‘Buy our sub-lingual vitamin B12 tablets and experience a sense of energy, heightened concentration and even weight loss!’

‘Suffering from mal-absorption issues? Don’t eat animal products? Want to bypass your absorption issues and get B12 delivered straight to your blood? Our vitamin B12 sublingual lozenges are the answer!’

Before you start to look for the price of those lozenges/tablets on this page hoping to order them right away, I’m going to have to disappoint you. First of all, the above statements are similar to what I’ve read or heard so far about these ‘magical’ sublingual tablets.

And secondly, we’re definitely not selling any of that magic here. So let’s get down to the facts and what you really need to know about this well-marketed form of B12 supplementation (possibly an ‘overly-marketed’ form).

What is Sublingual B12?

The term ‘sublingual’ means ‘that which can be placed under the tongue’. It’s available in the form of tablets, lozenges, sprays, liquid drops,and even lollipops containing B12 are being sold these days but that’s another story (I hopefully won’t be writing about how cool B12 lollipops are so don’t get your hopes up!).

Back to sublingual B12 – once you put these little things under your tongue (whether it’s a tablet, a few drops or a spray done under the tongue), you’re supposed to let them stay there till they dissolve and according to the people selling them, they enter your blood stream directly since they get absorbed through the tissues in your mouth (meaning your cheeks and the lining under your tongue). However, that’s not what ACTUALLY happens. Read on and you’ll know what I’m talking about.

Sublingual B12′s Dealbreaker Myth

Pharmaceutical companies and the likes have been marketing this form of B12 as being superior to other oral supplemental forms of B12 which are meant to be swallowed. They say that sublingual B12 is absorbed in the mouth and it doesn’t need to pass through your digestive system for absorption so those who have problems absorbing it can benefit from this form. That sounds pretty cool, so why I am being such a spoilsport?

Well that’s because the above claims of nutritionists and pharmaceutical companies are plain false.

Research has proven that there is NO DIFFERENCE whatsoever in the effectiveness of oral or sublingual B12. A study done in 2003 compared the effect of administering 500µg B12 per day in both the sublingual and oral forms. The research was done on B12 deficient patients and it was concluded that both these forms of B12 were equally effective in treating vitamin B12 deficiency.

When I read about the above research, I tried to look for a reason as to why the sublingual B12 isn’t more effective than the oral form (since the theory given by those who are selling it had me convinced until I could find an explanation for what the research claimed). And then I came across Don Goldberg. Here’s what I learnt from his blog.

Vitamin B12 deficiency is caused by numerous things, one of them being malabsorption. Pernicious Anemia is the most notable cause of this malabsorption (others include Crohn’s disease, Celiac, disease, etc) in which intrinsic factor is not produced (without which B12 cannot be absorbed). Some time ago, injections of B12 were thought to be the only way by which this form of B12 deficiency could be treated because these injections deliver B12 straight to your muscles (from where it is slowly absorbed and reaches its target organs), removing the need for absorption from your gastrointestinal system.

There was a problem in this perfect little story – injectable vitamin B12 could not be sold in the health/fitness stores. Plus, most of them need a prescription. Hmm…so what else could people with pernicious anemia take that they wouldn’t have to rely on their gut for absorption. Sublingual B12 was the clever answer ! A shrewd but intelligent marketing technique nonetheless.

That should solve our problems, no? Well here’s a tiny detail I skipped in the discussion above (yes, I did it on purpose to add some drama) : Sublingual B12 CANNOT be absorbed sublingually. Why? Simply because B12 is too large of a molecule to be absorbed from under your tongue.

Another question I had was if that’s really the case, how come the research done proved that BOTH sublingual and oral forms of B12 could help improve the B12 deficiency. Here’s why: When you take in sublingual B12, you end up swallowing some of it. That’s the one that enters your gut.

So basically, B12 given in high doses is what really cures the deficiency, it doesn’t matter if that dose is oral or sublingual because eventually B12 will be taken up by absorption through your gut whether you chose the sublingual route or the oral route. Chose whichever one you want, but technically, they will both be taken up the same way.

So to sum up, sub-lingual B12 is NOT absorbed through your oral cavity and the little amount that you do get is via absorption through the gut because you obviously end up swallowing at least some amount of the dose under your tongue. I’m not a pharmacist and in my years of studying medicine, nothing came up about the size of B12 molecules so I couldn’t be too sure regarding this theory.

I looked it up once again and interestingly, I finally confirmed through a couple of books and online references that the B12 moelcule is indeed too large to be absorbed in the mouth. The main cause behind its efficacy when given sublingually (and orally) is that its high dose causes it to be passively absorbed in the gut.

Who Should Take Sublingual B12?

Any one taking the oral form can take the sublingual vitamin B12 form and vice versa. The above discussion proves that the sublingual form is not superior to the oral form so it’s really a matter of personal preference. For those who have pernicious anemia or any other cause of B12 deficiency (gastric surgery, crohn’s disease, etc), injections are the initial form of B12 supplementation followed by oral supplementation of B12 shots for life, depending on their medical history, severity of deficiency, etc.

Are There Any Side Effects to the Sublingual Form of B12?

There are no side effects specific to this form but those due to vitamin B12 supplementation in general do apply. For more details regarding the possible side effects of B12 supplementation, please refer to this post (excluding the side-effects exclusively due to injections, such as pain at the site of injection, etc).

With that said, our discussion comes to an end for now. You can still use sub-lingual B12 as an alternative to the oral form if you’re a fan of keeping a tablet under your tongue (especially if it’s cherry flavored like some of them are), but I really don’t see a reason to use this form anymore. Our recommended form of B12 supplementation is methylcobalamin B12 shots, they provide the best value and absorption efficiency of all supplements.

Written by Dr. Aqsa Ghazanfar, main author of ‘The B12 Deficiency Survival Handbook’.

