Vitamin B12

[Lou]

Dr. Greger’s Vitamin B12 Recommendations​

• At least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach
  • or at least 50 mcg daily of supplemental cyanocobalamin (you needn’t worry about taking too much)
  • or servings of B12-fortified foods three times a day (at each meal), each containing at least 190% of the Daily Value listed on the nutrition facts label (based on the new labeling mandated to start January 1, 2020—the target is 4.5 mcg three times a day).
• Those over 65 years of age should take at least 1,000 mcg (µg) cyanocobalamin every day.

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Ok, I'll shop for a 1000mg sublingual or chewable or liquid.

 

[Lou]

Dr. Greger’s Vitamin B12 Recommendations​

• At least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach

odd. on the bottle the directions say, preferably with meals.

 

[silva]

odd. on the bottle the directions say, preferably with meals.

Do you trust manufacturers recommendations
It's worth listening to the whole explanation:

The Best Type of Vitamin B12: Cyanocobalamin or Methylcobalamin? | NutritionFacts.org

For prevention and treatment of vitamin B12 deficiency, cyanocobalamin in chewable, sublingual, or liquid forms (rather than in a multivitamin) is best under most circumstances.

nutritionfacts.org

 

[Lou]

Do you trust manufacturers recommendations

Yeah, sure. why not?

It's worth listening to the whole explanation:

Oh, no. not another video!
You hit the highlights and I'll send you some love.

 

[Brian W]

I have been researching and it seems there is a consensus that B12 is best taken on an empty stomach if you can handle it, to avoid conflicts, but can be taken with food as well.

 

[Brian W]

Dr. Greger’s Vitamin B12 Recommendations​

• At least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach
  • or at least 50 mcg daily of supplemental cyanocobalamin (you needn’t worry about taking too much)
  • or servings of B12-fortified foods three times a day (at each meal), each containing at least 190% of the Daily Value listed on the nutrition facts label (based on the new labeling mandated to start January 1, 2020—the target is 4.5 mcg three times a day).
• Those over 65 years of age should take at least 1,000 mcg (µg) cyanocobalamin every day.

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Ok, I'll shop for a 1000mg sublingual or chewable or liquid.

I have been a bit suspicious because I got the impression people on this forum treated Dr Greger like a god when he is only one person whose advice is often alone. I just now did some research, however and I found out about how he and his team review stacks of nutrition science every year to draw their conclusions. This has given me more trust in him although I still wonder why his advice stands alone. I have to think about this but I might get some separate B12 supplements to add to my present intake.

 

[Lou]

I have been a bit suspicious because I got the impression people on this forum treated Dr Greger like a god when he is only one person whose advice is often alone. I just now did some research, however and I found out about how he and his team review stacks of nutrition science every year to draw their conclusions. This has given me more trust in him although I still wonder why his advice stands alone. I have to think about this but I might get some separate B12 supplements to add to my present intake.

I think there are several of us who use Dr. G's videos and essays as our Go-To source for accurate info.
And there are a few of us who have read at least one of his books. How Not To Die is considered the roadmap for following the WFPB diet.

In this case, his essays and videos on B12 are easy to find and read. They are both detailed and well referenced.

I would never characterize his advice as unique or different. There is a whole gaggle of doctors with diet books that have similar advice. They do have some small differences but for the most part their advice is the same.

I don't think there are any WFPB advocates who don't think B-12 is required. I think they all agree on the recommended dosages, too.

It is very reassuring to me so many authors and doctors all pretty much agree on the major things. Campbell, Fuhrman, Barnard, McDougal, Esselstien, Davis, Robbins, and Ornish, to name a few.

 

[Brian W]

I don't think there are any WFPB advocates who don't think B-12 is required.

I don't believe I suggested such.

 

[Brian W]

It is very reassuring to me so many authors and doctors all pretty much agree on the major things. Campbell, Fuhrman, Barnard, McDougal, Esselstien, Davis, Robbins, and Ornish, to name a few.

Those are all big internet names which is why I don't trust them. I would rather search for established mainstream science. At least one Ornish study has been thoroughly refuted.

As for dosage, the Vegan society recommends:

Eat fortified foods two or three times a day to get at least three micrograms (mcg or µg) of B12 a day
OR Take one B12 supplement daily providing at least 10 micrograms
OR Take a weekly B12 supplement providing at least 2000 micrograms.

Not the 50 mcg daily that Greger recommends. I'm sure if you researched outside of your usual go-tos, you would find even more variation. I don't want to fall prey to the advice of faddish internet doctors.

