B12, also known as cobalamin, is an essential vitamin that is necessary for cognitive and cardiovascular health as well as normal nerve functioning.
You can obtain B12 from most animal foods but only from fortified vegan sources. Good sources of B12 include beef, liver, clams, oysters, oily fish, meat, poultry, eggs, and dairy products.
Vitamin B12 is actually produced by bacteria in the soil and even by bacteria in animal and human intestines.
Plant foods that have been shown to contain B12 include spirulina, algae, tempeh, seaweed, and barley grass. However, plants rarely contain a considerable amount of B12 and therefore are not a reliable source.
Vegans may need to supplement or include fortified foods such as non-dairy milks, cereals, and nutritional yeast.
What are the benefits of B12?
Vitamin B12 is stored throughout the body thus it can take years for a deficiency to develop. However, this is an essential vitamin that is critical for brain health and cognition but also overall bodily functions. Therefore it’s important to ensure that you are getting B12 either through your diet or from supplementation and that you are actually absorbing it.
Benefits and uses of B12:
Improves mood and brain function
Reduces the risk for birth defects and supports healthy fetal development
Prevents pernicious anemia
Supports production of hemoglobin (protein in red blood cells that carries oxygen throughout the body)
Stimulates growth and repair
Involved in the metabolism of fatty acids
Vital for melatonin production, an important hormone which supports sleep
Promotes healthy nerve function
Supports adrenal hormone production
Involved in the regulation of homocysteine (high levels of homocysteine can increase the risk of cardiovascular disease)
Promotes absorption of nutrients by supporting the regeneration of our mucosal lining in the small intestines
Helps to reduce fatigue and improve energy levels
Supports methylation (an important process that controls chemical interactions in the body)
Protects against heart disease
What are some other causes of B12 deficiency?
An obvious reason for deficiency is inadequate intake through the diet.
However, there are other causes that can contribute to low B12 levels:
Poor nutrient absorption
Certain medications (proton pump inhibitors, histamine 2 receptor antagonists, metformin..)
Stress and emotional trauma
Depleted soil and conventional animal products
Who is at risk?
The elderly and vegan populations are at the highest risk for B12 deficiencies as well as those taking certain medications (such as antacids and metformin). Other causes for deficiency include gastrointestinal surgery, anemia, alcoholism, heavy smoking, or inflammatory gastrointestinal disorders.
You may be eating sufficient B12 foods but are you actually absorbing it?
The most common issue with B12 deficiency is digestive malabsorption. Many people may be eating or even supplementing with B12 but not actually absorbing it due to intestinal damage or lack of hydrochloric acid in the stomach. If you suffer from Crohn's or Celiac disease or have parasites you are at a greater risk for deficiency.
Deficiency and testing
In order to absorb B12 our stomach needs to produce sufficient stomach acid and an enzyme called “intrinsic factor”.
Most omnivores get enough B12 through their diet but many are not actually absorbing it due to poor digestive function.
Addressing your diet and supplementing accordingly to repair digestive function is critical in order to restore B12 levels.
Vitamin B12 deficiency can cause symptoms like tiredness, weakness, moodiness, memory loss, depression, constipation, loss of appetite, weight loss, brain fog, cardiovascular disease, pale skin, megaloblastic orpernicious anemia and nerve problems like tingling hands and feet.
You can ask your doctor to test your serum B12 to verify your levels. The most accurate testing involves methylmalonic acid (MMA) and holotranscobalamin II (holo-TC). Homocysteine can also indicate a B12 deficiency while serum B12 is the least sensitive marker (1).
B12 supplements are not created equal. There are different types of B12 on the market you should be aware of when choosing a supplement:
Cyanocobalamin: a synthetic form of B12 that is cheaper and easier to produce making it the more popular choice. However, your body needs to convert cyanocobalamin first into hydroxocobalamin, adenosylcobalamin, and then finally into the active form methylcobalamin. If you have methylation issues, this conversion may not be happening.
Methylcobalamin: The active, coenzyme form of vitamin B12 which has been shown to be more effective, specifically for brain and nervous system health as well as better sleep cycles. Whether you know you have methylation issues or not, this is the preferred form because it skips the conversion processes and gives your body exactly what it needs.
As many of us have compromised digestive function, B12 injections or sublingual methylcobalamin tablets are recommended to ensure you are actually absorbing the vitamin. Remember you don’t have to be experiencing digestive symptoms to have malabsorption or impaired digestion. Make sure you test your levels to assess the adequate dosing for your situation.
Don’t like tablets? Use gummies or a spray instead!
How to improve your B12 status
1. Eat B12 rich foods found in liver, shellfish, beef, chicken, fish, lamb, cheese, and eggs.
2. If you are vegan or deficient, you will most likely need to supplement. Use sublingual tablets or injections for best absorption and look for the form methylcobalamin which is the active, coenzyme form of vitamin B12.
Laurence Annez is a Certified Nutritional Practitioner and Health Coach, specializing in PCOS and women's hormones. She also holds a degree in Creative Writing and has extensive experience writing on health and wellness topics. Laurence's mission is to inspire and motivate individuals to take control of their own health and reach their ultimate health goals.
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