References 

Br J Clin Pharmacol. 2003 Dec;56(6):635-8. Replacement therapy for vitamin B12 deficiency: comparison between the sublingual and oral route. Sharabi A, Cohen E, Sulkes J, Garty M. Recanati Center for Medicine and Research and Clinical Pharmacology Unit, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

DonGoldberg .com

Chemical structure of Folic Acid

Vitamin B12 and Folate Functions

Before going through the rest of this article, it’s better if you know about the functions of vitamin B12 – read more about it here.

Folic acid, on the other hand, is involved in the synthesis and repair of DNA. Therefore, it is required in large amounts when our cells are dividing rapidly in situations such as pregnancy, infancy and childhood. It is required for the formation of rapidly diving cells too, such as red blood cells. Along with B12, it also helps in the reduction of homocysteine levels, a chemical that has been long associated with an increased risk of heart disease.

At a biochemical level, Folate is required for the transfer of one-carbon units from donors such as serine,histidine and glycine to substances (known as intermediates) which are involved in the formation of amino acids, purines and thymine (which is a type of pyrimidine) – certain types of both of these groups participate in the formation of DNA.

Vitamin B12 & Folate: How Are They Related?

Vitamin B12 helps convert folic acid into a form that is usable by the body since we consume it in a form which is not biologically active. Without enough vitamin B12, we cannot effectively use the folate we take in. Therefore, those who have a B12 deficiency can also get deficient in folic acid even though their folate intake might be normal. Interestingly, the anemia can improve slightly when folate is given even if the person is not deficient in it and actually has a B12 deficiency.

That causes an improvement in the symptoms of anaemia making the patient believe he was suffering from folate deficiency. In this way, he will continue to stay deficient in B12 and his nervous system will undergo irreversible damage (since B12 is required to keep it healthy).

Simply said, anyone who is deficient in B12 will also get a functional deficiency of folic acid. The symptoms mostly overlap those of B12 deficiency so it doesn’t show up as a ‘separate’ deficiency. So even if you’re taking in enough folate, it won’t be used by your body in the absence of folic acid. In medicine, we refer to that as the ‘folate trap hypothesis’ because without vitamin B12, folic acid will end up getting trapped in your body. That’s one of the few aptly-named scientific phenomenon I have ever come across.

Staying true to my word, here’s the juicy and rather contradictory bit:

FOLIC ACID ADMINISTRATION MIGHT BE HARMFUL TO B12 DEFICIENT PEOPLE

Woah – that sounds mightily absurd, doesn’t it? Let me tell you a story (I promise to keep it short, rest assured).

Once there was a time when many babies were found to have severely disabling and debilitating problems. These were called the ‘neural tube defects’ and included problems such as the spina bifida (where a baby’s vertebral column fails to fuse during foetal development) and parts of their spinal cord might protrude out through this defect. Obviously this might cause neurological problems depending on the degree of the defect (these problems can range from muscular weakness to complete paralysis and loss of normal bladder function).

I don’t want to scare you too much by going into the details of these defects, the point being that these neural tube defects could result in varying degrees of medical problems, even recurrent abortions or the birth of anencephalic babies (anencephaly literally means absence of the brain).

Luckily, the incidence of these defects has decreased massively – thanks to the discovery that the deficiency of folic acid before and during the first trimester of pregnancy causes these defects.Therefore, females planning to conceive as well as those who already are pregnant are now supposed to take an amount of folic acid higher than other people (for details, refer to the section of recommended daily intakes discussed below in this post).

To decrease the incidence of these defects, many food items of daily usage have been supplemented with folate (such as flour, bread, etc). Research has now shown that the administration of folic acid through these fortified foods to the general population might be one of the causes of the under-diagnosis of Vitamin B12 deficiency.

That’s because when people keep getting a constant supply of folate (when they are also B12 deficient), their anaemia gets partly cured. However, the damage to their nervous system continues to occur because they remain B12 deficient (since B12 is crucial in the normal functioning of the nervous system).

No, this does not mean that you shouldn’t take folate if you’re deficient in B12. It simply means that you need to take both when you’re deficient in B12. It also doesn’t mean that the general population should discontinue their usage of folate from the fear that they might have an undiagnosed B12 deficiency. If they discontinue folate intake, they will only make matters worse for themselves (along with increasing the incidence of neural tube defects, abortions, etc).

However, it does mean that doctors need to be way more vigilant when diagnosing people with megaloblastic anaemia (the type of anaemia that both folate and B12 deficiency cause). Both these vitamins go hand in hand and this should NEVER be forgotten.

Signs and Symptoms of a Folate & B12 Deficiency

The signs and symptoms of B12 deficiency have already been discussed here whereas those observed along with a folic acid deficiency are as follows.

• Pallor
• Tiredness
• Fatigue
• Light-headedness
• Shortness of breathe
• Heart palpitations
• Peripheral neuropathy (which causes limb numbness, etc)
• Pregnancy complications (such as neural tube defects in the foetus, miscarriages, etc).
• Confusion, irritability and forgetfulness
• A decrease in cognitive function
• Sore or swollen tongue
• Ulcers in the mouth
• Heart disease (due to an increase in homocysteine levels).

Causes of B12 and Folate Deficiency

You can find the full causes of B12 deficiency in detail within our previous post. As a re-cap, it should be noted that B12 deficiency usually results due to inadequate B12 intake, gastric or intestinal surgery, diseases or tumors of the stomach or intestines, or parasites / toxins that compete for it. The causes of Folic acid deficiency are usually:

• Reduced intake
• Crohn’s disease, celiac disease and other causes of mal-absorption
• Certain medicines, such as anti-epileptic drugs
• Chronic dialysis
• Haemolytic anaemia
• Alcoholism and drug addiction

Daily Dosage and Sources of Folate

The RDI (Recommended Daily Intake) for folate is -

There are many sources of folate to be considered. You can find it especially in green leafy vegetables, Broccoli, Asparagus, legumes (Beans, peas and lentils), Avocado, brussel sprouts, sunflower seeds, egg yolks, liver, baker’s yeast and more.

