Category Archives: Vitamin B12

Facts About Iron-Deficiency Anemia

Red Blood CellsIron-Deficiency Anemia is a very common health issue. Many women have been told at some point in their life they have Iron-Deficiency Anemia and that it is “chronic.” Unfortunately, the term “chronic” typically means the diagnosing doctor has chosen to not identify the cause of the condition. The doctor assumes the woman’s anemia is “normal” for her and therefore can only be controlled, not treated. I beg to differ.

Iron-Deficiency Anemia always has a cause or causes. It is never a “normal” state of being. Never. Let me clarify that I am speaking about Iron-Deficiency Anemia, the type of anemia that occurs when the body’s iron stores are below normal. Please note I am solely referring to Iron-Deficiency Anemia, not Sickle Cell Anemia, Thalassemia, Pernicious Anemia, Aplastic Anemia or any other form of anemia. Although the symptoms of the various types of anemia may be similar, they each have very distinct causes and cannot be addressed using the same approach. Please note that all references in this article are for adults, not children.

Common Symptoms

Iron-Deficiency Anemia results in a deficiency of red blood cells and diminishes the body’s ability to carry oxygen to the cells and carbon dioxide away from cells. The most common symptoms of Iron-Deficiency Anemia include:

  • Fatigue
  • Easy bruising
  • Headaches
  • Cold hands and feet
  • Elevated heart rate/heart palpitations/chest pain (Seek immediate medical attention for any form of chest pain)
  • Breathlessness
  • Dizziness
  • Swollen tongue/sore tongue/cracks in corners of mouth
  • Muscle pain
  • Pale skin
  • Depression and/or a lack of motivation
  • Brittle nails
  • Frequent infection/illness
  • Irritability/inability to concentrate
  • Bluish coloration to whites of eyes
  • Cravings for unusual items (chalk, clay, paper, etc.) or a strong desire to chew ice

Each of those symptoms could also be a sign of other health conditions, some more serious than others. Please consult a trained practitioner if you experience any of the symptoms listed above.

Possible Tests for Iron-Deficiency Anemia

Iron-Deficiency Anemia is typically identified via blood tests. When checking for Iron-Deficiency Anemia, the following tests should be run at a minimum. Please note that each lab has its own definition of what “normal” ranges are. The ranges provided below are general guidelines:

  • Complete Blood Count (CBC):  An overview of blood composition.
  • Hemoglobin:  A protein in red blood cells that carries oxygen throughout the body. Normal range for men is between 13.5-17.5; for women 12.0-15.5. Please note that results which are within “normal” but are at the low end may still cause symptoms of Iron-Deficiency Anemia.
  • Iron:  A measure of the iron in the blood stream. Normal ranges between 60-170 mcg/dL.
  • Ferritin:  A protein that stores iron. Is a measure of the body’s iron stores. Although some labs state that levels as low as 10 are “normal,” most people do not begin to feel anything close to normal until their Ferritin levels are at least 40. Please note that levels as low as zero are not a definite indicator of cancer or other serious disease. Extremely low levels need to be researched in more detail to determine the cause, but are not necessarily an indicator of a terminal condition. I once had Ferritin levels of zero which my doctor erroneously assumed meant I had cancer. After having a bone marrow biopsy, the consulting hematologist looked at me and asked why on earth the doctor ordered a bone marrow biopsy instead of investigating the cause and type of anemia first. Good question!
  • Vitamin B12:  Vitamin B12 is essential for iron to be absorbed. A deficiency can lead to Iron-Deficiency Anemia. Normal ranges vary between 200-900 pg/mL.
  • Total iron-binding capacity (TIBC):  A measure of the number of proteins available for transporting iron. Normal ranges are typically between 240-450 mcg/dL.
  • Transferrin Saturation:  A measure of how saturated with iron the proteins responsible for transporting iron are. Normal ranges are between 20-50%.

