcg
pregnant women	2. 6 mcg
Breastfeeding women	2.8 mcg

While high vitamin B-12 may be a sign of other conditions, consuming excess vitamin B-12 doesn’t appear to cause any adverse health effects.

Vitamin B12 Side Effects, What They Mean and More

Evidence Based

This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information.

With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses (1, 2, etc.) are clickable links to these studies.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Note that the numbers in parentheses (1, 2, etc.) are clickable links to medically peer-reviewed studies.

Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

By Rachael Link, MS, RD

July 23, 2022

Vitamin B12, also known as cobalamin, is an important water-soluble vitamin that plays a central role in several aspects of health, including brain function, red blood cell formation and DNA synthesis. It’s also considered an “essential nutrient” because your body is unable to produce it on its own and needs to obtain it from food sources or supplementation. In recent years, research has unearthed a number of vitamin B12 side effects, including positive effects, such as its ability to improve energy levels, enhance mood and keep your heart healthy.

Although incorporating a good variety of vitamin B12 foods in the diet can help most people meet their needs for cobalamin, supplementation is sometimes necessary for those who may have underlying health conditions or take certain medications. Like all supplements, however, there are several vitamin B12 benefits and side effects to consider.

So what are the side effects of vitamin B12? How can you minimize these potential vitamin B12 side effects while maximizing the benefits? Here’s what you need to know.

Positive Vitamin B12 Side Effects

Does B12 have side effects? What does B12 do for your body? Here are a few of the top vitamin B12 benefits for men and women:

1. Prevents Deficiency

Taking a vitamin B12 supplement is one of the easiest and most effective ways to prevent a vitamin B12 deficiency, especially if you don’t regularly consume foods high in this important water-soluble vitamin. Some of the most common side effects of vitamin B12 deficiency include weakness, anemia, constipation, decreased appetite and unintentional weight loss.

2. May Boost Energy Levels

Vitamin B12 plays an integral role in energy production and is essential for converting the foods that you eat into a form of  energy that can be used by the body. It’s also necessary for the formation of red blood cells, which help supply the cells with oxygen so they can function properly.

While research is lacking on whether taking a vitamin B12 supplement can improve energy levels on its own, it can aid in energy production and may be especially beneficial for boosting energy levels if you’re lacking in this key micronutrient.

3. Supports Growth and Development

Vitamin B12 is absolutely essential during pregnancy for ensuring healthy fetal growth and development. Not only is vitamin B12 crucial for preventing birth defects, but a deficiency may also increase the risk of miscarriage or premature birth.

For this reason, vitamin B12 is a common component of most prenatal vitamins and can also be found in many fortified foods.

4. Keeps Skin, Hair and Nails Healthy

Some of the most visible signs of vitamin B12 deficiency can be spotted right in your hair, skin and nails. In fact, some of the most common symptoms of deficiency include hyperpigmentation of  the skin and nails, hair changes, vitiligo, and angular stomatitis, which is a condition that causes cracks and inflammation in the corners of the mouth.

Fortunately, several case reports have found that these changes may be reversible by correcting the deficiency with supplementation.

5. Improves Mood

One of the most surprising vitamin B12 injections side effects is the ability to improve mood and mental health. This is because vitamin B12 acts as a cofactor for neurotransmitters like serotonin and dopamine, both of which are key regulators of mood and emotion.

Preliminary research also shows that pairing vitamin B12 supplementation with antidepressants could help significantly reduce symptoms of major depressive disorder to a greater extent than treatment with an antidepressant alone.

6. Promotes Heart Health

Vitamin B12 is important for the metabolism of homocysteine, a type of amino acid in the blood that may be tied to a higher risk of heart disease. In addition to decreasing homocysteine levels, which could potentially help reduce the risk of heart disease, some research also indicates that higher vitamin B12 levels may be linked to improved outcomes for those who have suffered from an ischemic stroke and may be associated with a lower risk of coronary artery disease.

Negative Vitamin B12 Side Effects

Despite the multitude of benefits associated with vitamin B12, can too much vitamin B12 be harmful and what happens when you have too much of it in your body?

Vitamin B12 is a water-soluble vitamin, which means that excess amounts are flushed out of the body through the urine, making a vitamin B12 overdose nearly impossible. However, while vitamin B12 is safe when used as recommended, there are several vitamin B12 injection side effects to consider as well.

Research indicates that there may be adverse effects of intramuscular vitamin B12, or B12 injections. Some common issues include fever, itching and tingling or numbness of the joint.

Other possible vitamin B12 shot side effects include:

• Headache
• Dizziness
• Rash
• Facial flushing
• Skin redness
• Cold symptoms
• Anxiety
• Swelling
• Diarrhea
• Vomiting
• High blood pressure

How to Prevent

The best way to avoid the potential side effects of too much vitamin B12 is to get the majority of your vitamin B12 from nutrient-rich food sources, including meat, poultry, seafood and dairy products. Enjoying these foods alongside a variety of other healthy ingredients as part of a balanced diet can help ensure you meet your needs and reduce the risk of too many vitamin B12 side effects.

