Vitamin B12 – Clarifying Some Misinformation
Nutrition | Dr. Nishant Rao | May 8, 2009 at 3:38 pm
Photo by tambako the jaguar.
Last night I watched an episode on NBC’s The Doctors. Don’t know the show? It stars four doctors with different specialties, each discussing popular health care topics. It was my first time watching it.
One of the topics for discussion was whether vitamin B12 injections have any effect. The answer from the panel was a quick, “No, the energy increase is simply a placebo effect.”
I was seriously surprised at the oversimplification and misinformation. The comment was essentially false and misleading. In an effort to provide valid health information, here’s the deal with vitamin B12:
Vitamin B12 is important for nerve and blood health among a host of crucial biochemistry. The best dietary sources are from animal products such as meat (especially liver), fish, eggs and dairy. As as side note, no plant foods can be relied on as a sole source of vitamin B12, If you are vegan I strongly suggest supplementing. I say sole source because you would have to eat several pounds of specific plants a day to get close to the daily requirement. There are bacteria in the colon which are capable of producing B12, but their location makes it difficult for absorption (hence why many vegetarian animals eat their own feces such as rabbits etc). The fermented soy, spirulina, seaweed, algae and nori products don’t actually contain B12, but an inactive analogue which does not serve the needs of an omnivore’s physiology nor lower MMA levels (test to determine biological activity of B12). Of course artificially fortified foods remain an option for those choosing this path.
As a side note, human feces is loaded with B12 due to these bacteria. Researchers found a group of Iranian vegans who showed no signs of B12 deficiency – it was discovered that the reason behind this was that they at vegetables fertilized with, you guessed it, human feces and then did not sufficiently wash the produce. I suppose that this remains a viable alternative (no please, I’m only joking). Anyhow, I digress.
The body has the capacity to store a few years worth of vitamin B12 (mostly in the liver, which is why Pâté is such a good source of B12 – bon appetit). This is probably why the panel made the comment about the vitamin B12 shot having no effect on the body as in theory it should all be there.
However:
It is generally not the lack of B12 in our diet that leads to a functional decrease in B12 levels, it is the assimilation. Vitamin B12 has a very complex absorption process, here are a few details.
- It starts in the stomach where adequate levels of stomach acid are required.
- Next, a protein complex called intrinsic factor (IF) is secreted from the stomach lining to bind to the B12.
- This B12-IF complex is finally absorbed at the end of the small intestine (ileum).
Each of these steps must be fully intact in order to guarantee B12 delivery into the system, here’s a short list of the most common reasons that they may be inhibited.
- The casual use of over the counter antacids and increasing prescription of acid inhibiting drugs.
- Poor eating habits lead to a functional decrease in stomach acid output from the stomach (that feeling of being full/bloated after a protein heavy meal).
Here are a few signs & symptoms which can be associated with B12 deficiency :
- Low energy, chronic fatigue
- Mental fog, forgetfulness, memory loss
- Depression
- Pernicious anemia, megaloblastic anemia
- Numbness, tingling in hands or feet
- Dizziness
- Headaches
- Neurological damage
- Gastritis
B12 functional deficiency is quite common especially because high stress depletes this vitamin. B12 shots CAN be an enormous impact for someone who has had a long term deficiency or someone who has problems with absorption. The shot is not the long term solution however, healing the G.I. tract and ensuring all the mechanisms for absorption are intact is the long term solution. In the meantime it can provide a drastic improvement in energy and mental function. The idea with the shot is to bypass all those steps needed for absorption from the diet and simply inject directly into the tissue. The wise approach would be to use these in the interim and get down to business and fix the actual problem.
Video on how-to make chicken liver pâté
Dr. Nishant Rao is a co-founder of WellWire.com. He is a well-traveled naturopathic doctor and new father, practicing an integrative approach to create wellness in and around Los Angeles. Become a patient or discover his practice.
Tags: B12, meat, stress, vegan, vegetarian, vitamins
Very interesting. I have watched that show and find it interesting but wonder if their opinions are accurate.
The body cannot stored vitamin B12; when you eat foods containing B12, your body uses what it needs and eliminates the rest through urine.
