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What Happens If Vitamin B12 Is Low

How Is It Treated

What happens if youre low on vitamin B12?

Vitamin B12 deficiency anemia is treated with supplements of vitamin B12. Taking supplements brings your level of vitamin B12 back to normal, so you do not have symptoms. To keep your level of vitamin B12 normal, you will probably need to take supplements for the rest of your life. If you stop taking them, you’ll get anemia again.

Your vitamin B12 supplements might be pills or shots. If you use shots, you can learn to give them to yourself at home. For many people, pills work just as well as shots. They also cost less and are easier to take. If you have been getting shots, ask your doctor if you can switch to pills.

You can take steps at home to improve your health by eating a varied diet that includes meat, milk, cheese, and eggs, which are good sources of vitamin B12. Also, eat plenty of foods that contain folic acid, another type of B vitamin. These include leafy green vegetables, citrus fruits, and fortified breads and cereals.

Tests To Identify The Cause

If vitamin B12 deficiency is suspected or confirmed, further tests may be required to identify the cause. This will help to determine the recommended course of treatment. These investigations may include further blood tests for pernicious anemia and other conditions.

Some people may be referred to specialists for further tests or treatment. These include hematologists, doctors specializing in blood conditions, and gastroenterologists, doctors specializing in the digestive system.

Are B12 Shots Safe

Studies have shown even mega-doses of vitamin B12 daily for years show no adverse effects. Your body tends to use what it needs and gets rid of the rest. Vitamin B12 shots are safe as long as theyre administered correctly. This doesnt mean there arent any side effects. Mild side effects from B12 shots include:

  • Nausea

Rarer side effects can include:

  • Irregular heartbeat
  • Cramps
  • Breathing difficulties

Certain medical conditions can also interact with vitamin B12 shots. Individuals should consult with their doctor before getting a shot. These conditions include:

  • Allergy to cobalt or cyanocobalamin
  • Kidney problems
  • Low potassium levels
  • Iron and folic acid deficiency

Note: Intramuscular injections should only be administered by a medical professional. This reduces the chance of infection and significant side effects.

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Intrinsic Factor: The Key To Absorbing Vitamin B12

For vitamin B12 absorption to be possible, a special transport molecule produced by the parietal cells is required. This molecule is called intrinsic factor .

Vitamin B12 is mostly bound to proteins in food and is separated by specific enzymes in the stomach. It is then transported to the small intestine by a different transport protein called haptocorrin, where it binds to IF. Following this, IF transports the B12 to receptors in the intestinal mucosa, where the vitamin can then gain access to the mucosal cells.

There is a limited number of intrinsic factor receptors, meaning that only around 1.5 to 2 µg of B12 per dose or meal can be absorbed in this way.

A further 1% of the dosage is absorbed via passive diffusion, bypassing the need for IF. Because it is only 1% that is absorbed, this method is only effective when high vitamin B12 doses are consumed .

High Activity High Stress

What Does Vitamin B12 Do For You &  What Happens if it is ...

Are you training intensely for an event or competitive season? Are you really busy and on the go with work and/or kids at home? The greater stress load on your body, the greater the demand for vitamin B12 which can put drain your levels, especially when combined with a diet that doesn’t contain enough of the essential vitamin.

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How To Raise Your B12 Levels Fast

The most common way to treat B12 deficiencies is by adjusting your diet. If this is unsuccessful, vitamin supplements may be recommended.

If youre looking to boost the amount of vitamin B12 in your diet, you should eat more animal products, like meat, seafood, dairy and eggs. Fortified breakfast cereals are another great way to get more B12.

It is possible that your doctor may want you to take a vitamin B12 supplement in addition to your diet change. Typically, these supplements come in both pill and nasal spray form.

If your doctor wants to raise your B12 levels quickly, he or she may give you a higher-dose vitamin B12 shot.

Vitamin B12 Overdose Symptoms: Should You Be Concerned

By Christine Ruggeri, CHHC

You know that theres a long list of vitamin B12 benefits that come with getting enough of the nutrient. In fact, you need enough of it to maintain hormone balance, the health of your nerve cells, DNA synthesis and enzyme production just to name a few. But what happens when you take too much vitamin B12? Can you suffer from a vitamin B12 overdose?

