Many people take many vitamins. There is a lot of “news” coming out suggesting that this type of self-treatment is, at best, a waste of time and money and, at worst detrimental. I strongly suspect that a lot of that “news” is part of the campaign of recent years to turn vitamins from OTC self-care products to a new prescription revenue stream, but I will leave that out of this post.

Here, I want to share critical information about vitamin B-12 ( the common name for Cobalmin), which is an essential vitamin – meaning you can’t make it yourself and so you need to get it in your food. This vitamin is a cofactor that is vital to the energy production system in your body (i.e. the “oxygen cycle”, aka the “Kreb’s cycle”). I just want to touch on a few important things…
1. B-12 has chiefly come from animal products in our diets but ultimately originates in the soil. The animals are just middlemen in the acquisition process as they consume B-12 as they graze.
2. Vegans don’t eat animal products and so they MUST supplement with B-12. But even non-vegans are increasingly low on B-12 due to commercial grain feeding techniques employed in industrial ranching that bypasses the livestock consumption of the dirt that normally comes up with the grasses. So even our animal food sources are not dependably sufficient in B-12 and many Americans are deficient and completely unaware.
3. There are many many constituents of our saliva, and one, enzyme, Salivary Hc protects the B-12 until it is bound by another protein in the stomach. This is an example of saliva’s role in the nutritional absorption process that may be bypassed with simply popping a vitamin capsule. The only significance here is to know that you may need to take more than the minimum to sufficiently raise your blood levels of a supplemented nutrient.
4. Most healthy young people readily absorb enough B-12 when it is present in their diet. However as we age, many people’s digestive health declines and absorption efficiency drops, so it is worthwhile for your doctor to do a B-12 level lab test as part of an occasional check up.
5. Another important part of the B-12 absorption process relies on “stomach acid”. Specifically, there is a protein produced in the lining of your stomach that is critically necessary for B-12 absorption. It is called Intrinsic Factor (IF). Some people have a genetic mutation that prevents the production of IF. I think it is pretty safe to say, for most people, you would know if you have that mutation. The point I do want to make here, though, is that if you have chronic reflux or take a lot of OTC or prescription meds (especially for “stomach acid”), you can be pretty comfortable that the lining of your stomach is not particularly healthy, or at least it cannot be depended on to stay that way. You might even have an overgrowth of H. pylori which needs to be addressed and shouldn’t be ignored. A change in your diet is VERY important for your continued health. And it is also something you should be discussing with your doctor.
6. In general, it seems everyone is marketing some whiz-bang supplement for this or that condition. This is just an extension of the reductionist healthcare model that tries to “isolate the good stuff so we can market it” approach to self-enrichment. In the realm of Vitamin B-12, you might see products like “Methyl B-12”, or “Adenosyl B-12” being marketed as more absorbable or “better”. Understand this: the best supplement is the one that you actually need and meets your need (i.e. it is easiest to acquire, costs the least, addresses your nutritional deficiency and that you will actually take).
7. Lastly, what you typically see in B-12 fortified foods and in multivitamins is the ingredient cyanocobalmin. I want to be clear, most people will be able to easily metabolize cyanocobalmin into methylcobalmin or adenosylcobalmin. This is the normal metabolic process. So most people will do JUST FINE taking cyanocobalmin as their nutritional source of vitamin B-12. And cyanocobalmin is inherently a more stable form of the nutrient. The other forms are more “reactive”. And you will no doubt hear that as a marketing point wherein it is described as “activated” B-12 or some other term like that. If you ensure that you are taking adequate cyanocobalmin and THEN you still test low on subsequent lab testing for B-12, THAT is when you need to look to other forms (methyl-, adenosyl-, liquid, sublingual, injectable, etc., etc.). This is another discussion you would have with your doctor.
Enough for now.
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