Vitamin B12

DISCLAIMER: The material on this website is correct to the best of my knowledge at this time and is provided to share information that I believe is crucial to individuals who may use my services. However, those who wish to use this information should verify it by consultation with a knowledgeable health professional in an appropriate field and should do personal research to gain the most current information. This information is a “work in progress.” I will add to it as I gain information and knowledge. I would appreciate feedback from those with greater expertise in this area.

Scroll down to read information concerning the following:



Is B12 deficiency so common that I should concern myself with it?

As stated on the B12 Awareness website, an estimated 15% to 25% of older adults have a B12 deficiency. B12 deficiency can occur throughout the lifespan and can often be misdiagnosed as conditions such as autism, developmental delay, depression, mental illness, multiple sclerosis, Parkinson’s disease, dementia, and Alzheimer’s disease. It can be a factor in forgetfulness, fatigue, frequent falling, and even infertility.


Why is it so critical to determine if I am low in B12?

A window of opportunity exists to correct a B12 deficiency. If treated in time, it can be cured and the symptoms reversed. But if it is left untreated, or is not treated in time, the damage to the body can be irreversible. Want more information? Watch this excellent documentary on B12. The 51 minutes you spend may alter the course of your future or that of someone you love!


Message to clients of a balance class:

As muscle weakness and balance problems are signs of B12 deficiency, it is critical that anyone coming to a balance class because of these problems determine if they are caused by a B12 deficiency. Exercise is not a substitute for treating a B12 deficiency. Reversing symptoms of B12 deficiency depends on prompt treatment. Do not delay evaluating and treating a B12 deficiency!


I couldn’t be low in B12. I eat a good diet and take supplements.

Many people say that they get plenty of vitamin B12 in their diets or supplements, without realizing that they can still be deficient if their body is unable to absorb and utilize it, which is often the case. Vitamin B12 is the most difficult of all the vitamins for the body to absorb and utilize.


Do I have symptoms of B12 deficiency?

Take one or all of the steps listed below and then return to this information. You will be amazed at the importance of B12 for so many systems in the body. What you find may be crucial to your health! 

  1. Complete Dr. Joseph Chandy’s B12 Signs & Symptoms AssessmentThis assessment includes factors that could put you at risk for B12 deficiency. You can download and print the assessment as a PFD form.
  2. Complete the Pernicious Anaemia Symptom Checklist from the Pernicious Anaemia Society. This checklist includes some of the early symptoms of B12 deficiency. You can download and print the checklist as a PFD form.
  3. Complete the CDCL questionnaire from the B12 Awareness website and calculate your CDR (Cobalamin Deficiency Risk) score. This assessment includes factors that could put you at risk for B12 deficiency.


If I have symptoms of B12 deficiency, what do I do next?

Take the information you found above to your doctor and ask to be tested for B12 deficiency. Your doctor will probably give you a blood test (serum B12) to check your B12 levels.


I have B12 deficiency symptoms, but my doctor said my serum B12 levels are “normal.”

Traditionally doctors have looked at your symptoms and used their diagnostic skills to come up with a diagnosis. Modern medicine has placed more reliance on various medical tests. However, the lab tests currently being used to test B12 deficiency have limitations and experts in this field believe test results should be considered in conjunction with clinical symptoms. As summarized by Dr. I. Chanarin, M.D., FRCPath“In the absence of a single perfect diagnostic test, the importance of clinical criteria to classify patients as deficient or non deficient in Cobalamin cannot be understated.” Therfore, the following approach is recommended in Could It Be B12?, which Jeffrey Dach, M.D. has called “the definitive book on B12 deficiency, diagnosis, and treatment.” If you have symptoms of B12 deficiency and: 

  • your serum B12 is less than 450 pg/ml: You should be treated for B12 deficiency.
  • your serum B12 is greater than 450 pg/ml (and you have not been supplementing B12): Your doctor should consider a therapeutic trial of B12 and monitor your response.
  • your symptoms include neurological manifestations: Your doctor should consider a therapeutic trial of B12 injections, regardless of your test results, and should monitor your response. The recommendation is methyl-B12 or hydroxo-B12  (initial series, then weekly for 3 months).