Although a vitamin B12 overdose is rare, research suggests that some groups of people are at a greater risk of adverse effects from taking an excessive amount of the nutrient. Are you at risk of a vitamin B12 overdose? If you have certain health conditions, you have to be careful of supplementing with this essential nutrient.

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Reason For Shortage: Weight Surgery

One of the more common weight loss operations is called âgastric bypass.â After the surgery, food bypasses parts of your stomach and small intestine. Thatâs usually where B12 breaks down into usable form. Your doctor likely will monitor your B12 levels and suggest supplements or shots if you need them.

Benefits Of B12 Vitamin Supplementation

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Types of Vitamin B12 Supplements

Vitamin B12 supplements come in three main forms:

  • Oral supplements and fortified foods
  • Intravenous drips
  • Intramuscular shots

There are also four types of vitamin B12 that are available as a supplement. Different supplement types will use different types of vitamin B12.

MethylcobalaminThis form of vitamin B12 is most often used in oral supplements and some vitamin B12 shots. Methylcobalamin is the active form of cobalamin found in your body helps maintain the myelin sheath of nerve fibers.

Methylcobalamin also works in the synthesis and repair of DNA, the synthesis of amino acids and proteins, and the production of red blood cells.

CyanocobalaminThis artificial form of vitamin B12 popular in vitamin B12 shots and IV supplements. One reason why cyanocobalamin is a popular choice is because its more stable, thanks to an added cyanide molecule. The amounts present are minimal, produce no adverse effects, and the FDA has approved cyanocobalamin for human use.

HydroxocobalaminHydroxocobalamin is mainly used in vitamin B12 injections. This type of B12 is lab-grown in bacterial cultures. Its readily converted by the body into its active form.

AdenosylcobalaminThis active form of cobalamin is rarely used as a supplement due to the instability of the molecule.

Which Type of Vitamin B12 Delivery is Best?

Many studies have tried to determine which delivery method and type of B12 is best.

Researchers have gotten mixed results.

  • Fatigue

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Dietary Sources Of Vitamin B12

Vitamin B12 is found naturally only in foods from animal sources, including dairy products and eggs. Beef liver and clams contain the highest amount. Many packaged foods are fortified with vitamin B12. People who follow a strict vegan diet by avoiding all foods from animal sources and those who have absorption problems because of disease or surgery should talk to their doctor about vitamin B12 supplementation.

Normal Absorption Of Vitamin B12

In humans, only two enzymatic reactions are known to be dependent on vitamin B12. In the first reaction, methylmalonic acid is converted to succinyl-CoA using vitamin B12 as a cofactor . Vitamin B12 deficiency, therefore, can lead to increased levels of serum methylmalonic acid. In the second reaction, homocysteine is converted to methionine by using vitamin B12 and folic acid as cofactors. In this reaction, a deficiency of vitamin B12 or folic acid may lead to increased homocysteine levels.


Vitamin B12 deficiency leads to a serum build-up of methylmalonic acid. Deficiency of vitamin B12 or folic acid can lead to increased homocysteine levels.

Information from Stabler SP. Screening the older population for cobalamin deficiency. J Am Geriatr Soc 1995 43:1291.


Vitamin B12 deficiency leads to a serum build-up of methylmalonic acid. Deficiency of vitamin B12 or folic acid can lead to increased homocysteine levels.

Information from Stabler SP. Screening the older population for cobalamin deficiency. J Am Geriatr Soc 1995 43:1291.

There are, however, a few caveats to keep in mind. Looking at the reactions that use vitamin B12 ,3 an elevated methylmalonic acid level is clearly more specific for vitamin B12 deficiency than an elevated homocysteine level. Vitamin B12 or folic acid deficiency can cause the homocysteine level to rise, so folic acid levels also should be checked in patients with isolated hyperhomocysteinemia.

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How Long Does It Take To Recover From B12 Deficiency

Once you begin treating your vitamin B12 deficiency, it can take up to six to 12 months to fully recover.

It is also common to not experience any improvement during the first few months of treatment.