 

[Lou]

Those are all big internet names which is why I don't trust them. I would rather search for established mainstream science. At least one Ornish study has been thoroughly refuted.

Well actually I don't know anything about Ornish. I just have seen his name referenced alot.
And I wouldn't put any of those guys in to the same boat as other "big internet names". They are not social influences - and least not ONLY social influencers. Almost evyone on my list is a physician and an author.

Although I respect your skepticism. Just being an author and a physician does not automatically make your statements true. Case in point : Stephen Grundy and the Plant Paradox. However I do find it reassuring when five or more authors agree on the major points.

As for dosage, the Vegan society recommends:

Not the 50 mcg daily that Greger recommends. I'm sure if you researched outside of your usual go-tos, you would find even more variation. I don't want to fall prey to the advice of faddish internet doctors.

@Brian W
Looking at the Vegan's Society recomendations, the first one and the third one are very similar if not exactly what Gregar recommends too.
The middle one is very different. I wonder if they made a mistake. 10 mcg a day is very different from what almost everyone else says.
I started doing a little googling around I'm seeing at least 50/day being the smallest recommendation.

Forks over knives says 250
Furhman says 75

although these numbers are different - they are not That different. Remember we are talking MCGs. Also they all say that is a minimum. Except maybe for smokers there is no issue with taking too much.



-https://www.forksoverknives.com/wellness/every-vegan-vegetarian-needs-vitamin-b12/
-https://www.drfuhrman.com/blog/223/why-take-a-multivitamin

 

[Brian W]

After doing some research, I am going to up to 50 mcg. My multi contains 15mcg so I need to find a separate supplement with at least 35 mcg. The form in my multi is cyanocobalamin which I am led to believe can be a bit stressful on the kidneys in higher doses so I am wondering if it is ok to take methylcobalamin in the morning and my multi with my lunch. I assume there is no issue with combining the two.

 

[Lou]

@Brian W ,
Keep in mind that the more you take the smaller the percentage of B12 gets absorbed.
It's complicated, but only the first 1 mcg gets absorbed at 100%. everything after that is around 1%.

I don't have the math exactly right. basically I've just rounded the numbers to make it easy on my brain.

According to my simplification - if you took 2 mcg - you would only absorb 1.02
5 mcg gets you 1.05.
10 mcg gets you 1.1
15 mcg gets you 1.15
Since you want to absorb 2.4 a day - a supplement of 250 should do it.

Keep in mind that no matter what the label says on the multi or fortified food - only about 1 mcg is going to be absorbed at 100%. So you want around 3 "doses" a day.

the gateway that only allows 1mcg in at a time resets after a few hours. So if you were going to rely on fortified foods you need to spread them out. One fortified food (or supplement) per meal should do it.

What I used to do was have a fortified food 3- 4 times per day.. Basically with each intake you would be getting around 1 mcg. So 3 doses per day do it.

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References and further reading.

Comparative Bioavailability and Utilization of Particular Forms of B12 Supplements With Potential to Mitigate B12-related Genetic Polymorphisms

Three natural forms of vitamin B[12] are commercially available: methylcobalamin (MeCbl), adenosylcobalamin (AdCbl), and hydroxycobalamin (OHCbl), all of which have been shown in clinical studies to improve vitamin B[12] status. They are bioidentical ...

www.ncbi.nlm.nih.gov

Is the Recommended Daily Allowance for Vitamin B12 1,000 Mcg?

The recommended daily allowance for vitamin B12 isn't 1,000 micrograms, by 2.4 to 2.8 micrograms depending on your age.

healthyeating.sfgate.com

Office of Dietary Supplements - Vitamin B12

Vitamin B12 overview for health professionals. Research health effects, dosing, sources, deficiency symptoms, side effects, and interactions here.

ods.od.nih.gov

 

[KLS52]

I'm so excited over my recent b12 test results. I was always low normal, in the 300's. I do not supplement but I eat (always have) a lot of nutritional yeast. I was shocked to see this result considering I've done nothing different that I know of!

 

[Lou]

I assume there is no issue with combining the two.

Actually some people recommend that. however at these low doses there is no issue about kidney damage. The only thing I've ever seen is that smokers need to be avoid cyanocobalamin.

Also there doesn't seem to be much difference as far as absorbing rates of the various kinds go. Actually after reading that first source I'm sort of re-thinking the advice of taking cyanocobalamin. I may have to re-read some stuff. but I think I remember that cyanocobalamin is preferred because of its shelf life.

@silva, do you remember?

 

[silva]

Actually some people recommend that. however at these low doses there is no issue about kidney damage. The only thing I've ever seen is that smokers need to be avoid cyanocobalamin.