Beef liver and a whole egg contain both B12 and folate. I recommend trying a combination such as salmon (high in B12) and a salad with leafy vegetables, legumes and beans (all are sources of folic acid) to form a meal that is very rich in both nutrients.

Alternatively, you can take vitamin supplementation tablets, etc which contain both B12 and folate, both of which are usually found in multi-vitamins, but always always opt for whole-nutrition before you surrender to artificial supplementation as a solution.

Written by Dr. Aqsa Ghazanfar, main author of ‘The B12 Deficiency Survival Handbook’.

When it comes down to what the best vitamin B12 supplement form for you is, things aren’t as simple as just choosing a type based on which one is absorbed the most. The following few things have to be taken into consideration.

• The cause of the deficiency

Is it due to low intake? gastric or intestinal surgery? fish tapeworm infestation? a chronic disease such as crohn’s or pernicious anemia?. Those who are deficient only because they aren’t taking in enough of this vitamin won’t need the same form as those who can’t absorb properly due to pernicious anaemia or a gastric surgery, for instance.

• The severity of the deficiency

Those who have a very severe deficiency and have undergone severe nervous system damage should be treated with injections for rapid delivery of B12 to their tissues.

• The possible efficacy as well as side effects of the form of supplementation chosen.

• Finally, the cost of the chosen supplement.

Various Forms of Vitamin B12 Supplements

Before I list the various forms of B12 supplements, let’s make one thing clear. People might refer to these forms as the various ‘types’ or ‘kinds’ of supplements. These words are used interchangeably also for the chemical type of B12 found in these supplements too, so it might be a little confusing.

There are three types of the vitamin B12 when it comes to their chemical composition, namely hydroxocobalamin, methylcobalamin and cyanocobalamin. The first one is the best form but it is too expensive and thus, methylcobalamin is currently believed to be practically the best one. If you want to know why, please go through our ‘Cyanocobalamin vs. Methylcobalamin’ comparison.

The method by which these chemically varied forms of B12 can be administered to the human body are what I will refer to as the forms of B12 supplementation. Without wasting any more time, let’s go through them and try to decide which one suits which group of individuals.

Oral Supplements

These include pills which you can swallow, sublingual tablets and oral sprays. Although sublingual tablets have been marketed as a superior form when it comes to absorption, this is not true. Research favors oral sprays instead. Tablets which you can swallow have only two advantage: they’re easily available over the counter and are cheap.

They contain cyanocobalamin (read more about it here) and cannot be absorbed. Methylcobalamin is the preferred chemical form of B12 for most people. In addition, oral pills which can be swallowed are literally of no use to those who have a deficiency due to gastrointestinal problems (gastric surgery, crohn’s disease, etc) since the orally taken B12 won’t be absorbed.

The worst downside is probably the fact that B12 tablets cannot be absorbed completely because the total amount of B12 absorbed in the intestines depends on the amount of intrinsic factor produced. The maximum amount of intrinsic factor production will only help you absorb around 10 mcg even if the ingested dose is 500 mcg. So if you want to take in high doses of B12, forget about ingestable tablets.

To cut the long story short, sprays are the best form out of all the available oral supplemental forms but they’re expensive. Tablets have pretty much the same pros and cons regardless of whether they’re to be swallowed or kept under the tongue.

Injections (Also marketed as shots)

This is one of the two best forms of B12 supplements (want to know the other one? Read on!) because it does not depend on intrinsic factor for absorption and high doses go straight into the blood stream. Moreover, you can get the highly useful methylcobalamin via this route and injections are not expensive.

The disadvantage is that B12 shots are not available over the counter (however, they can be bought online at TrimNutrition, our favorite vendor), can cause pain where injected and might require you to learn how to inject yourself (If you buy them online, they usually come with easy-to-follow instructions).

Read more about vitamin B12 shots.

Nasal Gels

This form is a good alternative for those who don’t want to use injections. However, these gels are slightly expensive and are usually available by prescription only. Their efficacy is comparable to that of injections and nasal sprays (see below).

Nasal Sprays

A rather uncommon form but yes, it does exist. These sprays boast amounts of B12 pretty much comparable to that obtained through B12 shots. In addition, they are available over the counter as well as by prescription and you don’t need to learn how to use them (as opposed to taking B12 shots).

Before you get your hopes up high, just know that this particular form is pretty expensive. It’s an excellent form, yes, but it’s just not worth the money when you have other cheaper and equally effective forms. Sure you can choose this form if you have a little extra money and don’t want to go through the hassle of getting B12 shots.

However, not all of us are that fortunate so let me unveil the second of the two best forms of B12 supplements which isn’t expensive at all.

The B12 Patch

In addition to B12 shots, B12 patches are the best available supplements available these days. It’s a matter of personal preference when it comes to which one is better out of these two. The B12 patch is extremely easy to use (the B12 shots are hard to self-administer), there is no need for multiple doses since you can wear the patch once a week and it usually only needs to be worn for 24 hours. It doesn’t cost much because you only have to wear it once a week and you can easily order it online.

Surely, there must be a downside? Skin reactions (which have been reported by a small minority of people who used this patch) are the only disadvantage. Whether you’re B12 deficient due to a chronic disease, etc or just want to take B12 regularly because you’re a vegan – you can use either the B12 shots or the B12 patch whichever one you like better.

My personal preference would definitely be the B12 patch due to its ease of use and larger ‘dosing intervals’ (meaning I would need to use it less often as compared to B12 shots).

Additional Options for Vegans

All vegans should regularly supplement their diet with vitamin B12. Supplementation with forms of B12 containing cyanocobalamin should be avoided. Therefore, you can use either B12 shots or the B12 patch. If you can’t afford these or simply can’t find them easily, don’t leave out supplementation altogether.

