Best Tests for and Sources of Vitamin B12

Best Tests For and Sources of Vitamin B12

This post is a follow-up to my last post, Surprising Facts You Need to Know About B12. Please refer to it if you want basic information about what B12 is responsible for in the body, what can cause a B12 deficiency, and what symptoms a B12 deficiency may create.If you want to use a supplement to increase your B12 levels, you have a variety of options. The best news is that Vitamin B12 is water-soluble, so you don’t need to worry about getting too much, although there’s obviously benefit from taking more than your body needs. Because it’s water-soluble, if you take more than your body needs, your body will easily flush the excess out in your urine. So, in other words, if you take more than you need, you will literally wind up flushing good money down the toilet.
So how much do you need? If you do not have absorption issues, do not drink alcohol, and are not taking any prescription medications that deplete the body of Vitamin B12, you probably don’t need more than 500-1000 mcg of B12 per day. (See my prior post for info on which lifestyle habits and prescription medications can cause a B12 deficiency.) Having said that, let me also say that many people feel better taking much higher levels. Since everyone has very specific, individualized needs, it is impossible to share a black and white number of what everyone needs. The RDA set a level that is deficient for most people, so let’s just say that taking 500-1000 mcg/day is sufficient to prevent complications for most people, but that some people need much more and that most people feel better taking higher amounts. 
Let me also say that Vitamin B12 is not a miracle cure. I often speak to people who expect a B12 supplement to “cure” every physical issue they have. B12 will only help health issues if you have a deficiency. If you do not, B12 supplementation may help you feel a little bit better, but if won’t address the issues you have. A prime example of this is people who are exhausted due to low thyroid function. Taking a B12 supplement may help address some of the secondary effects of hypothyroidism and may mildly increase energy levels, but will NOT address the true cause of the fatigue. Please work with a practitioner to identify the specific causes of your health issues before adding supplements willy-nilly. 

Vitamin B12 Tests

So how can you know for sure you are deficient and need a B12 supplement? Any of the following methods work well:

  1. B12 Blood Test: This is a simple, inexpensive blood test that checks serum levels of B12. It is accurate and insurance almost always pays for it. If you need to have blood work done anyway, ask your doctor to add this test and to repeat it on a yearly basis. If you have any digestive disorder, are taking prescription medications, drink alcohol more than three times per week, or have a thyroid disorder, I recommend having this test a minimum of every six months.The B12 blood test will be the most accurate if done while fasting at least 10-12 hours. Note that drinking alcohol or taking Vitamin C prior to the test can affect the results. Most labs list “Normal” levels as anything between 200-800 pg/ml. However, most people are symptomatic of a B12 deficiency when their levels fall below 400. I like to see levels of at least 500 and tend to recommend a supplement if levels are any lower.
  2. Anti-parietal Antibodies: The parietal cells in the digestive tract produce a chemical called Intrinsic Factor that is necessary for the absorption of Vitamin B12. If someone has an autoimmune condition that causes an inability to absorb B12 (Pernicious Anemia), then the person’s body will typically produce antibodies that attack and kill the parietal cells. The Antiparietal Antibody blood test is a very accurate indicator that a person may not be able to absorb B12 due to an autoimmune condition. If you have consistently low B12 levels, I recommend asking your doctor to order this test.
  3. Folic Acid test: Many people who have low B12 levels also have low Folic Acid levels. Folic Acid is another B vitamin that may produce symptoms similar to a B12 deficiency if levels are low. It is another blood test that is very inexpensive and which insurance typically pays for without question.
  4. Homocysteine and Methylmalonic Acid: Homocysteine and Methylmalonic Acid are chemicals that may become elevated in the presence of a B12 deficiency. Neither is a definitive indicator of a B12 deficiency, but it may be helpful to have these blood tests run on a yearly basis if you’ve had low B12 levels in the past.
  5. Complete Blood Count (CBC): A CBC can be helpful to identify anemia caused by a B12 deficiency and as a general check of blood health. A B12 deficiency can cause a deficiency in red blood cells and may create red blood cells that are overly large (megaloblastic anemia). A CBC is not an indicator of a B12 deficiency, but may be helpful in recognizing a B12 deficiency and may help identify other issues. If you’re having blood work done anyway, this is another test I recommend having run.
  6. Electro-Dermal Scanning: This is an assessment technique that uses a system consisting of testing stylus connected to a measuring unit that measures nerve flow through specific energy centers and acupuncture points on the body. It is a very accurate, highly reliable test method that provides valuable insight into nutritional deficiencies and systemic weaknesses. This test method is used by many mainstream MDs and is recognized as valid by the FDA.
  7. Kinesiology and Muscle Response Testing: This is another form of assessment that measures nerve flow through specific points to assess nutritional deficiencies and systemic weaknesses. The B12 point is very valuable and very accurate.

