If you’ve been feeling unusually sluggish and weak or if you can’t seem to stay awake during the day, you may be wondering if you’re getting enough of your essential nutrients. A big one to watch: vitamin B12, especially if you follow a plant-based diet.
Also known as cobalamin, think of vitamin B12 as fuel for your engine—it plays essential roles in energy production within your body, says Stephanie Gray, D.N.P., M.S., A.R.N.P., a doctorally prepared functional medicine nurse practitioner and owner of Integrative Health and Hormone Clinic in Hiawatha, IA. It also tamps down chronic inflammation within the cardiovascular system (that can, in turn, lower heart disease risk), helps maintain the nervous system (including the myelin sheath, “insulation” that surrounds nerves), and produces neurotransmitters (a.k.a. your body’s chemicals messengers).
“Vitamin B12 is necessary for normal processing of carbs, proteins, and fats in the body and for the normal formation of red blood cells,” adds Elizabeth Somer, M.S., R.D.N., a dietitian based in Salem, OR and a medical advisory board member for Persona Nutrition. “It’s essential for the replication and maintenance of all body cells.”
How much vitamin B12 should you get in a day?
Most adults should aim for at least 2.4 micrograms per day, according to the National Institutes of Health (NIH). It is possible to hit this mark through your diet, especially if it’s rich in certain seafoods and dairy products. “Vitamin B12 is found in animal foods, such as chicken, fish and shellfish, eggs, milk, cheese, beef, pork, and more,” Somer says. “It’s not found in plant foods, unless those foods are either fortified, such as fortified soymilk, or fermented, such as tempeh.”
Do you need a vitamin B12 supplement?
Since the symptoms of a vitamin B12 deficiency are fairly common—especially mid-pandemic—it can be challenging to determine if your levels are too low. “Symptoms are broad and include tiredness, weakness, loss of appetite, weight loss, and a specific type of anemia called ‘megaloblastic anemia.’ Nerve problems, such as numbness and tingling in the hands and feet, are also a risk,” Somer says. “Over time, a deficiency of B12 can cause problems with balance, confusion, depression, poor memory and [possibly] dementia, and it can even cause permanent damage to the nervous system. That means treating a deficiency as soon as possible is crucial.”
A deficiency can result from several causes:
- Poor dietary intake of vitamin B12, especially in vegetarians and vegans
- Low secretion of either hydrochloric acid or intrinsic factor, two gastric substances required for the vitamin’s absorption (which may be especially common among the elderly and in those who have had weight loss surgeries)
- Medications that impact vitamin B12 absorption, such as metformin and some drugs used to treat heartburn or acid reflux
“While poor intake is rare, poor absorption is not uncommon, especially as people age. As a result, about 15% of Americans are low in vitamin B12,” Somer says. A physician can order blood tests to assess your vitamin B12 status, but if you suspect a nutrient deficiency, a comprehensive nutritional analysis may also be beneficial, Gray says.
How to find the best vitamin B12 supplement
Because vitamin B12 is water soluble (meaning it dissolves in water and is excreted in your urine), “vitamin B12 supplements are very safe even at doses several times the recommended dietary allowances,” Somer says. “Like all vitamins, B12 works best with its team of other nutrients. So taking it in a multivitamin is best, unless you have been diagnosed with a deficiency. In that case, a physician might prescribe large doses to correct the deficiency, followed by a lower maintenance dose.”
If you do require a vitamin B12 supplement, follow this advice from our experts:
✔️ Seek out methylcobalamin. Most vitamin B12 supplements contain cyanocobalamin, which contain trace amounts of cyanide, Somer says. It’s also far less efficient than supplements made with methylcobalamin. “In order for cyanocobalamin-based B12 supplements to be utilized in the body, the liver must first remove the cyanide molecule and attach a methyl group to form methylcobalamin, the biologically active, tissue-ready form. Research has shown that methylcobalamin is more efficiently used and retained in the body than the cyanocobalamin form,” Gray says.
✔️ Read the label. The form of B12 should be clearly listed. Ditch the “cyano” (yes, even though it’s often the most affordable) and switch to safer “methyl” or new “hydrozyl” forms, Gray suggests. In addition, look for “a capsule or liquid form taken under the tongue since they work quicker than tablets.”
✔️ Ask about other B deficiencies. Many times when individuals need more vitamin B12, they are also shy in other B vitamins as well, like B9 and B6. Ask your doctor if a B complex is the right fit.
Now that you know what to keep in mind, the following B12 supplements all feature highly-absorbable forms of the vital vitamin.
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