Take the oral B12 supplements (the ones you swallow or the sublingual form – whichever one you prefer) but do not allow yourself to get deficient in B12. You can also include the B12 rich nutritional yeast in your diet, it’s one of the best sources of B12 for vegans overall.

Final Verdict: Winners of the Best B12 Supplement

To sum things up, our favorite supplements are the highly-effective methylcobalamin B12 shots and the easily-applied patches. I highly advise you to take care of your deficiency as soon as possible. It can get pretty nasty later.

Written by Dr. Aqsa Ghazanfar, main author of ‘The B12 Deficiency Survival Handbook’.

Vitamin B12 Anemia

This vitamin is involved in the production of your red blood cells. I could tell you the steps involved in red blood cell production but I’m a little scared you might not share my crazy passion for medicine so I’ll refrain from stating the boring details. In a nutshell, without vitamin B12, red blood cells cannot be produced normally. Even though their number does not increase or decrease as such in the blood, their shape is what mainly changes when a vitamin B12 deficiency occurs.

Vitamin B12 anaemia is grouped under a type of anaemia known as ‘Megaloblastic Anaemia’ due to the characteristic shape of the red blood cells. They turn into large abnormal looking cells which do not resemble their disc-shaped normal counterparts at all. They are large and immature, thus the name ‘megaloblasts’ – meaning large and immature.

Folic acid deficiency has very similar effects on red blood cells and is the other type of megaloblastic anaemia currently known. In addition, a type of white blood cells called ‘neutrophils’ are also seen to have a similarly abnormal shape along with exhibiting more lobes within their nuclei as compared to their normal counterparts.

Enough with the boring details, let’s examine the more interesting part.

Signs and Symptoms of a B12 Anemia

So what do all these abnormally shaped red blood cells do? As a matter of fact, the symptoms of B12 anemia are pretty much the same as any other type of anemia because the basic problem is the same – your tissues aren’t getting enough oxygen. However, a person might have other symptoms related to the cause of the deficiency such as neurological issues (seen with B12 anaemia), etc. The signs and symptoms seen only due to the anemia of B12 deficiency are:

• Lethargy
• Tiredness
• Pallor
• Heart palpitations
• Light-headedness
• Shortness of breath
• Drowsiness
• Decreased energy

In addition, B12 deficiency causes symptoms such as numbness, tingling, balancing problems, confusion, memory loss, diarrhoea, etc. More details regarding the symptoms of B12 deficiency can be found here.

What is Pernicious Anemia?

Pernicious anemia (also called Biermer’s anemia, Addison’s anemia, or Addison–Biermer anemia) is a type of anemia which results due to an auto-immune process that attacks particular cells of the stomach which are responsible for helping in B12 absorption. These cells produce a substance called intrinsic factor without which B12 cannot be absorbed in your intestines.

An auto-immune process occurs when your own immune system starts attacking particular cells of your body falsely perceiving them as foreign. The reason as to why that happens is massively discussed and researched on within the medical community but we are still not exactly sure as to what the cause is. Genetics, infections, environmental causes, race and numerous factors have been hypothesized and proven to be the contributing factors but how they do that still needs to be researched upon further.

Simply said, pernicious anemia is an auto-immune process that attacks those cells of your stomach without which you cannot effectively absorb vitamin B12 from your gut. It’s a cause of B12 deficiency and is associated with other auto-immune conditions such as Addison’s disease, Thyroiditis, etc.

Therefore, people who have this form of B12 anaemia will need B12 supplementation via the intramuscular or intravenous route (such as B-12 injections) for as long as they live and might have symptoms of other auto-immune conditions associated with this disease.

Other Causes of B12 Anemia

• Stomach surgery

• Ulcers or cancer of the stomach

The stomach produces intrinsic factor which is necessary for B12 absorption.

• Consuming little or no B12

Vegans and vegetarians are at an increased risk.

• Surgery of the small intestine

The small intestine absorbs vitamin B12, therefore a decrease in its length can cause B12 deficiency.

• Diseases of the small intestine

Crohn’s disease, ulcerative colitis, celiac disease, etc.

• Infestation with the fish tapeworm

• Old age

One of the reasons for old people being at a greater risk of developing B12 deficiency is that with age, the lining of the stomach ‘wears off’ and thus intrinsic factor producing cells decrease.

• Certain medications (such as metformin, etc).

How is B12 Deficiency Anemia Diagnosed?

A history and physical examination are the key to making a differential diagnoses by doctors. These can be narrowed down and the final diagnoses can be reached by ordering the right tests. In case of B12 deficiency anaemia, blood tests are required. Urine testing can also be done. Another test, known as the Schilling test, is done to find out the particular cause of B12 deficiency. For more details, please refer to the information given here.

Important: Is B12 Deficiency And Its Symptoms Reversible?

Vitamin B12 Deficiency is reversible with supplementation which can be done via pills, injections, patches, etc. The dosage and frequency depends on the cause, the severity of the deficiency, etc. However, what you should know is that some very serious symptoms of B12 deficiency are NOT reversible.

Since B12 is involved in the formation of the protective myelin sheath which surrounds your nerves, its deficiency causes problems in the nervous system (such as pins and needles sensations, confusion, depression, loss of balance, tremors, etc). When the damage to your nervous system reaches a certain point, it will be impossible to get it back to normal.

With continued deficiency of B12, nervous system damage could reach a point where a person could become paralyzed and permanently disabled. Therefore, don’t think that this deficiency is reversible and you can get back to normal by mere supplementation. Things won’t be looking that positive when you’ve been deficient for too long.

So yes, the deficiency is usually reversible, except for its most serious symptoms which show up when you’ve been deficient for too long.

Written by Dr. Aqsa Ghazanfar, main author of ‘The B12 Deficiency Survival Handbook’.

For those of you not aware, Methylcobalamin and Cyanocobalamin are two different forms of Vitamin B12. Let’s dive right in and have a look at them separately. I believe it will answer everything you want to know.