This article is very interesting to me because I have been taking b12 shots for a year and a half. My doctor tells me I’ll have to take them for the rest of my life. Your article has cleared-up a lot of confusion for me. My doctors prognosis is that I can not absorb the tablet. Now I feel confident of his opinion.
Thank you again,
Sincerely B.J.Leeming
P.S. I am over 75 years old
I noticed your article did not cover the sublingual approach or time-release capsules, what is your position on these methods of B12 administration? Calcium when combined with B12 assists the body with absorption of B12, and B-6 and vitamin C will actually increase absorption, yes?
Dear Clara,
Yes, you are correct some of those nutrients/vitamins that you mention do in fact have a synergistic activity in the body. The article’s main purpose was to give an overview of the body’s physiology and the relationship to Vitamin B12. Also, the emphasis was on the food sources, rather than supplementation. However, to give a very brief response to your question, there are numerous ways to supplement B vitamins. Some of these methods of supplementation include sublingual, liquid, various forms of slow-release capsules, as well as intramuscular injections. Different people may often require different forms of delivery and/or supplementation with B vitamins, as there are often numerous health and lifestyle factors that can have an effect on their absorption & bioavailability.
Hope this helps some.
Yours in health,
Dr. Igor Schwartzman
Love this! I use B12 a whole lot in my practice and I’d say, easily, 95% of my patients respond strongly to super-loading (2000mg/day for 2 weeks). Amazing response from patients, it harmonizes hormones, increases energy, decreases anxiety, helps with appetite, clears the blues, stops crying fits almost instantly and of course is fantastic for the heart! Great article Nishant:)
Tyna! Great to hear from you and thanks for sharing some of your clinical experience!
Wanted to clarify, I INJECT 2000 IU/day IM. I DO NOT get the same results w/sublingual. Interestingly, I do not get the same results intravenously as well. Something about that IM injection that does the trick!
B12 is one of my favorite topics and a very useful nutrient. Decades ago it was commonly used in allopathic medicine especially to forestall dementia and other effects of aging. B12 shots did not require a blood test to be sure your serum levels were low, even when it is the intracellular level that is important. It was just something that doctors did with little concern except to benefit health. Thyroid care was another useful therapy and it wasn’t with synthetic products, and adequate testing was common, not as it is today. Much of ALZ could be prevented with B12 shots and proper thyroid care.
Then consider that most on oral hypoglycemics and many of the acid blocking drugs lose needed B12 as a side effect from the drug yet get no additional support for this vital nutrient.
I also believe cell phones and wireless devices reduce B12 availability because of its link with pineal function.
B12 issues are probably epidemic.
Actually Denny the body most definitely does store B12, there is absolutely no question about this. The liver is the primary storage organ in the body for B12. 80% of the stored B12 is in the liver, and the average amount is around 2-5 mg – which is a lot and generally a few years worth if you were to lose all dietary sources. If you want more information start with WebMD . There is no conflicting information about whether or not the human body stores Vitamin B12.
This is why a serving of beef liver has 47.9 micrograms of B12 compared to a serving of beef which has 2.4 micrograms. Pâté!!
As far as eliminating through the urine, vitamin B12 is water soluble, however, what is excreted in the urine are usually B vitamin metabolites.
Vitamin B6, when broken down in the body, releases a water soluble compound called 4-pyridoxic acid, this contributes to the neon yellow color.
Additionally, vitamin B2 has a yellow-orange color and when taken in large doses, a small amount of this is excreted in the urine giving it that neon color.
This does not mean it is not getting absorbed which is another common misconception, it is a spill over effect. Nutraceutical doses, when compared to dietary sources, are the equivalent of an atomic bomb’s worth of vitamins, the intention is often to overload what one would need in an effort to super load the absorption routes. This compensates for the fact that many people have impaired absorption.
There is a lot of misinformation about Vitamin B12 out there and that was the reason for this article.
Thank you so much for your comment!!!
Yes. There are a lot of misinformation about B12. But when i came to this site http://products.mercola.com/vitamin-b12-spray/ it says “Vitamin B12 supports a healthy mood and feelings of well-being.* And then there’s this — it also provides excellent support for your memory, mental clarity, and concentration.*” Is it true?