In some cases, supplementation may be necessary, especially if you don’t regularly consume foods high in vitamin B12 or have issues with vitamin absorption.

In that case, be sure to stick to the recommended vitamin B12 dosage, and use only as directed. If negative vitamin B12 supplement side effects persist, consider decreasing your dosage, or consult with your doctor.

Related: Vitamin B: Top 6 Benefits of B Vitamins & How to Get More in Your Diet

Precautions/When to See Doctor

Supplementing with vitamin B12 may not be right for everyone and can even be contraindicated in some cases due to the potential vitamin B12 side effects. For example, those with high blood pressure, heart problems, skin conditions, blood disorders, gout and low potassium levels should use vitamin B12 with caution and may want to consider talking to a trusted health care practitioner before starting supplementation.

Certain medications or supplements can also interfere with vitamin B12 supplements. What medications should not be taken with B12?

Folic acid, potassium, vitamin C and chloramphenicol, a type of broad-spectrum antibiotic, may all interfere with vitamin B12 in the body.

In order to minimize vitamin B12 supplements side effects, it’s best to stick to the recommended dosage and use as directed. If you experience any persistent vitamin B12 tablets side effects or serious symptoms, talk to your doctor to determine the best course of treatment for you.

Conclusion

• In recent years, research has unearthed a number of vitamin B12 side effects, including positive effects, such as its ability to improve energy levels, enhance mood and keep your heart healthy, and negative effects that may occur when there’s too much in the body.
• The best way to avoid the potential side effects of too much vitamin B12 is to get the majority of your vitamin B12 from nutrient-rich food sources, including meat, poultry, seafood and dairy products.
• For some people, taking supplements is necessary, but to minimize vitamin B12 supplements side effects, stick to the recommended dosage and use as directed.

What you need to know about vitamin B12

WHY YOU NEED VITAMIN B12

Vitamin B12 (or cyanocobalamin) is needed for the formation of red blood cells, neuronal development and DNA synthesis. Its deficiency can lead to the accumulation of homocysteine ​​(a neurotoxic compound), anemia, loss of balance, numbness of the limbs, fatigue and memory impairment.

Lack of vitamin B12 is most pronounced: at an older age, after surgery to reduce the stomach, with reduced stomach acid or medication to reduce it, when taking heartburn medications, with diseases of the gastrointestinal tract (Crohn’s disease), with a vegan diet.

Vitamin B12 is stored in the liver. Normally, there is a reserve in the human body for several years, but then it can be exhausted. Therefore, people who switch to a vegan or raw food diet feel good at first, especially if they ate a lot of meat before. After a few years, most people go back to eating meat and do not have time to feel the symptoms of vitamin B12 deficiency.

VITAMIN B12 RATES

The daily requirement for vitamin B12 depends on age. For adults, it is 2.4 mcg per day, for pregnant and breastfeeding women – a little more. Vitamin B12 has traditionally been prescribed by injection, but 1000 micrograms of the vitamin per day orally has now been shown to be effective, even in people with poor absorption and low acidity. If there are problems with the gastrointestinal tract, then vitamin B12 will be poorly absorbed from food. But taking in large doses will solve the problem. This vitamin can accumulate and is non-toxic, so it is advisable to drink or inject it not constantly, but in courses.

B vitamins interact, so sometimes it is important to drink not vitamin complexes, but those that are not enough. Such an interaction exists, for example, with vitamin B9. Its excess can mask the lack of vitamin B12. A person, for example, eats a lot of vegetables and does not eat meat. If a person does not use B12 for a long time (several years), and then he does an analysis for homocysteine, then the indicator is likely to be normal. This is because B9 and B12 are involved in the same metabolic pathway. But this does not mean that you can do without B12. Masking does not mean compensating.

Another reason to take vitamin B12 alone is that the cobalt ion in it destroys other vitamins. B12 interacts with some medications, so if you are taking any medications, especially for treating heartburn, ulcers, and diabetes, be sure to check with your doctor.

WHEN THERE IS A DEFICIENCY OF VITAMIN B12

A lack of vitamin B12 can be suspected by the results of an analysis of homocysteine ​​- this substance becomes more with a lack of vitamin B12. But this analysis is not completely reliable. If you consume a large amount of folic acid, for example, thanks to a vegan diet, the level of homocysteine ​​will be normal.

Another marker of B12 deficiency is megaloblastic anemia. It is diagnosed with a blood test. Anemia caused by a lack of B12 passes safely, but neurodegenerative processes due to a lack of cyanocobalamin are irreversible. A number of studies have shown that people with various forms of dementia often lack vitamins B12 and B9, but the therapeutic effect of these vitamins on patients with dementia is rather weak.