Potential Causes of Iron-Deficiency Anemia

Your doctor may order other tests if s/he wishes to identify the specific cause of the Iron-Deficiency Anemia. Potential causes of low iron levels and Iron-Deficiency Anemia may include:

Iron Deficiency Anemia Red Blood Cells

Red blood cells in a person with Iron-Deficiency Anemia

  • Lack of iron in the diet
  • Inability to absorb iron in the digestive tract
  • Unidentified bleeding (in oral cavity, lungs, stomach, digestive tract, etc.)
  • Other forms of anemia not yet tested for or identified
  • Pregnancy and lactation
  • Extremely heavy menstruation
  • Frequent blood donation
  • Excessive exercise (Iron-Deficiency Anemia is common in long-distance runners)
  • Celiac, Inflammatory Bowel Disease, Crohn’s or other digestive disorders
  • H Pylori infection (stomach ulcer)
  • Use of a proton pump inhibitor such as Prilosec, Nexxium, etc.
  • Kidney disease
  • Gastric bypass surgery/colostomy
  • Thyroid imbalances or other hormonal imbalance
  • Enlarged spleen or splenic dysfunction
  • Lead poisoning

Further Testing to Identify the Cause of Chronic Iron-Deficiency Anemia

Consistent Iron-Deficiency Anemia can be caused by any of the factors discussed previously, but may also be an indicator of more severe health issues. I advise considering the following to identify the root cause of Iron-Deficiency Anemia:

  • Check antiparietal antibody levels to ensure Pernicious Anemia is not the cause of the anemia
  • Test for other forms of anemia if symptoms and blood work indicate a possibility
  • Test for digestive disorders
  • Test for vitamin and nutritional deficiencies and supplement as needed
  • Test for food allergies (the inflammation caused by food allergies can impair iron absorption)
  • Check for bleeding in the digestive tract and digestive disorders
  • Check for bleeding in the respiratory system
  • Test thyroid levels (with a complete thyroid panel including TSH, Free T3, Free T4, TPO and Reverse T3 at a minimum)
  • Test hormone levels and have a gynecological exam if extremely heavy menstruation is suspected as the cause
  • Test for pregnancy (if appropriate)

Reversing the Deficiency

Many factors may contribute to Iron-Deficiency Anemia, so work with your doctor to determine what approach should be taken to reverse the deficiency. The most common approaches used to reverse the deficiency include:

  • Identify and Address the Cause:  Although it is imperative to get iron levels up using supplements or other approaches, it is also essential to identify why the iron deficiency exists and address the cause. If the cause can be identified and eliminated or greatly alleviated, the body can more easily restore iron levels to normal levels. If testing reveals a more severe form of anemia exists, additional steps will be needed. I will share more about the other forms of anemia in future posts.
  • Increase Iron Consumption:  Increasing the amount of iron eaten on a daily basis can be helpful, but may not be sufficient in cases of absorption and digestion challenges. Please be aware that the iron contained in plants is called “non-heme” iron. It is not as easily absorbed as the heme iron in animal products. The body must convert non-heme iron into heme iron before it can absorb it. The best way to assist the body in making converting non-heme iron into heme iron is to eat fruits or veggies high in Vitamin C with foods containing non-heme iron. (Eating foods high in Vitamin C will assist with the absorption of iron in animal products, too, but is especially important for vegetable sources of iron.) This is one reason why spinach salads often contain oranges. The food that is highest in iron content is liver. Other foods high in iron include red meat, chicken and turkey, quinoa, organ meats, raisins, dark leafy greens, egg yolks, prunes, molasses, beans and lentils, salmon, nuts and seeds, dark chocolate (at least 80%), broccoli and others. I am not a fan of “iron fortified” milk and cereals because the iron those foods contain is in a form that is very difficult to absorb.
  • Use Iron Supplementation:  Iron pills or supplements should never be taken if testing has not proven you are deficient in iron. Excess iron in the bloodstream can have negative affects which are as bad or worse as an iron deficiency. Please also be aware the forms of iron most commonly sold in drug stores are difficult to absorb and often cause constipation. Ferrous sulfate is the most commonly sold form of iron, but is very poorly absorbed and often causes constipation. It is not a form I recommend. My preferred forms of supplemental iron include iron citrate, iron gluconate, iron bisglycinate and/or chelated iron. Iron is best absorbed when it is taken on an empty stomach. My favorite iron supplements are Hematinic Formula and Vitamin Code Raw Iron.
  • Severe cases of Iron-Deficiency Anemia may require blood transfusions or intravenous iron. Those approaches are usually not needed unless other health issues are present.