Are there any side effects or problems associated with B12 treatment?

Moderate B12 supplementation is reportedly very safe for most people.  According to Pacholok and Stuart, “It is important to note that the toxicity of vitamin B12 is nil, except for extremely rare allergic reactions. The only exception … involves patients with Leber’s hereditary optic neuropathy, a very uncommon disease in which the use of cyanocobalamin is contraindicated … B12 is safe, water-soluable, and non-toxic.” (Could it Be B12?, 2nd Edition, p. 224)

However, there may be some precautions to consider when being treated with B12 supplementation. For example, some people receiving vitamin B12 supplementation could experience a drop in potassium levels during the healing process and this could potentially be dangerous. Even with oral supplementation, potassium levels may need to be monitored. B12 supplementation is best undertaken under the guidance of a physician who is fully aware of B12-related issues and the healing process.

In addition, according to the B12 deficiency Support Group website, “People starting on B12 supplements after severe deficiency often find that they are “reversing” back out of the symptoms on their way to wellness.” As with so many avenues of healing, there may be initial symptoms to deal with as the body adjusts. Browsing through the support website can provide information and reassurance from those who have been through it.


I can buy B12 over-the-counter. Why can’t I just try it?

B12 deficiency is a medical condition with potentially serious ramifications. As such, it needs evaluation, treatment, and monitoring by an appropriate medical professional with expertise in this area. As I’ve been studying this information about B12, I’ve found it is more complex than it appears at first glance. Many factors, which are outside of the scope of this website, need to be considered for success in treating a B12 deficiency. These include such issues as:

  • Is methylcobalamin (one of the two active forms of B12) the preferred form of supplementary B12?
  • Do I need to take injections or can I take an oral form of B12 (sublingual, spray, or tablet)?
  • What is the best dosage of B12, initially and long-term?
  • Do I need to take adenosylcobalamin (the other active from of B12) along with methylcobalamin?
  • What are the dangers of taking folic acid (the synthetic form of folate)?
  • Should a biologically active form of folate (such as Metafolin) be taken along with B12?
  • Should a whole B-complex be taken along with high-dose B12?
  • What other supplements would be necessary to use along with B12 to optimize its benefit?
  • What medications or supplements may interfere with B12?
  • Do I need any special timing of taking B12 with other supplements, such as potassium or vitamin C?
  • Is it necessary to monitor potassium levels when supplementing with B12?
  • What are the symptoms of dropping potassium levels?
  • What should be done if potassium levels start to drop?
  • What “side effects” can I expect when supplementing with B12?
  • What precautions or contraindications need to be considered?

Some physicians are reluctant to test B12 or to treat it. Since B12 deficiencies could have such devastating consequences if left untreated, it is important to continue searching and to find reliable guidance. The B12 deficiency Support Group is a good place to turn for advice. You will find you are not alone in searching for answers regarding your health. Keep your long-term well-being in your control by searching and becoming more knowledgeable. But also know your limits and seek medical professionals with expertise in this area when appropriate.


B12 Links and Resources:

  1. You Tube video “Diagnosing and Treating Vitamin B12 Deficiency”
  2. You Tube video of the work of Joseph Chandy, MD with B12
  3. You Tube video of interview with Sally Pacholok, Part 1 (continues directly into Part 2)
  4. You Tube video of interview with Sally Pacholok, Part 2
  5. B12 Awareness website
  6. B12 Deficiency Support Group
  7. Vegan Health on B12
  8. Could It Be B12? by Sally M. Pacholok, R.N., B.S.N. and Jeffrey J. Stuart, D.O.
  9. Nutrients for Neuropathy by John A. Senneff
  10. Drug Muggers by Suzy Cohen, RPh (especially chapter 14 on Methylcobalamin – Vitamin B12)
  11. The Methylation Miracle: Unleash your body’s natural source of SAMe by Paul Frankel, Ph.D. with Nancy Pauline Bruning
  12. Methyl Magic: Maximum Health through Methylation by Craig Cooney, Ph.D. with Bill Lawren


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