Methylcobalamin

This is one of the two forms of B12 found and used in the human body (the other form being adenosylcobalamin). That means that even when you take other forms of B12 (such as cyanocobalamin), they will have to be converted to one of these forms so that the body can use the B12 effectively for the chemical reactions that require the presence of this vitamin.

Chemically, methylcobalamin (also mecobalamin, MeCbl, or MeB12) contains a methyl group attached to the cobalamin (or B12). Since it’s already one of the two forms that your body uses, there is no further conversion required and it can be used as soon as it is administered.

Cyanocobalamin

As its name implies, this form of B12 contains cyanide attached to the B12. Yes, cyanide is the poison you commonly hear about. However, the amount of cyanide released from this form is so small that its effect on a normal healthy individual’s body is negligible. That means that the amount of cyanide present in this form is not significant from a toxicological point of view.

Since cyanocobalamin is not one of the forms used by the human body, it has to be converted to either methylcobalamin or adenosylcobalamin for effective use of the administered Vitamin B12.

Methylcobalamin vs. Cyanocobalamin

Both methylcobalami and cyanocobalamin are forms of B12. The latter is eventually converted to the former so why do we have to compare them?

First, the effects of these two forms on the human body are not the same (explained later). These two forms are chemically different and therefore behave differently.

Cyanocobalamin is safe for use in individuals who are otherwise healthy but its use is questionable in people who smoke, those who have excessive nervous system damage due to B12 deficiency, etc. Therefore, the comparison between these two can help us decide which one is better for which situation.

A lot of sources claim that cyanocobalamin is toxic for your body – that’s obviously bad news for those who use this common form of B12. Most pharmaceutical companies sell this form and therefore, its usage is much more common.

Methylcobalamin is expensive and therefore, most people would prefer the cheaper alternative cyanocobalamin. We’ll discuss why that might not be a good choice for you.

Without further ado, let’s get down to the actual discussion – Methylcobalamin versus Cyanocobalamin.

From a ‘chemical’ point of view:

• Methylcobalamin occurs naturally whereas cyanocobalamin is a synthetic source of B12 – it is not made by animals, bacteria, etc.

• Methylcobalamin is one of the forms of B12 used by your body whereas cyanocobalamin has to be converted to either methylcobalamin or adenosylcobalamin so that your body can use the B12 in it.

• Cyanocobalamin contains the toxic substance cyanide. Although the amount of cyanide present in it is not harmful for healthy people, it has to be used with caution in people who smoke or have other problems due to which their body cannot eliminate cyanide (see below).

• Cyanocobalamin is made by a chemical reaction and therefore it’s cheap for pharmaceutical companies to make this form of B12. Methylcobalamin cannot be made by such a reaction and has to be obtained from bacteria and therefore, it is much more expensive to procure this form of B12.

• Once these two enter your body, they behave very differently. Methylcobalamin is used up as it is and no additional substances are required to convert it into a usable form. Cyanocobalamin, on the other hand, needs removal of its cyanide group which is done by using up glutathione and methyl groups in your body.

Glutathione is a substance that helps lower homocysteine (which contributes to heart disease when present in high amounts. For more info, see below), reduces damage caused by oxidative radicals, etc. So in a nutshell, cyanocobalamin makes your body do more work at the biochemical level and depletes your glutathione and methyl stores – both of which are required in crucial processes within your body.

Methylcobalamin, in comparison generates SAMe (S-adenosyl methionine) which is the most important methyl donor in your body providing the much needed methyl groups for crucial chemical reactions to help maintain your health.

At this point you might be thinking something like ‘hey, that’s a lot of medical mumbo jumbo – I still don’t know which form is better for me and why!’ Well let’s apply the above knowledge to your body and see which form does what. So from a medical point of view, here’s what you need to know.

From a medical point of view:

• Methylcobalamin, according to latest research, has been proven to be the more easily absorbable and more bioactive form of B12. Moreover, it stays within your body for a longer period of time (meaning that it doesn’t get flushed out of your system as soon as cyanobalamin does due to which a single dose lasts longer than that of cyanocobalamin).

• Methylcobalamin lowers homocysteine levels whereas cyanocobalamin does not. High levels of homocysteine cause heart disease and atherosclerosis. It is best to use folic acid in conjunction with methylcobalamin to reduce homocysteine levels.

• Although methylcobalamin is used mainly in the liver, brain and nervous system; it is extremely useful for maintaining nervous system health. So if this system is not functioning well, methylcobalamin should be the preferred form of supplementation. Your vision has a lot to do with your nervous system since the optic nerve (the nerve within your eye which is involved in processing all sorts of visual information) is a part of it. So problems related to vision as a result of B12 deficiency benefit from methylcobalamin.

• Methylcobalamin has been scientifically proven to help modulate your sleep-wake cycle. The exact mechanism is not completely understood but it has been suggested that this form of B12 could modulate the synthesis of melatonin, a hormone involved in regulation of your sleep-wake cycle.

• It has been suggested that 3000 mcg of methylcobalamin taken daily along with exposure to bright light in the morning can help fix a messed up sleeping schedule. So for those of you who feel that they can’t sleep before the clock hits 3 in the morning, methylcobalamin might just be the ultimate ‘cure!’

• Those who take methylcobalamin for supplementation of B12 report that they need less sleep as compared to those who take the cyanocobalamin form. In addition, the former group is more likely to wake up more refreshed and have more energy during the peak hours of the day probably due to a higher body temperature at this time. All these effects are not noticeable with the use of cyanocobalamin. Individuals who have blood types A or AB have lower body temperatures and therefore, could benefit even more with methylcobalamin than those with other blood groups.

• Those who smoke or have liver problems should not be given cyanocobalamin because they cannot effectively eliminate the cyanide from their body.

• Cyanocobalamin is usually given only intramuscularly whereas methylcobalamin can be given intramuscularly, intravenously and intra-articularly (within the joints) due to the fact that it is the more bioactive form.

• Methylcobalamin is slightly more painful when injected as compared to cyanocobalamin.

