Vitamin B12, also known as cobalamin, is an essential nutrient that is a member of the B-complex vitamins. B12 is the largest and most structurally complex of all known vitamins. There are several forms of vitamin B12, all of which are termed “cobalamins” because they contain the trace mineral cobalt in their nucleus structure. Some forms of B12 are not immediately bioavailable and your body must use enzymes to convert them to a usable form. However, methylcobalamin and hydroxocobalamin (5-deoxyadenosylcobalamin) forms are highly bioavailable.
Where Can You Get Vitamin B12?
Your body doesn’t make vitamin B12, you need to get it through your diet or by supplementation. It’s found mostly in foods of animal origin such as meat, fish, and eggs. Even though only bacteria and archaea can synthesize B12, animals integrate B12 into their tissues via bacterial symbiosis, which is why animal foods are naturally the richest source of B12. Fortified foods and supplements are also common sources of the nutrient.
Why You Need Vitamin B12
Vitamin B12 plays an important role in a number of ways. The body functions that rely on adequate B12 include:
Brain and nervous system health via myelin sheath function
DNA synthesis
Red blood cell formation
Healthy cell metabolism (of nearly every cell in your body)
Cardiovascular health
Individuals with the MTHFR gene mutation may be at a higher risk for elevated homocysteine levels. When homocysteine levels are higher than normal, osteoporosis, blood clots, and atherosclerosis are common symptoms. Dietary intervention via vitamin B12 supplementation (as well as folate and B6) is necessary for bringing homocysteine levels back into balance. [1]
How Much Vitamin B12 Do You Need?
The Institute of Medicine and Food and Nutrition Board — the premiere scientific health bodies officially sanctioned by the U.S. government on matters of nutrient intake — set daily recommendations of vitamin B12 for normal adults at 2.4 mcg/day, with up to 3 mcg/day for pregnant and lactating women. [2]
Keep in mind these numbers are absolute minimums. Research suggests that average vitamin B12 intake among the U.S. population is ~3.4 mcg/day, clearly above the adequate recommended daily intake. [3] Regardless, due to digestion and absorption issues, disease status, and prescription medication interference, some data suggests a sizable number of the population is B12 deficient.
The typical human body can absorb up to 1.5 mcg of vitamin B12 from food, but supplementation has been shown to allow for higher absorption rates by bypassing the digestive process. Although some will tell you that humans store between 2 to 5 mg of vitamin B12 (mostly in the liver), which can last up to five years in the absence of daily intake, I wouldn’t advise taking that chance. [4]
Are You Vitamin B12 Sufficient or Deficient?
Despite a healthy and balanced diet, physiological (genetics, disease) and environmental (medications for diabetes, etc.) factors can interfere with normal B12 absorption for many people, leading to depletion or outright deficiency.
Blood level testing is the surest diagnostic method to assess if you are B12 deficient. Here is a general guideline to follow to determine whether or not you are vitamin B12 deficient:
180-914 ng/L – Normal high/low range
450+ ng/L – Healthy/Optimal
180-400 ng/L – Conditionally low levels
150-180 ng/L – Low levels where disease symptoms start
Depending on test results and potential concurrent symptoms, other simple follow-up blood tests which indirectly test for B12 status may be suggested, including homocysteine and methylmalonic acid/MMA (levels of these molecules rise when vitamin B12 deficiency-symptoms unfold, testing of which often allows for a more thorough assessment, in conjunction with B12 testing).
Symptoms of Vitamin B12 Deficiency
Below are just some of the overt symptoms of low levels and deficiency of this crucial vitamin.
- Pernicious anemia
- Neurological impairments such as depression, confusion, disorientation, schizophrenia, ADHD
- Memory loss, Alzheimer’s/dementia, Parkinson’s, brain fog, cognitive decline, brain shrinkage
- Peripheral neuropathy
- Bowel/urinary tract incontinence
- Paresthesia (tingling in the limbs)
- Fatigue
- Loss of balance
- Fatigue
- Alzheimer’s, dementia, cognitive decline and memory loss
- Multiple sclerosis (MS) and other neurological disorders
- Mental illness (depression, anxiety, bipolar disorder, psychosis)
- Cardiovascular disease
- Learning or developmental disorders in kids
- Autism spectrum disorder
- Autoimmune disease and immune suppression
- Cancer
- Male and female infertility
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