Vitamin B12

June 16, 2021

By Barret Procyshyn, Pharmacist at Dauphin Clinic Pharmacy

The vitamins and minerals section at the pharmacy, can be a little overwhelming. There are often various formulations, brands, doses, and price points. There are more and more products hitting the market, often with some particularly good advertising. Sometimes there is a lack of information available on the medication if it is a vitamin, mineral or natural health product. Does the product have evidence it works? How much should be taken, at what dose? Do we need any beyond our regular diet? What if we take too much for too long? Unfortunately for many natural health products we do not have the answer to this. Luckily for vitamin B12 we do.

Vitamin B12 or cobalamin is a water-soluble vitamin responsible for some very key body functions. It is directly involved in the formation of red blood cells. Red blood cells contain a protein called hemoglobin, which carries oxygen from the lungs to all parts of the body. Vitamin B12 also has a key role in the function of the brain and the nervous system. To sum the importance of B12 up, it is involved in the metabolism of every cell in the human body.

At levels slightly below normal deficiency symptoms such as fatigue, depression, and poor memory can occur. If you are finding yourself consistently tired, it could be due to a lack of B12. In more significant deficiency, symptoms of depression, mood disorders and psychosis can occur. Although extremely rare, severe deficiency of vitamin B12 can cause a severe type of anemia and irreversible damage to the brain and nervous system.

Deficiency of Vitamin B12 can be caused by low intakes, mal-absorption, certain intestinal disorders and use of certain medications. Interestingly, PPI's (an example is esomeprazole), which are commonly prescribed to treat severe acid reflux have shown to cause decreased vitamin B12 absorption. The elderly population, who may be subject to diets with limited meat or animal product consumption, are also at risk.

So now that we know how important this vitamin is, we next need to know where it comes from. Vitamin B12 is not found naturally in any plant or fungi products. Unlike a Vitamin such as D, we are not able to synthesize it ourselves. Food sources of vitamin B12 are meat, fish, and dairy products. However, many foods are fortified with Vitamin B12, and it is available in many low-cost supplements, available in pill and injectable form. We even have creative ways to get your B12, such as flavored strips you dissolve on the tongue and flavored gummies.

The current estimated average requirement for Vitamin B12 for everyone aged 14 and up is 2 mcg/day. In pregnancy and breastfeeding it should be slightly higher than that at about 2.6 mcg/day. Due to the issue up to 1/3 of adults over the age of 50 are unable to effectively absorb vitamin B12 naturally occurring in their diet, they may need to consume B12 fortified foods or use a B12 supplement. Interestingly, with Vitamin B12 there is no defined upper limit to what you must consume. There is no scientific data showing side effects or poor health outcomes from too much Vitamin B12 naturally or in supplement form. In the pharmacy you will find doses available ranging from 250 mcg to 1200 mcg. With its safety profile it is imperative to get enough. Now remember Vitamin B12 is a water-soluble vitamin, so it must be taken daily to be effective and get your levels up. Remembering to take your daily dose is crucial.

Vitamin B12 pills are available in the sublingual form, which dissolve on or under the tongue. While studies show they do not necessary increase absorption, they are a great option for someone who has difficulty swallowing pills. If someone does not find it convenient to take vitamin B12 or has trouble taking it daily, the prescription injection form may be best. Usually provided once per month, many people find it more convenient and therefore more effective. Pill or injection form vitamin B12 is one of the lowest cost medications available at the pharmacy.

If you are over the age of 50 and are feeling like you have a lack of energy and focus, vitamin B12 supplements could be a good place to start. It is a natural product, which we know is safe and effective. Your vitamin B12 is being monitored by your family doctor if they are doing regular blood work. Vitamin B12 levels are standard with the bloodwork you get at the lab. If your doctor has mentioned your vitamin B12 is low or close to being low, make sure you use regular supplementation. Usually, your doctor will recommend continuing to take vitamin B12 even after levels stabilize, because its safe and effective.

Knowing which vitamins and minerals you need can be very confusing, especially with all the choices available. If you have questions, remember to always talk to your clinic pharmacist first so you get the right product. We will also help you determine the best time to take natural health products and can analyze your medication profile for any medication interactions.

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