Your Guide to B12

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Vitamin B12 Deficiency Can Sneak Up on You.

What is vitamin B12, and why’s it so important?

Vitamin B12 is one of eight B vitamins that are vital for keeping our bodies in tip-top shape. A water-soluble vitamin, B12, is required for building red blood cells, metabolizing nutrients, and supporting our immune system. Since our body does not make B12, we must get it from foods such as meat, eggs, poultry and dairy products, fortified foods, dietary supplements or prescription medications.

How much vitamin B12 do you need?

In Canada, the daily Recommended Dietary Allowance (RDA) for most adults is 2.4 mcg, 2.6 mcg for those pregnant, and 2.8 mcg for nursing moms. However, Health Canada notes that 10-30% of people over 50 may not absorb as much vitamin B12 from food as they need and recommend they consume fortified foods or take vitamin B12 supplements. [1]

 Woman with anemia sleeping

When we don’t get enough vitamin B12, a deficiency begins to develop. Since the symptoms of a vitamin B12 deficiency often appear gradually and are varied, the condition is often overlooked.

Symptoms may include anemia, loss of appetite, constipation, confusion and numbness and tingling in our hands and feet. If left untreated, a B12 deficiency can lead to permanent neurologic problems and blood diseases [2]. As such, it’s vital to ensure you are getting enough vitamin B12.

Am I at risk for vitamin B12 deficiency?

Vitamin B12 deficiency can be caused by not getting enough of this vitamin through your diet, problems with absorption or taking a medication that interferes with its absorption. Deficiency is more common among older adults and those with poor diets, pernicious anemia, impaired cognitive function, or malabsorption conditions. A simple blood test can reveal the status of your B12 levels. 

What about vitamin B12 supplements?

Taking a B12 supplement may be the best solution for someone who has difficulty absorbing B12 or who’s diet is lacking this vitamin. It’s important to realize that there are many different B12 supplements to choose from, and it’s important to make an informed decision. Let’s take a look at the differences.

Different forms of B12 have different levels of bioavailability (amount of vitamin absorbed and ready to use). Vitamin B12 is found in both active and inactive forms. Most supplements use one of two forms of vitamin B12: methylcobalamin and cyanocobalamin, which is more common. A third form, dibencozide, is also found in some newer formulas.

Our bodies efficiently use both methylcobalamin and dibencozide, bioavailable coenzymated forms of vitamin B12. They offer immediate, direct nutritional support, even for those with genetic differences that impair the absorption of B vitamins.

In contrast, cyanocobalamin requires many metabolic processes to occur, such as removing the cyanide molecule from the nutrient before it offers up active vitamin B12. As such, anyone at an increased risk of vitamin B12 deficiency or who is actively trying to correct a deficiency may have greater success with a metabolically active biocoenzymated form of the nutrient. Cyanocobalamin does cost quite a bit less, so it remains a good choice for those less concerned with maximum absorption. 

Which form is better methylcobalamin or dibencozide?

There are also a couple of key differences between methylcobalamin and dibencozide. Methylcobalamin is predominantly found in the blood, while dibencozide is found in cellular tissues, namely in the mitochondria. These two forms are essential cofactors for specific enzymes, meaning that their roles in supporting good health do differ slightly.

Methylcobalamin works alongside folate in the formation of red blood cells and to support the healthy development of the brain in childhood and the nerves in adulthood. Methylcobalamin is also crucial for intracellular metabolism, including the synthesis of nucleic acid, which controls growth and cellular division. Working with folic acid, B12 helps lower homocysteine levels, a strong indicator of heart disease risk.

Dibencozide (also known adenosylcobalamin) is an essential cofactor for the proper metabolism of carbohydrates, fat and amino acids. A deficiency in dibencozide interferes with myelin’s formation, the protective sheath around nerves, essential for an effective nervous system function. 

Are vitamin B12 supplements safe?

When taken at appropriate doses, vitamin B-12 supplements are generally considered safe with few to no adverse reactions recorded in human studies. That said, folic acid supplementation should always be complemented with vitamin B12 supplementation because folic acid can mask a B12 deficiency. While folic acid can reverse markers for B12 deficiency (macrocytic anemia), it cannot reverse the neurological damage caused by unresolved B12 deficiency.

Some sublingual vitamin B12 supplements contain lactose, a natural sweetener that may cause an upset stomach in people who are lactose intolerant or vegan.

Why do some vitamin B12 supplements contain much higher doses of the nutrient than the recommended RDA?

In short, because these formulas can help to prevent vitamin B12 deficiency for those at risk and restore vitamin B12 in those diagnosed with vitamin B12 deficiency or pernicious anemia. This includes taking medications that deplete vitamin B12. 

What about B12 injections?

Typically, vitamin B12 deficiency is treated with vitamin B12 injections since injections bypass any potential problems with digestion and absorption. However, the National Institutes of Health (NIH) notes that “high doses of oral vitamin B12 may also be effective.” Based on a review of randomized controlled trials, a daily dose of 2,000 mcg of oral vitamin B12, followed by a daily dose of 1,000 mcg daily and then 1,000 mcg weekly, then monthly might be as effective as intramuscular administration. [3,4] 

What about taking vitamin B12 sublingually?

Sublingual formulas are ideal for those with difficulty swallowing tablets and may provide better absorption, even when compared to injections. And finally, if you’re looking for a vitamin B12 formula where you’ll truly feel the difference, consider Natural Factors BioCoenzymated™ Methylcobalamin & Dibencozide, which includes Farm Fresh Factors™.

Farm Fresh Factors™ is a synergistic base of bioenergetic phytonutrients including:

  • organic cruciferous vegetables, sprouted garlic, artichoke, black radish, and dandelion, among other whole foods
  • a broad spectrum of fully active glucosinolates and myrosinase enzymes from wasabi rhizome and fresh freeze-dried sprouted broccoli
  • fruit polyphenols from grape, pomegranate, bilberry, organic Indian gooseberry, schizandra berry, red orange, organic açai berry, and more
  • Theracurmin® curcumin, organic echinacea, and other herbals; and whole plant sea vegetables such as organic spirulina and chlorella, blue green algae, and kelp

There’s a lot of goodness packed into those quick dissolve sublingual tablets!

Natural Factors
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  1. Health Canada. (2010). Dietary Reference Intakes. Retrieved from:
  2. National Institutes of Health Office of the Dietary Supplements. (2020). Vitamin B12 Fact Sheet. Retrieved from:
  3. Vidal-Alaball J, Butler CC, Cannings-John R, Goringe A, Hood K, McCaddon A, et al. (2005). Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev, (3): CD004655
  4. Butler CC, Vidal-Alaball J, Cannings-John R, McCaddon A, Hood K, Papaioannou A, et al. (2006). Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. Fam Pract, 23:279-85.