• Latest research proves that methylcobalamin, in high doses, can help regenerate nerves and can be useful in the treatment of peripheral neuropathies. Patients with multiple sclerosis did not improve with respect to their motor symptoms but methylcobalamin did seem to improve their visual and auditory symptoms.

Those with Alzheimer’s disease noticed an improvement in memory and intellectual functions when given this form of B12. It has been proven to have a beneficial effect on patients with Bell’s palsy (facial nerve paralysis), amytropic lateral sclerosis, parkinson’s disease, etc.

Much more research still needs to be done till doctors can finally agree upon the exact dose and duration of therapy required to treat patients with these diseases but methylcobalamin (and NOT cyanocobalamin) has at least been proven to have a positive effect in all the above mentioned conditions.

The Final Verdict: Cyanocobalamin vs. Methylcobalamin

After having read the above discussion, the choice is up to you. Which form do YOU prefer? If it were up to me, I’d say we should stop the production of cyanocobalamin altogether and make efforts to lower the cost of methylcobalamin so that it can easily be used by everyone. But hey, thing’s aren’t always that simple now, are they?

If you’re looking to buy B12 shots, TrimNutrition’s Methylcobalamin are very very recommended. They are very reasonably priced and are produced in the U.S.A. They also sell Cyanocobalamin shots. I’ve personally checked their product and the quality is just fabulous.

Written by Dr. Aqsa Ghazanfar, main author of ‘The B12 Deficiency Survival Handbook’.

It’s all pretty intriguing of course but we should know better than to believe what fancy exciting advertisements tell us. Since this topic is pretty ‘in’ these days, we decided to discuss it here to help you decide whether B12 will really do you any good with regard to weight loss and increased energy.

B12 and Metabolism

Vitamin B12 is a water soluble substance which is involved in numerous reactions within your body. In this article, we’ll only discuss those concerned with your metabolism. B12 is required for energy production within your body and without it you can’t effectively get energy from the food you eat. This means that B12 helps maintain a normal metabolism along with the provision of energy to your body through whatever you eat.

Vitamin B12 and Weight Loss: Can It Really Increase Your Energy?

As mentioned above, vitamin B12 helps your body obtain energy from the food you eat. If you’re deficient in vitamin B12, you will feel lethargic and exhausted all the time even when your daily food intake is optimal. That might make you eat more to keep up your energy stores but eventually, you’ll gain weight. Your metabolism would also be slow which serves as an additional factor for weight gain.

In people who are deficient in vitamin B12, its administration causes an immediate boost of energy and they will feel more active. They most probably will also lose weight. But that’s only the case with those are deficient in this vitamin. For those of you who do not have a B12 deficiency, B12 shots are sadly not the magical cure for rapid weight loss.

Yes Justin Beiber, Madonna and Katy Perry have been reported to rely on B12 for heightened energy and metabolism. Even Margaret Thatcher is said to have taken regular B12 shots around thrice a week. However, scientific research that has been done so far in this regard does NOT show that B12 aids weight loss or an increase in metabolism in non-deficient cases.

The simple explanation for that is that B12 is like a fuel – when you fill up a fuel-consuming machine with whatever fuel it uses, it begins to work as you expect it to. However, if you add more than its fuel tank can hold, the extra fuel flows out and won’t help the machine work better than it’s supposed to.

Metabolism, energy production and weight modulation are complicated processes involving numerous hormones such as thyroid hormone, Cortisol, Growth hormone, Leptin, Ghrelin, etc. Additional factors such as genetics, geography, race, etc also play major roles so what you should really consider for losing weight is a generally balanced lifestyle and healthy eating. Don’t look for short-term weight loss strategies – always opt for what’s best in the long run.

Written by Dr. Aqsa Ghazanfar, my partner and main author of ‘The B12 Deficiency Survival Handbook’.

It took a very long time to seek treatment. It took an even longer time to realize that I was the one that was getting in the way of my own recovery.

My Anxiety and Depression Mistakes

It took me a while to realize how often I was contributing to my own anxiety, but there was no denying I played a serious role in fueling my anxiety experiences. I was doing classic anxiety producing mistakes. I was not exercising. I was looking for ways to potentially verify my fears were accurate, and I wasn’t taking care of my diet.

Anxiety is a complex problem, and rarely does it have a single specific cause. Most of the time it’s made up of a combination of a variety of factors, including genetics, upbringing, and life experiences. I know that I was nervous at a young age, but I also know that there were plenty of times where I allowed very small experiences to continue to fuel my anxiety. My mother was an anxious person as well, and I’m sure I picked up on some of those anxieties.

It’s rare that generalized anxiety disorder, depression, panic attacks, and other mental health problems only have one cause. That’s why if your goal is to reduce or cure your mental health problems, as mine was, you need to look at every contributing factor, and my diet was one of the main issues that was affecting my anxiety.

Diet: Anxiety and Depression

It’s well known that diet affects anxiety and depression in a myriad of ways. Coffee can contribute to panic attacks (I did drink too much coffee), a poor diet causes hormonal imbalances (I ate a lot of unhealthy delivery), magnesium deficiency can lead to a feeling of anxiousness (I tended to have bleached grains), and more. There are ample links between anxiety and diet, including an often forgotten nutrient: Vitamin B12.

Vitamin B12 is known as cobalamin, which is not exactly an everyday word when it comes to nutrition. Vitamin B12 is found in most animal products, especially seafood and internal organs (liver, kidneys, etc). (Note from Regev: Here’s a list of the richest sources of B12)

I was a vegetarian (non-Vegan) so I was getting some eggs and milk in my diet, but beyond that it I was getting very little B12 – and even those that eat meat or eggs or dairy may not be getting enough, depending on the amount that they eat, where they buy the products, cooking preparation and so on.

B12 plays a substantial role in the human body. It binds itself to every red blood cell, produces energy, improves DNA regulation, and more. Many people make claims about what vitamins do or don’t do, but B12 is without a doubt one of the most important and least well known vitamins in the entire spectrum of nutrition.