Most of these tests can be ordered through online services without a doctor’s prescription. Please use caution when ordering your own blood work. Interpreting abnormal results is best done by a professional, but knowing your blood level of certain vitamins can be helpful. 

Supplement Forms

Vitamin B12 is available in the following forms. One thing to be aware of is that B12 can be difficult to absorb through the digestive tract unless it is in the natural form found in foods. If you have a B12 deficiency, I recommend taking B12 in a sublingual (under the tongue) form or asking your doctor to prescribe B12 injections. Note that B12 is typically listed in microgram doses (mcg), but that higher dosages may be listed in milligrams (mg). There are 1000 micrograms in a milligram, so a 5 mg dose is the same as a 5000 mcg dose. The most typical forms of supplemental B12 include:

  • Methylcobalamin B12: This is the form I recommend taking. This form is known to be the most absorbable and has a variety of benefits over other forms. It is best taken sublingually in a tiny lozenge that is placed under the tongue and allowed to melt. This form of B12 is more easily absorbed because your body does not have to convert it and can much more easily metabolize it to absorb it. The Methylcobalamin form of B12 also provides methyl groups (one carbon combined with three hydrogen) which are essential for the detoxification of certain hormones and toxins in the body. A B12 deficiency typically causes a decrease in methylation in the body, which can cause a wide variety of other issues. Taking Vitamin B12 in the Methylcobalamin form helps replenish Vitamin B12 AND provides the methyl groups necessary for methylation … it’s a win-win!Sublingual B12 lozenges come in a wide variety of strengths ranging from 500 mcg – 10,000 mcg. Most people get the best results taking 1000-2000mcg/day, although people with Pernicious Anemia or neuropathy often take much higher doses. When shopping for a sublingual B12 supplement, try to find one that is fairly tiny and which does not contain a lot of fillers, artificial flavors and sugars. My favorite OTC options include: Natural Factors Methylcobalamin (1000 mcg)Solgar Methylcobalamin B12 (5000mcg)No-Shot Methylcobalamin B12 (10,000mcg). (Most people probably don’t need 10,000mcg on a daily basis, but those with neuropathy, a severe B12 deficiency or severe absorption issues may benefit from using a dosage this high.)Methycobalamin B12 is also available as an injection. If you take B12 by injection, be aware that it must be injected into a muscle (intramuscularly) and cannot be injected into fat tissue under the skin (subcutaneously). The advantage of taking B12 by injection is that higher doses can be taken and that the injections only need to be taken once per week in most cases. (Some people with severe deficiencies or with Pernicious Anemia may need to take the injections daily or multiple times per week, but most people only need the injections once per week.) You can either receive B12 injections in your doctor’s office or can ask for a prescription for B12 injections you can give yourself at home. Work with your doctor to monitor your B12 levels to determine which option is best for you. Another advantage of the B12 injections is that they don’t contain the fillers that many sublingual lozenges do. The injections may therefore be a better option for anyone with chemical sensitivities or extreme food allergies.On a personal note, my husband has used high doses of sublingual methylcobalamin Vitamin B12 for several years to control neuropathy in his feet. He found that switching to weekly B12 injections was far more effective than the sublingual lozenges.
  • Cyanocobalamin B12: This is the cheapest, most commonly found form of B12 in supplements. It is a synthetic form and was the first one created in a laboratory Your body must convert the cyanocobalamin form of B12 into methylcobalamin before it can absorb it. The conversion process creates cyanide, which is a known poison. The amount of cyanide created is very tiny and is not dangerous, but why take the risk? I only use the methylcobalamin form and it is the only form I recommend to my patients and clients. The cyanocobalamin form is only acceptable, in my opinion, if and only if the methylcobalamin form is not available.
  • Other Forms: There are a few other forms of Vitamin B12 available, such as Hydroxocobalamin, but the other forms are disappearing from use because there is more commercial demand for the cyanocobalamin and methylcobalamin forms.