Also there doesn't seem to be much difference as far as absorbing rates of the various kinds go. Actually after reading that first source I'm sort of re-thinking the advice of taking cyanocobalamin. I may have to re-read some stuff. but I think I remember that cyanocobalamin is preferred because of its shelf life.

@silva, do you remember?

I only know of cyano being preferred because of it's stable shelf life, and Greger doesn't see issues other than smokers, or those with compromised kidney function.
I did look up the links you posted and now wondering if I would be better off with a couple drops a day rather than the 2000 once a week? I could do that. What I use is 5000mcg a dropperfull, so it would be a few drops

 

[Lou]

I only know of cyano being preferred because of it's stable shelf life, and Greger doesn't see issues other than smokers, or those with compromised kidney function.
I did look up the links you posted and now wondering if I would be better off with a couple drops a day rather than the 2000 once a week? I could do that. What I use is 5000mcg a dropperfull, so it would be a few drops

The thing that I don't understand it that the limiting factor for absorbability -- I thought that was in the small intestine. So I would have thought that sublingual administrations would side step that. but I don't see any references to that in the literature.

I think at some point the main concerns are cost and connivance. Personally I think one pill a day is the most convenient. Being that I take two other pills once a day. And I use one of those little plastic medicine reminders tray. in the past I have used them to keep track of once every other days doses, too.

I do take liquid sublingual melatonin on nights I'm not sleepy. (used to take it every night but I sleep better now). One mg is also one ml so it's pretty easy to measure the right amount with the provided eye dropper. But I hold it under my tongue for at least 30 seconds. I don't think I would like to rely on that for B12.

 

[MargueriteVargas]

Comments on daily B-12 vitamin --> # of mcgs level. Some say if you eat the right foods, you don't need it. I've heard 1000mcg per day for vegans / vegetarians is common. Costco sells 5000mcg capsules!! I recognize some folks with a B-12 shortage need more. Assume a healthy person w/no shortage. Any helpful comments are welcome (snarky are not) I'm here to learn. Thanks!

Here are some helpful comments regarding daily B-12 intake:

Dietary Sources: While it's true that some foods contain B-12, such as meat, dairy, and eggs, plant-based sources are limited. Therefore, vegetarians and vegans may have a higher risk of B-12 deficiency and often rely on fortified foods or supplements.

Recommended Daily Intake: The recommended daily intake for B-12 varies depending on age, sex, and individual needs. For most adults, including those who consume animal products, the recommended intake is 2.4 mcg per day.

Higher Dosage for Vegans/Vegetarians: It's common for vegans and vegetarians to consume higher amounts of B-12 to compensate for the limited dietary sources. A dosage of 1000 mcg per day is often recommended for these individuals to ensure adequate intake.

Supplements: B-12 supplements can be a convenient and reliable way to meet your daily needs. However, it's important to choose reputable brands and follow the recommended dosage. The 5000 mcg capsules you mentioned from Costco are likely intended for individuals with specific needs or to be taken less frequently.

Individual Variations: Everyone's nutritional needs can vary, and some individuals may require more B-12 due to factors like malabsorption issues or certain medical conditions. If you suspect a deficiency or have concerns, it's best to consult with a healthcare professional who can assess your specific situation.

 

[Lou]

Here are some helpful comments regarding daily B-12 intake:

Hi, welcome to the Forum.
We've pretty much covered this ground in this thread.

Dietary Sources: While it's true that some foods contain B-12, such as meat, dairy, and eggs, plant-based sources are limited. Therefore, vegetarians and vegans may have a higher risk of B-12 deficiency and often rely on fortified foods or supplements.

It's not only vegans who need to supplement but Vegans Do need to supplement.

Recommended Daily Intake: The recommended daily intake for B-12 varies depending on age, sex, and individual needs. For most adults, including those who consume animal products, the recommended intake is 2.4 mcg per day.

Absolutely true but as we have mentioned a few times. Just taking a supplement with 2.4 mcg a day won't do it. We can absorb much more than (ok I forgot) something like 0 .6 mcg per meal.
After the 0.6, the absorption rate falls off to like .01%

Higher Dosage for Vegans/Vegetarians: It's common for vegans and vegetarians to consume higher amounts of B-12 to compensate for the limited dietary sources. A dosage of 1000 mcg per day is often recommended for these individuals to ensure adequate intake.

The reason why you see these recommended higher doses is only because of the absorption rate. If you just relied on 3 or 4 doses of fortfied foods a day you would be fine. also seniors may have absorption issues. so the recommendation for us is 1000 a day. One thousand every other day would be fine for almost everyone else. or 5000/week