Vitamin B12 sufficiency, deficiency and you

As an essential vitamin for human health, vitamin B12 can feature in very low levels in some diets. So, how’s your vitamin B12? See if you’re getting enough, and if not, what you can do about it.

Vitamin B12 is an essential vitamin for human health, necessary for the metabolism of carbohydrates, fats and proteins, blood health, cell growth and replication as well as for the synthesis of myelin, the protective sheath surrounding many nerves. So, how’s your vitamin B12? Do you get enough or are you at risk of deficiency?

Getting adequate vitamin B12

Most vitamin B12 in the diet comes from animal products, with high levels of vitamin B12 found in liver, sardines, oysters, egg yolk, fish, beef, kidney, cheese and milk. In Australia, the main dietary sources of vitamin B12 are milk products (30%), meat, poultry and game products (29%), cereal-based products (13%) and fish and seafood products (8.8%)[1]. The reliance on animal products to supply adequate levels of vitamin B12 puts many vegetarians and vegans at risk of vitamin B12 deficiency.

The recommended dietary intake for vitamin B12 is 2.4 micrograms per day for adults and children aged 14 years and over, 1.8 micrograms for children aged 9-13 years, 1.2 micrograms for children aged 4-8 years and 0.96 micrograms for children aged 1-3 years[2].

Absorbing vitamin B12 from foods

Once ingested, vitamin B12 is released from food using a combination of enzymes and hydrochloric acid in the stomach. Vitamin B12 then binds to a specific protein excreted by the stomach, intrinsic factor, which facilitates absorption in the small intestine. For there to be sufficient dietary absorption of vitamin B12, stomach acid, pancreatic enzymes, intrinsic factor, and good intestinal function are all needed[3].

Supporting good gut health is an important consideration in helping to maintain good vitamin B12 levels. Alternatively, vitamin B12 supplements that absorb in a sublingual form, such as sublingual tablets or sprays, can help to bypass the reliance on the gut for absorption.

Risk factors for low vitamin B12

To-date there is no exact definition of vitamin B12 deficiency and a lack of consensus about the most accurate way to test for adequate levels of vitamin B12.

As a result, vitamin B12 deficiency frequently remains undiagnosed. This is further complicated by the fact that moderate vitamin B12 deficiency can produce non-specific symptoms, and can be slow to develop, as body stores of vitamin B12 can last for years.

Primary vitamin B12 deficiency is generally due to either low dietary intake or poor absorption in the gut.

Unfortunately, measuring vitamin B12 in blood tests can be deceiving as blood levels of vitamin B12 do not always reflect total cellular vitamin B12, and serum vitamin B12 levels can be maintained at the expense of vitamin B12 stores in tissue[4].

Deficiency signs & symptoms of vitamin B12

Vitamin B12 deficiency signs and symptoms can be non-specific, and therefore difficult to diagnose. Common symptoms include:

  • Fatigue
  • Skin pallor
  • Low exercise tolerance
  • Shortness of breath
  • Palpitations
  • Numbness
  • Poor cognitive function and memory

Improving your vitamin B12

For those not following a plant-based diet, the first place to start to improve your levels of vitamin B12 is by increasing your dietary sources.

Where this may not be possible, a vitamin B12 supplement may be helpful.

Herbs of Gold produce two activated vitamin B12 supplements, one in a sublingual tablet form and the other in a convenient oral spray. Herbs of Gold Activated Sublingual B12 provides 1000 micrograms of co-methylcobalamin in a pleasant-tasting, sublingual tablet that conveniently dissolve under the tongue, where Herbs of Gold Activated B12 Spray provides high-strength co-methylcobalamin in a delicious mixed berry flavoured spray that readily absorbs under the tongue, both of which help to prevent a dietary vitamin B12 deficiency. 

[1] Australian Bureau of Statistics. (2000). Australian Health Survey: Usual Nutrient Intakes, 2011-12 financial year.

[2] National Health and Medical Research Council. (2014). Nutrient Reference Values Australia and New Zealand: Vitamin B12.

[3] Van de Lagemaat, E., de Groot, L., & van den Heuvel, E. (2019). Vitamin B12 in relation to oxidative stress: A systematic review. Nutrients11(2), 482.

[4] Infante, M., Leoni, M., Caprio, M., & Fabbri, A. (2021). Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World Journal of Diabetes12(7), 916.

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