In conclusion, I’d like to say that Iron-Deficiency Anemia can usually be quickly addressed and reversed. More difficult cases may require further testing and additional therapies, but quality of life can usually be restored fairly quickly.

Red Blood Cell Photograph courtesy of Wellcome Images
Anemia Blood Cell Photograph Courtesy of Alpha Images



Ten Tips for Avoiding Hangovers

I want to take this opportunity to wish you a joyous night of celebration and a very Happy New Year. Please celebrate with caution and be careful! This post is dedicated to ways to avoid hangovers.

I don’t condone excess drinking, but we all know that New Year’s Eve is typically a night filled with alcohol.Beer Bottles Why does excess alcohol cause a hangover? For the following reasons:

  • Alcohol causes dehydration, which leads to inflammation and feeling generally horrible.
  • Alcohol contains two highly toxic compounds: acetaldehyde and malondialdehyde. These two chemicals create massive cell damage throughout the body. The damage caused by these chemicals is so severe it resembles the damage caused by radiation. There’s a good reason you feel so bad! 
  • Alcohol lowers blood sugar and can cause hypoglycemia. Typical symptoms of hypoglycemia include weakness, dizziness, nausea, and more. Sound familiar? If you ever notice someone acting far drunker than their consumption warrants, chances are they have a low blood sugar. Get them something to eat! 

If needed, use the following ten tips for avoiding hangovers:

1) Don’t drink. (This is the only certain way to avoid hangovers. You know it.) Please don’t waste your money on products claiming to be a hangover “cure.” There is no such thing. The only way to avoid hangovers is to not drink, or to drink very small amounts of alcohol.

2) Alternate every alcoholic drink with a big glass of water or other beverage. Dehydration is one cause of hangovers, so drinking a non-alcoholic beverage between each alcoholic beverage will help limit your intake and will help keep you hydrated. Staying hydrated is key to avoiding hangovers.

3) Add trace minerals to every drink. In addition to replacing essential electrolytes, trace minerals help counteract alcohol’s acidic effects. My favorite trace mineral is I like this one: Premier Polar Mins, but drinking coconut water is also an excellent way to replace trace minerals. It makes a good mixer, so it’s a win-win.

4) Don’t mix different types of alcohol. Stick to one type. Mixing beer and wine and distilled liquors puts a heavy load on your body’s ability to metabolize both the alcohol and the other ingredients in the drinks. There’s no guarantee that only drinking one kind of alcohol will avoid a hangover, but it may diminish the symptoms.

5) Drink lighter colored forms of alcohol. Darker alcohols (bourbon, dark rum, etc.) contain higher amounts of congeners, the toxins in alcohol which cause hangovers. Cheap booze also has higher amounts of congeners, so splurging on name brands which are more expensive may reduce hangover symptoms.

6) Avoid bubbly mixers. The gases in bubbly mixers can cause alcohol to enter the bloodstream more rapidly and may make it more difficult for the body to eliminate the toxins in the alcohol. Instead of carbonated mixers, use coconut water (loaded with electrolytes), fruit juice, water, etc.

7) Eat before you start drinking. Eating slows the absorption of alcohol and helps your body eliminate alcohol’s toxins. Eating a meal high in healthy fats is known to reduce hangover symptoms.

8) Order drinks on the rocks. The ice will melt and dilute the alcohol and will help keep you hydrated.

9) Ask for a larger glass. Ask your server to put your drink in a 16-ounce glass and fill the empty space with water.