My passion is helping people improve their health by identifying and correcting systemic imbalances. I have helped thousands of people eliminate their health challenges using a holistic approach If you are ready to improve your health, please feel free to contact me to schedule a consultation.

As always, these statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure or prevent any health condition. Please check with your practitioner before adding any supplement to your daily care regimen and never stop taking prescription medications without consulting with your physician.

The following two tabs change content below.
Dr. Pamela Reilly is a Naturopathic Physician dedicated to helping people improve their health and eliminate symptoms using natural, integrative methods. She has over 25 years of experience and has helped men, women and children improve their health using a holistic, client-centered focus. She sees clients in Indianapolis, does house calls, and also conducts consultations via Skype or telephone. Please feel free to contact her or visit her Consultations page for more information. Dr. Pamela speaks nationwide on a wide variety of health topics and welcomes speaking invitations.

Latest posts by Dr. Pamela Reilly (see all)

7 Responses to Best Tests for and Sources of Vitamin B12

  1. Viola Register says:

    Hi, I noticed my arm and leg muscles becoming weak and tingly a few months back but didn’t think much about it. I broke my foot on 6/5 and did not have an appetite after that. I ate mostly ramen and sandwiches. Then on 7/5 I was diagnosed with a pulmonary embolism and my life has been turned upside down. In the hospital they gave me xanax, so the doctor has me in that and lexapro. I don’t remember ever being depressed before my hospital stay, so now since I’m definitely not eating right and taking warfarin I have weakness in my arms, sleep disturbances, very bad anxiety and hypertension, racing heart and you name it. I’ve been reading a lot on B12 deficiency and these articles really help, but I’m afraid when I mention this to my doctor he will shrug it off. Since I’m on warfarin can I take the sublingual B12 and how much? Please help!!!!!

    • Hi, Viola. I’m so sorry to hear about your health challenges. I apologize that liability issues make it impossible for me to provide recommendations to anyone who is not a client. If you’d like to schedule a consultation, please feel free to contact me. There is no reason you cannot take Vitamin B12, so I encourage you to discuss it with your physicians. Thanks much. I wish you the very best!

  2. fresh…

    Best Tests for and Sources of Vitamin B12 – Good Works Wellness…

  3. James says:

    What do you think of the NOW brand Methyl B12 and is it as good as the other brands you mentioned or not? I like taking Now methyl B12 because it is made for vegans, which brand would you recommend for vegans?

    • GWWR says:

      Hi, James. I think the NOW brand is great. Use whichever brand is best for you. I merely shared a few examples. Thanks!

  4. […] Vitamin B12 Injections for Weight Loss – HealthmangoVitamin B12 Injections for Weight Loss – Buy Vitamin Injections15 or 25 Vitamin B12 Injections at Physicians Weight Loss Centers (74% Off)Best Tests for and Sources of Vitamin B12 […]

  5. […] to brain and nerve cells that is very difficult to reverse.You can read more about Vitamin B12 in Tests for and Sources of Vitamin B12. B12 deficiencies are a personal passion of mine because I have an autoimmune condition […]

Leave a Reply

Your email address will not be published. Required fields are marked *