Boosting Your B12

Question:

I need to boost my Vitamin B12 intake. It was suggested that I get 1000mg SL (sub-lingual) tablets, ones that go under my tongue. Do you have any suggestions what I should be taking?

Answer:

Thank you for your question.  I would have a few questions for you, too! 

But first, vitamin B12 is water-soluble vitamin plays an essential role in the proper formation of red blood cells, nerve function and synthesis of DNA, among other functions.  Deficiency of vitamin B12 results in fatigue, weakness, constipation, loss of appetite, and weight loss.  When left untreated, vitamin B12 deficiency leads to more serious complications. The most severe type of deficiency, caused by an autoimmune disorder, leads to pernicious anemia. Vitamin B12 is found in protein foods like meat, fish, poultry, eggs and milk/milk products), nutritional yeast, and is added (fortified) to breakfast cereals.

My questions for you would be: how old are you, do you take antacids or an acid reducing medication for reflux and have you had any gastrointestinal surgeries?  Do you take large supplements of folic acid?  Has a doctor or naturopath provided you with a diagnosis of some sort? The reason would I ask is in order for food sources of vitamin B12 to be absorbed in the gut, one requirement is the presence of adequate stomach acid. Furthermore, large doses of folic acid can mask the symptoms of vitamin B12 deficiency.  The second requirement for absorption of vitamin b12 is that it has to combine with a compound called intrinsic factor in the stomach and the production of intrinsic factor decreases after the age of 50.  After that, the vitamin B12/intrinsic factor combo is absorbed at the end of the small intestine.  Supplement forms of vitamin B12 don’t require stomach acid to be absorbed but they do still require intrinsic factor and an intact end of the small intestine.

Regardless, for one reason or another, you have been advised to take sublingual (under the tongue) vitamin B12 supplements.  Although advertised as being more available to the body than oral supplements (ones that are swallowed), the research shows no difference between the efficacy of oral and sublingual forms.

Another option, if determined necessary by your doctor or other trusted health care provider, vitamin B12 can be administered by intramuscular injection.  This is usually reserved for to treat vitamin B12 deficiency caused by pernicious anemia or other conditions that result in poor absorption of vitamin B12 and severe vitamin B12 deficiency.  Some practitioners begin treatment with an injection and then follow up with daily supplements of 2000 micrograms (mcg) and then taper the doses to 1000 mcg.  The dose may then continue to be tapered as deemed appropriate by your healthy care team.  This is something to discuss with your health care provider.

Finally, to answer the crux of your question ("can I make a suggestion") – yes, a couple!  Talk to your doctor to make sure you are clear as to why vitamin B12 supplements are being recommended to you and to pop in at Pomme to pick up some healthy vitamin B12-rich foods and vitamin B12 supplement.

Thank you again for your question.  Wishing you all the best in health and happiness.


Health science changes quickly.  The information contained in this material should not be misconstrued as medical advice.  Always consult with your doctor or trusted health provider to determine what is best for you.