10) Use supplements. Yes, supplements can reduce the effects of a hangover. Many hard core alcoholics know that taking Lecithin and Milk Thistle before, during and after drinking can help reduce hangover symptoms. The added bonus is that these also help repair the liver, so there is some value in using them.

Alcohol depletes the body of B Vitamins, Magnesium, Potassium and other essential nutrients, so taking a multi-vitamin before you drink and a B Complex vitamin can help. Taking potent antioxidants can also help prevent the damage done by alcohol’s damaging chemicals. Taking all of the previously mentioned supplements as soon as you wake up may also help.

Related Articles:

Surprising Facts About Vitamin B12

Why You Need More Magnesium

Unusual Ways to Keep the Holidays Healthy

My Holiday Prayer for You

Common Nutritional Deficiencies Caused by Medications

Prescription Bottle

Many people do not realize the prescription they are taking to address one health issue is depleting nutrients that may cause other health problems. Unfortunately, few patients are told about nutritional deficiencies that can be caused by prescriptions. This results in health issues developing which may be a mystery but which can typically be reversed very quickly simply by replenishing the nutrient that was depleted by the prescription medication. In a strange twist of fate, many of the prescription medications I listed below deplete the body of a nutrient that is essential for preventing or controlling the very condition the prescription is used to remedy. Unfortunately, many doctors are not aware of the nutritional deficiencies caused by the medications they prescribe. As a patient, it is imperative to look up each prescription medication you take to see if you should be supplementing to replace what it is depleting. In my office, I review each client’s prescriptions medications to ensure they are taking measures to prevent a potential deficiency.

The table that follows provides a list of just a few of the most common prescriptions that can cause a nutritional deficiency. I’ve provided information about the prescription medication, the nutrient(s) it is known to deplete in the body, and information on which supplement might be used to help counteract or prevent deficiencies. I’ve shown one possible supplement per deficiency, but many options exist. I’ve merely shown the one I like or use personally. Please note this is a very tiny list and is not complete. If you’d like to pick up a book providing excellent, detailed information on deficiencies caused by prescriptions, I highly recommend Suzy Cohen’s Drug Muggers: Which Medications are Robbing Your Body of Essential Nutrients and Natural Ways to Restore Them.

Please also note this table does not list interactions which may occur between foods or supplements taken with prescriptions. Please consult your MD, read the information that comes with your prescriptions, and research to determine which supplements and foods should never be taken with your prescription medications.

NOTE: This information is being shared for educational purposes only. If this information concerns you, please discuss it with your MD before making any changes to your care plan. Please DO NOT begin taking any supplements without checking with your MD. Additionally, never stop taking a prescription medication or alter the dosage without the express consent of your MD or other healthcare practitioner. None of these statements were reviewed by the FDA and none are intended to diagnose, treat, cure or prevent any medical condition.

Nutritional Deficiencies Caused by Prescription Medications

Medication Deficiency Caused Potential Source of Replenishment
  • Statin Drugs
  • Anti-Diabetics (Micronase, Glynase, DiaBeta, Dymelor,  Glipizide/Glucotrol, Metformin/Glucophage, Tolinase)
  • Pamelor and other Tricyclic Antidepressants
  • Beta-Blockers Used for High Blood Pressure (Lopressor, Toprol, Inderal, Coreg, etc.)
Co-Enzyme Q10 (CoQ10) Co-Enzyme Q10 is essential for heart health, so it is concerning that statin and drugs used to treat type 2 diabetes cause a severe depletion in this nutrient. Some studies indicate congestive heart failure’s base cause is a deficiency in CoQ10. If you take a statin drug of any of the antidiabetics listed, I strongly encourage you to take a Ubiquinol Supplement on a daily basis. I recommend taking .5-1mg per pound of body weight. Your body must convert CoQ10 into Ubiquinol in order to absorb it, so it is much more efficient to simply take the Ubiquinol.
  • Metformin
  • Most Antibiotics (Azithromyzin/Z-Pack, Amoxicillin, Penicllin*)
  • Most heartburn and GERD medications (Cimetidine, Omprazole, etc.)
  • Colchicine and other anti-gout medications

*Almost all antibiotics deplete Vitamin B12. A complete list would not fit in this table.

