We know about B12, but how much do we need to pursue it?
How do you know if you are suffering from vitamin B deficiency?
Low blood count or anaemia
My blood tests are normal...
Normal is not normal. Anything below 300ng/ml is low.
Not deficient does not mean you do not need more, due to metabolic conditions that may mean you require a higher than normal maintainence dose. This requires a thorough history and clinical exam, with an integrative medicine trained practitioner.
The ultimate blood test for B12
Methylmalonic acid (MMA) is produced in small amounts in the body, where it is converted into succinyl Coenzyme A. When there is not enough vitamin B12, there would be a relatively higher concentration of MMA in blood and urine.
This test is more expensive and I usually reserve this for those who are not responding to regular supplementation, or have high serum B12 levels in the presence of low B12 symptoms.
Am I at risk of vitamin B deficiency?
Vegetarians and vegans are susceptible to it as vitamin B12 is mostly derived from animal products.
Regular consumption of alcohol depletes serum B12 levels
Previous gastric bypass, and reduced ability to absorb B12 from the gut
Autoimmune diseases like Crohn's or celiac prevents body from absorbing B12 effectively
Metformin which is used in the management of Diabetes, intereferes with B12 absorption and diabetics will benefit from B12 supplementation
Older adults, as ability to absorb B12 decreases with age
What treatments are available for me?
If your vitamin B deficiency is due to a low b12 diet, simply include foods with a high content of vitamin B12, such as meats, fish, dairy products and egg.
If you are vegetarian or adopt a vegan diet, yeast extract and soy products serve as alternatives to meat and dairy products.
When you want to supplement, I find sublingual, sprays and liquid forms of Bs give the best outcomes.
Always ensure you target both folate and B12 at the same time as it is no good to be high in one and low in the other.
Occasionally, you may need injections to replenish the low levels of vitamin B12 in your body.
While injecting vitamin B12 into your body is generally safe and is proven to be effective, as long as practiced by a doctor who is aware and able to help you avoid unwanted long term effects.
As we all lead different lifestyles and have different eating habits, each of us have different dosage needs, hence it is best to seek a doctor on how to deal with vitamin B12 deficiency.
Which form of B12?
AdenosylB12 is great for mitochondria and nerve cells
MethylB12 for DNA synthesis and methylation
HydroxyB12 is absorbed well
CyanocoB12 is the cheapest most available form, but absorption is the poorest compared to all of the above.
Each individual may have a different issue, so it's best to consult a trained integrative doctor to help you choose the best form for you.
Book now for a consult!