But of all of the vitamin functions, one of the most interesting (and frightening) is the way the vitamin impacts mental health.

Vitamin B12 and Mental Health

According to the National Institute of Health, just a small amount of deficiency in the vital nutrient can lead to fairly unique, potentially long term problems with your mental health. What’s more, these problems are rarely actually diagnosed as a vitamin B12 deficiency. NIH lists the following symptoms when you do not get enough B12 in your diet -

• Confusion
• Depression
• Memory Loss
• Trouble with Balance
• Fatigue
• Weakness

There are also plenty of non-psychological symptoms, but the above list represents the common ones that can affect those not getting enough B12.

True deficiency – as in, the type of deficiency that is extremely dangerous to your health – will manifest itself in a variety of other ways, including anemia and other potentially deadly health problems. But there are varying degrees of efficiency, and there is good chance that a small deficiency leads to the above psychological symptoms.

I mentioned earlier that my own diet was one of the issues affecting my mental health. While I was going through treatments I was improving, but I wasn’t receiving the results I wanted, and there seemed to be a lot of things holding my back. Diet was clearly one of those areas.

It wasn’t just vitamin B12. I found that my poor diet was causing me to lack in a variety of important nutrients, like magnesium and iron. But I was also lacking in vitamin B12 as well. I started on a psychologically oriented multivitamin (in order to get the correct doses of nutrition that were recommended for psychologically healthy living) and in no time I was experiencing a tremendous difference in my overall mental health.

Researchers are now finding that this is true for others as well, and in some cases they’re using these ingredients as a potential depression and anxiety cure. When you suffer from depression, anxiety, and panic attacks, you need to find a way to make sure that you’re successfully getting the right nutrition in your body. Through supplements and shots, doctors are trying out vitamin B12 on more and more psychological patients, and finding that yes – in many cases, symptoms of anxiety and depression appear to be relieved.

How to Determine if You Need B12 (And Subsequent Treatment)

Your B12 levels can be identified via a thorough blood test. Your doctor can order a complete analysis of your blood and vitamin health, and determine if you’re in need of some type of treatment. If you’re concerned about how your diet is affecting your mental health, consider the following:

• Schedule a visit to your doctor and request a blood test for potential dietary causes of anxiety.
• Avoid limiting yourself just to B12. There are several deficiencies that can contribute to anxiety.
• Once you get the results, ask your doctor if you should start taking some type of supplementation.

Your doctor may recommend vitamin B12 shots. These shots are the most efficient way to get B12 into your blood stream. Yet they may also advise simple oral supplements, especially if your B12 levels are low, but not dangerously so.

Should your doctor determine that you need to add vitamin B12 (or any other vitamin to your diet) make sure you take it seriously. Vitamin deficiencies are no laughing matter, and those prone to these types of deficiencies can expect them to come back in the future.

Not a Cure, But a Complementary Tool

It would be a lie to say that nutrition caused my depression and anxiety. I had problems from a very young age with sadness and anxiousness, and my upbringing and experiences without a doubt contributed to those feelings and experiences.

But it would also be a lie to claim that it was entirely my upbringing and experiences. Everything is a contributing factor when it comes to your mental health, and my diet was absolutely affecting the way that I felt on a regular basis. Through vitamin B12, better nutrition, and healthier living, I was able to complement the treatments that I was also using to improve my mental health, and ultimately was able to control these experiences once and for all.

A: Vitamins are nutrients that your body needs in minute amounts to fulfil numerous basic functions. In the world of science, these are specifically those nutrients that an organism cannot synthesize on their own and needs to take it in with their diet. That means that some substances might be vitamins for humans (because we can’t synthesize them) but they’re not vitamins for those living things which can make such nutrients on their own.

For example, vitamin B12 is made by certain bacteria which live in the soil and the guts of some animals – therefore, it’s a vitamin for us, not those germs that make it! There are 13 vitamins currently known to be needed by humans.

When we talk about a vitamin, it doesn’t mean we are referring to just one compound or substance – the term ‘vitamin’ refers to a group of substances which are similar because they act in the same way biologically and/or chemically. Vitamins are not classified based on their chemical structure (thank God since I wasn’t a big fan of chemistry back in school, unless it had something to do with the human body – typical medical geek, I know!)

What Are Vitamins Important For?

Different vitamins have different functions, the absence of any one of them causing major health issues. For example, Vitamin D is required for maintaining the health of your bones and aiding in their growth whereas vitamin A is needed for normal vision. Therefore, deficiency of the former causes stunted bone growth and low levels of the latter cause visual deterioration and ultimately blindness.

By now, you know that vitamins are pretty awesome and interesting since your body doesn’t make them and without them, crucial functions are lost. Yes, I might just force my opinion on you in order to make you believe that you need these nutrients. Let their functions fascinate you so that you get how they work because without that, I don’t think you’ll be motivated enough to grab adequate amounts to include in your diet (in case you’re not taking enough already). If that doesn’t happen, REALLY bad things will happen to you (for example, low Vitamin A levels could make you blind, as I mentioned earlier).

Where Did The Name ‘Vitamin’ Come From?

A Polish scientist called Kazimierz Funk combined the two words, ‘Vital’ and ‘Amine’ to form the word ‘Vitamine.’ That’s because in 1912, it was proposed that diseases which result due to the deficiency of certain nutrients could be prevented by the intake of amines. So ‘Vitamine’ was basically ‘Vital Amine’ or ‘Amine of Life.’ However, we know now that these substances are not amines and therefore, the term ‘Vitamine’ has been dropped in favour of just ‘Vitamin.’

What is Vitamin B12?

Vitamin B12 is one of the eight B-Vitamins and contains a number of similar compounds. These include: cyanocobalamin, hydroxycobalamin, adenosylcobalamin and methylcobalamin. Crazy, boring names I know! Only the later two are utilized by your body. If you take in any of the former two types, they will eventually be converted to any of the other two that your body likes to use.