Vitamin B12 There are many differing opinions about how much Vitamin B12 a person should take to replenish a deficiency caused by a prescription medication. Luckily, Vitamin B12 is water-soluble, so it is very difficult to develop an excess without taking ridiculously high amounts. My recommendation is to take a minimum of 2000mcg of sublingual, Methylcobalamin B12 on a daily basis. I also recommend having your B12 levels checked every three months if you are taking a medication known to deplete B12. Please see my post, Surprising Facts You Need to Know About Vitamin B12 for more information about how important Vitamin B12 is and how many health issues may result from a deficiency.
  • Ritalin
  • Most Blood Pressure Medications
  • Most Acid Blockers and Antacids
  • Most Antibiotics
  • Most Oral Birth Control
  • Inhaled Corticosteroids (Flonase, Nasonex, Flovent, Pulmicort, Rhinocort, etc.)
Magnesium Magnesium is essential for lowering blood pressure, yet almost all blood pressure medications deplete the body of this essential nutrient. Seems somehow backward, doesn’t it? Several studies found that 70-85% of the US population – children included – are magnesium deficient. (See my post Why You Need More Magnesium for more information on the importance of Magnesium and information on which types are most beneficial.)
  • Valium (Diazepam)
  • Xanax (Alprazolam)
  • SSRI Antidepressants (Fluoxetine/Prozac, etc.)
  • NSAIDS (Celebrex; Ibuprofen/Motrin, Advil, etc.; Naproxen/Aleve, Naprosyn, etc.; Lodine; Daypro; etc.)
  • Hydrocortisone
  • Prednisone
  • Beta-Blockers Used for High Blood Pressure (Lopressor, Toprol, Inderal, Coreg, etc.)
Melatonin Oddly enough, Melatonin is a hormone that is essential for maintaining serotonin balance and for maintaining a positive outlook. Deficiencies can cause depression and insomnia, and may also increase the effects of aging because Melatonin is such a strong antioxidant. Dosage of Melatonin varies from person to person. I generally recommend starting with 1-3 mg each night and increasing the dosage (up to 10 mg) until restful sleep is easily attained. If you take Melatonin and it does nothing for you, that’s a good indicator that you are not deficient. However, most people taking anti-anxiety medications are deficient and find their symptoms improve very quickly once a Melatonin supplement is started.
  • NSAIDS (Celebrex; Ibuprofen/Motrin, Advil, etc.; Naproxen/Aleve, Naprosyn, etc.; Lodine; Daypro; etc.)
  • Aspirin
  • Anti-GERD Medications, both OTC and prescription (Axid, Tagamet, Pepcid, Prevacid, Prilosec, Nexium, Protonix, etc.)
  • Hydrocodone
  • Anti-Cholesterol Medications (Cholestyramine, Collestipol, Questran, Colestid, Atromid-S, etc.)
  • Colchicine (anti-gout)



Please read Facts About Iron-Deficiency Anemia to learn more about combating anemia.

A word of warning about iron: Do not take an iron supplement unless you know you need it. Additionally, iron may interfere with the absorption of many prescription medications. (One example is that it should never be taken with thyroid medications such as Synthroid or Armour.) For best absorption and to prevent interactions with medications, I recommend taking iron supplements on an empty stomach, at least two hours before or after taking prescription medications.Many forms of over-the-counter iron supplements are almost impossible to absorb. This is why many of them cause constipation. I prefer to use forms of iron which are very easily absorbed and therefore do not cause digestive upset or constipation. My recommendation is to never purchase iron supplements from standard drugstores, as I have yet to find one that carries iron in a form that is easily absorbed. (Please let me know if you find one!)

Have you suffered from a nutritional deficiency you later learned was due to a prescription? How did you counteract it? If you’re taking one of the medications listed, I’m curious to know if your doctor told you in advance about the possibility that it might cause a deficiency? Were you warned and given a list of recommended supplements? I hope you were!

