By: Amanda Schroeder

Vitamin B₁₂ is typically marketed by mainstream media as a natural energy booster. Would you be surprised to hear that there is actually no scientific evidence to support this? It’s true! It also seems that, lately, the general population is becoming increasingly aware of and concerned about B₁₂ deficiency. What constitutes deficiency? And what does B₁₂ even do? Vitamin B₁₂ is a water-soluble vitamin that plays a pivotal role in red blood cell formation, nerve function, and even the creation of DNA! It is available in food products, as well as many forms of supplementation, including oral medication and even injections. Given all of the attention B₁₂ has received as of late, you might be thinking about it, too! Should you be wary of deficiency? Is supplementation dangerous? Clearly you can’t trust mainstream media to give you accurate information, but don’t fret; I’ve done the research for you!

Overall, the majority of us regularly consume enough B₁₂ to satisfy our body’s requirements, though there are particular groups of people who might have more trouble absorbing it into their circulatory system. Those with pernicious anemia (an autoimmune disease affecting 1-2% of older adults) do not produce enough of a protein called intrinsic factor. Intrinsic factor is required to adequately absorb B₁₂ and, without it, only about 1% of the B₁₂ that you consume can be absorbed and used by your body. Typically, these people are treated by a doctor with B₁₂ injections or very high oral doses. In addition, those who have had gastrointestinal surgery, particularly surgeries which remove a portion of your stomach or intestines, or those suffering from Celiac Disease or Crohn’s Disease absorb less B₁₂ than they consume. B₁₂ is absorbed through the surfaces of the gastrointestinal tract, so surface area is of the utmost importance! Removal of any portion of the GI tract decreases the surface area available and, therefore, decreases nutrient absorption. Similarly, intestinal disorders are characterized by a reduced ability to absorb many nutrients, including B₁₂. Another at-risk group is older adults, particularly those over 50 years of age. About 10-30% of those over 50  develop a condition called atrophic gastritis, which interferes with the amount of stomach acid your body can produce. Inadequate levels of stomach acid reduce your capacity to break down and absorb B₁₂. They can also encourage overgrowth of bacteria naturally found in your GI tract that use the vitamin as a food source. These bacteria essentially steal B₁₂ from your stomach, leaving far less for you. (How rude, right?) Interestingly, atrophic gastritis mainly reduces your ability to absorb B₁₂ that is found naturally in foods. This means that most people are still able to absorb it from oral supplements, injections, or even foods which have been fortified with added B₁₂. This particular vitamin is only found naturally in animal products, so those who have removed animal products from their diet are also at risk. Just like the other at-risk groups, though, consumption of fortified foods (many breakfast cereals have added B₁₂) or supplementation, orally or via an injection, are both great options to increase and maintain healthy levels. As you might imagine, many people fall into one or more of these categories, so B₁₂ deficiency is relatively common, affecting 1.5% – 15% of the general population.

The symptoms of B₁₂ deficiency are varied. The most common symptoms include constipation, loss of appetite, weight loss, and fatigue. Deficiency can also damage the nervous system, so you could notice tingling or numbness in your hands and feet, issues with balance, poor memory, confusion, depression, or even dementia. Pregnant or breastfeeding women should pay extra attention to their B₁₂ levels. As you know, fetuses obtain all necessary nutrients from their mother. B₁₂ is also found in breast milk and, particularly if your infant acquires most or all of his/her nutrition from breastfeeding, it is important that you have enough to provide for both of you! Deficiency in infants can cause issues with movement and delay the achievement of many of the expected developmental milestones. Recommended consumption of B₁₂ varies greatly by age and life stage. So, how much do you need? Take a look at this table of recommendations to find out!

(https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/)

Vitamin B₁₂ is water-soluble, meaning that our bodies are capable of excreting excess quantities in urine. In fact, there is a very minimal risk of toxicity. Despite this, it is always recommended that you consult your healthcare professional before beginning any type of large volume supplementation. A blood test is the only real way to diagnose deficiency and your results will make much more sense if you include your doctor! In addition, certain medications, like some antibiotics or diabetes medications, can interact with B₁₂ and produce a variety of undesirable outcomes. Therefore, if you are taking any pharmaceutical drugs, speaking with your doctor is especially important!

So, where can you find B₁₂? Supplements and fortified foods are excellent sources, particularly for the at-risk groups we spoke about previously, but you can also find it naturally in animal products. Clams and liver both have very large quantities (over 1,000% of the daily recommendation!). Other good sources include fish, milk, cheese, meat products, and eggs.

Interested in increasing your intake? Check out these recipes for inspiration! Happy eating!

• Beef and Cheese French Bread
• Baked Parmesan Catfish
• Breakfast Burritos

References:

• https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/