The B12 vitamin contains the metal Cobalt and has a central ring called the ‘Corrin’ ring which is why this group of compounds is sometimes also known as the “Corrinoids.”

Note from Regev: There are gazillion uses and benefits for B12.

Some Facts About Vitamin B12

Now, let’s dig deeper into the wonder that is vitamin B-12. It’s cool because it’s different from the other vitamins. That’s because: It is the largest and has the most diverse structure of all the vitamins.

It is stored in very large amounts in the human body – children having lesser amounts as compared to adults because this vitamin slowly accumulates (that doesn’t mean that the elderly individuals have the largest amounts of this vitamin! That’s because in old age, there are problems in the absorption of this vitamin – something that we go in much greater detailed in our ebook).

The Un-Cool Pseudo-B12?

Pseudo-B12 is like B12 but it’s of no use to your body because you can’t utilize this form. Pseudo-B12 isn’t cool at all because if someone has this form of B12 in their body, it will come up in the B12 serum tests and show that that particular person has adequate amounts of B12 in their body, when they are actually deficient in it since the form they have can’t be used by their body. Pseudo-B12 is found in some Algae and the bacterium Spirulina.

Bonus Story: How Was Vitamin B12 Discovered?

Many, many years ago, a horrible and severely debilitating disease affected numerous people eventually putting them to death. Doctors were trying hard to find a cure but all efforts were in vain. Patients who had this disease got severe anaemia, had very low red cell counts, neurological damage and eventually died.

A doctor then noticed that something found in the diet could cure this disease – he was soon joined by another fellow physician who had similar beliefs. Their theory was backed up by the fact that after dogs were bled, their red blood cell counts increased by the administration of liver (red meats and vegetables were found to be less effective) – an experiment that had been conducted by another researcher.

These two doctors began feeding their patients with liver and noticed how their patients condition improved. That cured the disease that was called ‘Pernicious Anaemia’ or the anaemia that results due to a B12 deficiency.

However, another researcher noticed that people who had had their stomachs surgically removed (due to cancer, etc) also suffered from Pernicious Anaemia even if liver and meats were fed to them. Guess what he did? Well, to tell you the truth, you couldn’t guess it in a million years so here goes: This researcher ate meat, vomited it out and fed his own vomit to his patients and noticed that they got better.

Since his stomach was intact and his patients didn’t have one, he concluded that something within the stomach aided in the absorption of B 12 vitamin from there. He called it the ‘intrinsic factor,’ a term we still use. Back then, B12 wasn’t known – just the fact that it existed was known. Therefore, he called it the ‘extrinsic factor.’ Vitamin B12 was isolated many years later and eventually given its unique name.

Note from Regev: If you’re having a deficiency, take a good read about B12 injections and available rich sources.

Written by Aqsa, my partner in crime and main author of “The B12 Deficiency Survival Handbook“.

“Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.” (Source)

How Do You Know If You Have Celiac Disease ?

The tricky thing about food allergies is that they can present such a wide spectrum of symptoms that can vary greatly from person to person. Doctors office visits for skin rashes and stomach problems often end with a prescription treating the symptoms rather than the source of the problem.

Most people never even consider that food allergies may be the cause of their health problems because they usually haven’t made any recent changes in their diet. They think ” I can’t be allergic to wheat or diary, I’ve been eating it all my life.”  This is precisely the point though. Many of the people suffering from from food allergies have had symptoms for years. While at times these symptoms are prominent other times they made be hardly noticeable.

Something else to keep in mind is that people who have food allergies are not always born with them. My girlfriend suffers from celiac disease, but didn’t notice any symptoms until she was in her mid twenties. The same was the case with her brother, who was also diagnosed with celiac disease.

After visiting with several doctors and doing her own research on the subject, she came to the conclusion that she was born with the celiac disease trait, but that it was dormant until she was in her twenties. Until then she was misdiagnosed many times as having acid reflux disease. Her Dermatitis Herpatiformis was also misdiagnosed as being herpes.

What Are The Signs and Symptoms of Celiac Disease ?

My girlfriend suffered from a lengthy list of symptoms which included:

• Headaches
• Dermatitis
• Herpatiformis (skin rash from gluten)
• Anxiety
• Fatigue
• Abdominal pain
• Acid reflux
• Depression
• Weight gain
• Indigestion
• Shortness of breath

After going off gluten, her symptoms began to clear up. She is still in the healing process though, due to the fact that the villi in her intestinal tract were damaged by gluten. This makes it much harder for her to absorb the nutrients in her food. According to her doctor and the online gluten free community, it could take over a year for the body to fully recover. While she is still recovering, it is clear that gluten was causing the symptoms she was experiencing.

In the vein of sharing her experiences so that others may benefit – she has created her own personal blog at MyGlutenFreeQuest.com.  It is is something that she’s put a lot of her time and herself into. If you have celiac disease, food allergies or gluten intolerance there’s a good chance that you can learn some really valuable things from her blog. It covers things such as symptoms, gluten free recipes, vitamins and supplements, workouts and much more. Her goal is to help as many people as she can and give everybody who is suffering someone to relate to and identify with. The mental aspect is so import in taking the right steps toward healing.

She probably wouldn’t have been diagnosed until much later on if it hadn’t been for her older brother who already discovered that he had celiac disease. Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. Celiac symptoms can include the ones listed above as well as the follow symptoms listed on the NIDDK website:

• Abdominal bloating and pain
• Chronic diarrhea
• Vomiting Constipation
• Pale, foul-smelling, or fatty stool
• Weight loss

Food allergies are more common than most people think. If you’re someone with a long and mysterious list of health problems that just wont seem to go away, you may want to get tested for food allergies. Getting a blood or skin test can tell you whether your symptoms are food allergies or something else.

John McKiernan is a health and fitness writer who blogs at SupplementHelper.com