My passion is helping people improve their health by identifying and correcting nutritional deficiencies and other causes of illness. I have helped thousands of people improve their health, reverse symptoms and reduce their need for medication. If you are ready to improve your health using a holistic approach, please contact me to schedule a consultation.

Please note that the links in this post are Amazon affiliate links but that my use of an affiliate link in no way encouraged my listing of these supplements. They truly are my favorite supplements, most of which I use myself.

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.

Surprising Facts You Need to Know About Vitamin B12

This post provides an introduction to Vitamin B12. Vitamin B12 deficiency is one of the most common deficiencies I see in my Vitamin B12practice. It’s important to discuss Vitamin B12 because it is a nutrient that is essential to many body functions and because many people are deficient and are suffering unnecessarily. (Magnesium is another nutrient that is vital for health but which many people are deficient in. Please read Why You Need More Magnesium – and how to get it for more info on that.) I plan to cover B12 in several blog posts, because I believe deficiencies in Vitamin B12 cause more severe health issues than other nutrient deficiencies, yet 80% of the general public is deficient and is completely unaware of the importance of B12. The symptoms caused by a B12 deficiency can be so severe that they limit one’s ability to function normally, yet replenishing this vitamin is very easily accomplished. Many people associate Vitamin B12 with boosting energy or assisting in weight loss, but it can help improve health in a multitude of different ways. Unfortunately, a severe deficiency may cause damage 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 (Pernicious Anemia) that destroys cells in my digestive tract (the parietal cells) which are responsible for absorbing Vitamin B12. I suffered horrible symptoms for many years simply because no one ever ordered the correct tests to identify this issue and because no one ever tested my B12 blood levels. I realized through my own research that I was deficient and began taking a supplement, but it was still several years before I a physician who confirmed my suspicions using specific blood tests. He was the first doc in over 20 years to order the proper tests and to give me a prescription for multiple high-dosage B12 injections per week. I’ll discuss proper testing and ways to replenish low levels later in this post. My primary concern is helping people recognize and eliminate the symptoms a B12 deficiency can cause because I know personally how severe they can be.

What is Vitamin B12 responsible for?

Vitamin B12 is present in, used by and necessary for the proper functioning of every single cell in the human body. Obviously, I can’t cover everything Vitamin B12 is responsible for in a singe blog post, so stay tuned for future info on B12. The most important roles Vitamin B12 plays in the body include:
  • Creation and repair of DNA
  • Creation and maintenance of the myelin sheath that insulates nerves in the body and neurons in the brain
  • Regulation of the production of S-adenosyl-L-methionine (SAM-e), a mood-regulating chemical
  • Support of methylation and detoxification
  • Metabolism of fatty acids and proteins
  • Maintenance of proper function of nerve cells and brain chemistry
  • Energy production
  • Production of red blood cells and hemoglobin
  • Reduction of inflammatory homocysteine – excess homocysteine is associated with coronary disease, Alzheimer’s disease, strokes, diabetes, osteoporosis and more (See Three Blood Tests Almost Everyone Should Request for more info on homocysteine.)

Symptoms of a Vitamin B12 Deficiency

Based on the above list, it is obvious that a B12 deficiency can cause severe health issues. Although all of the B vitamins are essential for true health, a deficiency in Vitamin B12 can affect health in ways that impact daily life more strongly than some of the other B Vitamins. A deficiency in Vitamin B12 may cause any or all of the following symptoms:
  • Anemia
  • Fatigue, sometimes severe
  • Feeling of heaviness in arms, legs and head
  • Muscle weakness
  • Depression and despondency
  • Easy bruising
  • Sleep disturbances and insomnia
  • Hormonal imbalances
  • Elevated liver enzymes
  • Diarrhea, constipation or other digestive woes such as nausea, vomiting, loss of appetite and/or bloating
  • Red, swollen tongue
  • Bleeding gums
  • Pale skin
  • “Brain fog,” problems concentrating, memory loss
  • Shortness of breath on even mild exertion
  • Numbness or tingling in extremities (neuropathy in severe cases)
  • Headaches and migraines
  • Ataxia (lack of balance, may affect gait)
  • Dizziness and lightheadedness
  • White spots on the skin of the forearm (may be misdiagnosed as Vitiligo)
  • Irritability and extreme mood swings
  • Tachycardia, skipped heart beats, irregular heart rhythm
  • Eye twitches and tics
  • Irregular periods, heavy bleeding, infertility
  • Decrease or disappearance of normal reflex responses
  • Some people report pain in their ring finger and palm

