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Vitamin B12

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Vitamin B12 is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement and a prescription medication. Because vitamin B12 contains the mineral cobalt, compounds with vitamin B12 activity are collectively called “cobalamins” . Methylcobalamin and 5-deoxyadenosylcobalamin are the metabolically active forms of vitamin B12. However, two others forms, hydroxycobalamin and cyanocobalamin, become biologically active after they are converted to methylcobalamin or 5-deoxyadenosylcobalamin.

Recommended Amounts

The Recommended Dietary Allowance for men and women ages 14 years and older is 2.4 micrograms (mcg) daily. For pregnancy and lactation, the amount increases to 2.6 mcg and 2.8 mcg daily, respectively.

A Tolerable Upper Intake Level (UL) is the maximum daily dose unlikely to cause adverse side effects in the general population. No upper limit has been set for vitamin B12, as there is no established toxic level. However, some evidence suggests that supplements of 25 mcg per day or higher may increase the risk of bone fractures.

Although epidemiological studies have found that vitamin B12 supplementation can decrease homocysteine levels, they have not consistently shown a decreased risk of cardiovascular events in taking the vitamin. Therefore the American Heart Association does not advocate for the routine use of B vitamin supplements in reducing cardiovascular disease risk. However, vitamin B12 supplements can be important for some individuals with genetic variants that lead to high homocysteine levels.

Deficiency

A B vitamin complex supplement is often touted to boost energy levels and mood. People who have a B vitamin deficiency may feel a rise in energy levels after using the supplement because the vitamin is directly involved in making healthy blood cells and can correct anemia if present. However, there is no evidence of benefit if people without a deficiency take extra B vitamins.

Measuring vitamin B12 in the blood is actually not the best way to determine whether someone is deficient, as some people with a deficiency can show normal B12 blood levels. Blood levels of methylmalonic acid, a protein breakdown product, and homocysteine are better markers that capture actual vitamin B12 activity. These values increase with a vitamin B12 deficiency. It is estimated that up to 15% of the general population has a vitamin B12 deficiency.

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