Fervent fans of a purely plant-based diet cite herbivorous primates as an example, since they eat only fruits and are not deficient in B12. But primates in the wild eat termites and other insects, and along with them – a sufficient amount of B12.

WHERE IS VITAMIN B12

Vitamin B12 is found in animal products, primarily in red meat, liver and fish, but also in eggs and milk. It can be added to food products at the factory, which must be indicated on the label.

WHO SHOULD USE B12:

• vegans and vegetarians with experience;
• people with low stomach acid;
• people with chronic bowel disease (Crohn’s disease, irritable bowel syndrome) or after surgery on the gastrointestinal tract;
• people over the age of 50;
• AIDS patients;
• people who take antacids, metformin to treat diabetes.

In some cases, B vitamins can be poorly absorbed or even harmful, so rule number 1 is to consult your doctor before taking any vitamins or medications.

Source

Memorial Sloan Kettering Cancer Center

Adult Medication

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Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

B-12 Compliance Injection [DSC]; Dodex; Nascobal; Physicians EZ Use B-12; Vitamin Deficiency System-B12

Trade names: Canada

Cobex [DSC]; Cyano Vit B12 [DSC]; JAMP-Cyanocobalamin [DSC]

What is this drug used for?

• It is used in the treatment of certain types of anemia.
• It is used to treat and prevent low levels of vitamin B12.
• This drug may also be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

All forms:

• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
• If you have an eye disorder called Leber optic atrophy.

Nasal spray:

• If you have any of the following health conditions: hay runny nose, stuffy nose, or signs of a cold.

This list of drugs and conditions that may interfere with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

All forms:

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Perform blood tests as directed by your doctor. Consult with your doctor.
• Consult your doctor before drinking alcohol.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

Injection:

• Very severe and sometimes deadly allergic reactions have rarely occurred. Consult your doctor.
• This medicinal product may contain aluminum. There is a risk of aluminum toxicity if you take this drug for a long time. The risk is higher if you suffer from kidney disease. The risk is also higher in premature babies. Consult your doctor.
• Some preparations contain benzyl alcohol. These drugs should not be given to newborns or infants. If you want to know if this medicine contains benzyl alcohol, ask your doctor.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Signs of low potassium, such as muscle pain or weakness, muscle cramps, or a feeling of irregular heartbeat.
• Chest pain.
• Feeling cold in the hands or feet.
• Inflammation, warmth, numbness, discoloration, or pain in the leg or arm.
• Shortness of breath, sudden weight gain, or swelling of the arms or legs.
• Balance change.
• Unusual sensations of burning, numbness, or tingling.
• Vision change.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Contact your doctor or seek medical attention if these or any other side effects bother you or do not go away:

All formulations:

• Feeling dizzy, tired or weak.
• Headache.
• Nervous tension and agitation.
• Diarrhea, indigestion or vomiting.
• Joint pain.
• Signs of a cold.

Nasal spray:

• Irritation of the nose or throat.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All oral preparations:

• It is best to take this medication with meals.
• Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.

Chewable:

• Chew thoroughly before swallowing.

Extended release tablets:

• Swallow whole. Do not chew, break or crush.

Sublingual tablets (sublingual tablets):

• Place under tongue and let dissolve completely. Do not chew, dissolve, or swallow the tablet.

Sublingual spray (sublingual spray):

• Shake well before use.
• Spray into the mouth under the tongue.

Oral fluid:

• Shake well before use.
• Liquid doses should be measured with caution. Use the dispenser that comes with the medication. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

Lozenges and orally disintegrating tablets:

• Let it dissolve in your mouth. It is not necessary to drink water.

Nasal spray:

• Not for oral use. For nasal use only. Avoid contact with mouth and eyes (possible burns).
• Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.
• Certain products need to be primed before first use or if they have not been used for some time. Some products do not need to be pumped. Ask your doctor or pharmacist if your model needs to be upgraded.
• Before use, clean the nose.
• Do not use this medication at least 1 hour before and 1 hour after eating hot food or drinks.
• If you are also prescribed other nasal medications, ask your doctor about the order in which you need to take them and when.

Injection:

• For intramuscular or subcutaneous injections.
• If you inject yourself, your doctor or nurse will teach you how to inject.
• Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.
• Wash your hands before and after use.
• Do not use if solution is cloudy, leaking, or contains particles.
• Do not use if solution changes color.
• Dispose of needles in the used sharps/needles container. Needles and other items cannot be reused. When the container is full, dispose of it according to local regulations. If you have any questions, ask your doctor or pharmacist.

What if I miss a dose of a drug?

• Take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.

How do I store and/or discard this drug?

Injection:

• If you need to store this drug at home, check with your doctor, nurse, or pharmacist for storage conditions.

All other dosage forms:

• Store at room temperature. Don’t freeze.
• Store in a dry place. Do not store in the bathroom.

Nasal spray:

• Do not expose to heat and light.
• Store upright with cap closed.

All forms:

• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General drug information

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options.