If you can, its a good idea to address whats causing the deficiency. In some cases, its possible that you will need to continue using supplementation for the rest of your life, even if your symptoms have improved.

To receive a proper B12 deficiency diagnosis, you should seek medical care as soon as symptoms arise.

How To Treat Vitamin B12 Deficiency

Signs of Vitamin B12 Deficiency and How to Fix It

There are lots of things you can do to increase your vitamin B12 levels.


Foods rich in vitamin B12 include:

  • organ meats like liver and kidney are the richest sources of vitamin B12
  • beef
  • fish like clams, sardines, salmon, and tuna
  • milk and dairy products
  • eggs

Vitamin B12 is only naturally available in meat, fish or dairy. But there are fortified plant-based sources of vitamin B12 like:

  • fortified milk alternatives

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Vitamin B-12, also called cobalamin in its natural form, is a large complex molecule used for a variety of functions in your body. It plays especially important roles in brain function, metabolism and blood production. B-12 levels in your body can drop too low due to dietary deficiency, poor absorption or lack of synthesis by friendly bacteria in your intestines. Symptoms of B-12 deficiency are broad and can mimic senility, emotional disorders and musculoskeletal injuries.

Diet Deficiency: 7 Warning Signs Of Low Vitamin D And B12

Do you persistently feel unwell? You may be suffering from low vitamin D and B12 without realizing it.

Vitamin D is essential for absorbing calcium which is essential for healthy bones. While B12 is responsible for healthy blood cells and nerve systems.

Together, these vitamins protect your immune system from autoimmune conditions like Lupus. Vitamin deficiencies can also result in painful Crohns and Celiac disease, as well.

Dont wait before its too late to do something. Look out for these critical warning signs now.

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Causes Of Vitamin B12 Deficiency

A number of things can cause vitamin B12 deficiency, these include:

  • pernicious anaemia your immune system mistakenly attacks cells in your stomach that produce intrinsic factor
  • diet plant-based diets, such as vegan, vegetarian, and dairy-free diets are sometimes lacking in vitamin B12
  • medication some medications, like proton pump inhibitors , can inhibit absorption of vitamin B12

Youre also more at risk of vitamin B12 deficiency if you:

  • are pregnant or breastfeeding
  • are over 50 years because you might stop producing enough hydrochloric acid in your stomach which is needed for absorption of vitamin B12
  • suffer from a gastrointestinal disorder like coeliac disease or Crohns disease

You should also keep in mind that folic acid supplements can mask vitamin B12 deficiency. This is because it can improve your symptoms so much that theyre not noticeable.

Can Vitamin B12 Be Absorbed In Pill Form

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Individuals with pernicious anemia cannot properly absorb vitamin B12 in the gastrointestinal tract . However, approximately 1% of oral vitamin B12 can be absorbed passively in the absence of intrinsic factor , suggesting that high oral doses of vitamin B12 might also be an effective treatment.

One may also ask, what is the best absorbed form of b12? The body may absorb cyanocobalamin better, while methylcobalamin has a higher retention rate. Both can prevent B12 deficiency, but methylcobalamin should be combined with adenosylcobalamin for best results.

Secondly, is oral b12 as effective as injections?

In both studies, high-dose oral B12 was as effective as intramuscular injection at achieving neurologic and hematologic response. Vitamin B12 is available over the counter in the form of tablets and lozenges .

How can I increase my b12 absorption?

To increase the amount of vitamin B12 in your diet, eat more of foods that contain it, such as:

  • Beef, liver, and chicken.
  • Fish and shellfish such as trout, salmon, tuna fish, and clams.
  • Fortified breakfast cereal.
  • Low-fat milk, yogurt, and cheese.
  • Eggs.
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    Who Is At Risk For Vitamin B12 Deficiency Anemia

    Risk factors for vitamin B12 deficiency anemia include:

    • A family history of the disease
    • Having part or all of your stomach or intestine removed
    • Autoimmune diseases, including type 1 diabetes
    • Crohn’s disease
    • Smooth and tender tongue
    • Fast heart rate

    The symptoms of megaloblastic anemia may look like other blood conditions or health problems. Always see your healthcare provider for a diagnosis.