Causes of a Vitamin B12 Deficiency

The following are all potential causes of a B12 deficiency:
  • Alcohol consumption
  • Smoking
  • Vegan or vegetarian lifestyle
  • Excessive junk food consumption
  • Digestive diseases and conditions which block absorption (Celiac, Crohn’s, IBS, malabsorption, etc.)
  • Removal or resectioning of the small bowel
  • Use of antacids and prescription drugs used to treat ulcers or GERD (Prevacid, Prilosec, Protonix, Nexium, Zantac, Tagamet, Axid, Alternagel, Maalox, Mylanta, Riopan, Tums, etc.)
  • Gastric bypass surgery
  • The following prescription drugs are known to cause deficiencies in B12: Zoloft, Metformin, Glucophage, Glucovance, K-Lor, K-Lyte, Klotrix, K-Dur, Micro-K, Slow-K, Colchicine (and other prescriptions used to treat gout), and some prescription antibiotics and cholesterol medications.
  • Parasitic infection
  • Liver dysfunction
  • Candida overgrowth
  • Aging – everyone absorbs less B12 as they age. Some experts recommend that anyone over age 50 should take a B12 supplement
  • Pernicious Anemia – an autoimmune condition which destroys the parietal cells in the digestive tract which are responsible for creating a chemical necessary for absorbing Vitamin B12
If any of the above points apply to you, or if you take any of the prescription medications mentioned, chances are you would benefit from using a B12 supplement or from having your B12 levels checked. The blood test to check B12 levels is very common and very inexpensive. Most insurance companies pay for it without question since a B12 deficiency can cause so many symptoms. I recommend having your B12 levels checked at least yearly, or more frequently if a deficiency is found. Alternative methods used to check B12 levels include Electrodermal Screening (EDS) and Kinesiology (Muscle Response Testing). Although I use both of those methods in my practice, the blood test is quick and easy and I recommend asking your doctor to add it the next time you have blood work done. It is especially important for vegans and vegetarians to have their B12 levels checked regularly. The liver can store extra B12 for several years, so it may take time before a deficiency occurs. It is important to check your levels regularly to recognize any change or decrease early. If your B12 levels are consistently low, you may also want to ask your doctor to order a test for Antiparietal Antibodies to check for Pernicious Anemia. (Pernicious Anemia sounds horrible but is very easily combated by taking B12 injections or using sublingual supplements. More about that in my next post.)My next blog post will discuss the different types of B12 supplements that can be used to boost levels in the body. Foods that contain Vitamin B12 include all animal products: all meat (shellfish and calf liver are especially high, but fowl and fish also contain B12), eggs, dairy, etc.
For the record, it is a myth that seaweeds contain B12. Seaweeds contain a chemical that is not B12, but which is close enough in chemical structure that it “fits” into cell receptors for B12, thereby preventing those cells from absorbing true B12. PLEASE DO NOT USE SEAWEED TO RAISE BLOOD LEVELS OF B12.Because plant materials do not contain Vitamin B12 in high enough amounts to improve health, it is IMPERATIVE that vegans supplement with Vitamin B12 on a daily or weekly basis.I’ll discuss ways to boost B12 levels and share my favorite form of B12 in my next post. Until then … live large and pursue wellness!
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 contact me to schedule a consultation. I will help you identify the cause of health challenges and will then work with you to create a plan to reverse them.