    Low Vitamin D & B12 Deficiency

    Vitamins generally should be supplied by the diet, although there are some, such as vitamin D, that the body can produce naturally through sun exposure. A deficiency of vitamins may be dietary in origin or due to secondary causes, such as improper absorption. A deficiency of vitamins D or B12 can result in serious health complications, and low levels of either of these vitamins are characterized by a unique set of symptoms.

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    Why Low Vitamin B12 Levels Are Common In Older Adults

    To understand how low vitamin B12 levels happen in aging adults, its good to start by learning how the body usually obtains and processes this vitamin.

    In nature, vitamin B12 is available to humans only in meat and dairy products. However, in modern times, you can easily get it via a supplement or multivitamin. The recommended daily allowance for vitamin B12 for adults is 2.4 micrograms. Experts have estimated that a Western diet contains 5-7 micrograms of vitamin B12, and a multivitamin often contains 12-25 micrograms.

    Once you ingest vitamin B12, it is processed by acids and enzymes in the stomach and small intestine. The processed vitamin is then absorbed by the small intestine and stored in the body, especially in the liver.

    This stash can actually meet the bodys needs for a few years although vitamin B12 is essential, only a tiny bit is needed every day. So if a healthy person stops taking in vitamin B12, it often takes a few years before the body runs out of it and develops symptoms.

    So why does vitamin B12 deficiency particularly affect older adults?

    As people get older, their ability to absorb vitamin B12 decreases. This is because aging adults often develop problems with the acids and stomach enzymes needed to process the vitamin.

    Common risk factors for low vitamin B12 levels in older adults include:

    What About B12 Shots

    Symptoms Of Low Vitamin B13 []

    If you’re very deficient in B12 and need to restore your levels quickly, then a series of B12 shots can be a good option. The injection is given intra-muscularly , normally in the back of your shoulder, and bypasses your digestive system dramatically increasing absorption. It’s most often used in clients with digestive conditions impairing their capacity to absorb B12.

    Its important to note that the typical form of B12 used in doctors offices is cyanocobalamin, a cheaper and subpar form of B12. Opt for methylcobalamin form, this active form of vitamin B12 does not require conversion in the body. B12 shots are typically given in 1,000mcg doses, weekly for 4-8 weeks depending on your levels and clinical picture.

    The Bottom Line: If you’re vegan, elderly, have a chronic digestive condition or struggle with consistent low energy, then you may have low vitamin B12 status.

    Use a variety of biomarkers to assess your B12 status, focus on B12 rich foods from animal sources to correct insufficiency/deficiency and talk to your doctor or nutritionist if supplements or B12 injections are right for you to build a personalized approach.

    Dr. Marc Bubbs ND, MSc, CISSN, CSCS

    > > Want more support to upgrade your nutrition to look, feel and perform better? Join the PRE-SALE list for our next PEAK40 Nutrition Coaching Program

    > > Listen to Dr. Ben Lynch talk about genetic SNiPs, folate and B12 in this clip…

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    What Are The Causes Of Low Vitamin B12 Or Vitamin B12 Deficiency

    Deficiency of Vitamin B12 occurs in certain conditions which include:

    • Pernicious anemia in which the body is unable to absorb vitamin B12 leading to its low levels.
    • Atrophic gastritis where there is thinning of the stomach lining.
    • Conditions that affect the small intestine, such as celiac disease, Crohns disease, parasite or a bacterial growth.
    • Surgery where a part of the small intestine or stomach has been removed, such as weight loss surgery.
    • Immune system disorders, such as lupus or Graves disease.
    • Heavy alcohol consumption.
    • Prolonged use of acid-reducing drugs, as stomach acids help in breaking down of the animal proteins which have vitamin B12.
    • Vegans or vegetarians can also get vitamin B12 deficiency as they do not consume animal products such as meat, cheese, milk and eggs.
    • Pregnant mothers who are vegetarians need to take vitamin B12 supplements or consume vitamin B12-fortified grains to ensure that their babies will be getting sufficient vitamin B12.
    • As a person ages, the risk of vitamin B12 deficiency also increases.


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