What is the best way to get vitamin B12?

What would you recommend as far as the best way to get B12 vitamins into our system, supplements? Will any over the counter supplement do? If one were lacto-ovo vegetarian, do they get vitamin B12 from cheese and eggs?

Vas Bouras / Originally asked in Vegan B12 Deficiency: Putting it Into Perspective


I’m so glad you asked! In my opinion, the easiest and cheapest way to get our B12 is to take at least 2,500 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement (you can’t take too much–all you get is expensive pee). I have a video about it here: Cheapest Source of Vitamin B12.

Or, if you’d rather get into the habit of taking something daily (instead of once-a-week), I recommend at least 250mcg (I know the math doesn’t seem to “add up” but that’s due to the vagaries of the B12 receptor system–see my video Daily Source of Vitamin B12). I also cover B12-fortified foods in that video. Such foods can be as exotic as a certain type of “nutritional yeast” or as simple as a bowl of Cheerios.

As I showed in Vegan Epidemic, ovo-lacto vegetarians are also at risk for deficiency. For why fortified foods and supplements are the best sources of B12 see my video Safest Source of B12. Eggs and dairy are not optimal sources of vitamin B12 because foods come as a package deal and eggs and dairy may bring along as baggage saturated fatcholesterol, and hormones). For more see my blog Vitamin B12: how much, how often?

Image credit: dominiquegodbout / Flickr

  • “cyanocobalamin” does contain animal substances or tissues???

  • Lyra

    Hi Dr. Greger,

    Great site! I was wondering if you could combine Azomite (an edible clay high in the cobalt necessary to produce B12) with some non dairy Kefir (high in natural bacteria) to produce Vit B12 in the gut? I saw this suggestion in an online forum and would like to know if this would work? Thanks.

    • I would stick with Dr. Greger’s recommendations for Vitamin B12 see… http://nutritionfacts.org/video/cheapest-source-of-vitamin-b12/ and avoid Azomite which contains trace minerals. With the increasing evidence that Alzheimer’s disease is associated with Aluminum, Zinc, Copper and Iron (another reason to not take multivitamins) it is best to limit supplements to Vit B12, iodized salt and food to get what we need. Also some non dairy kefir is made from coconut milk which should be avoided see… http://nutritionfacts.org/video/is-coconut-milk-good-for-you/. Dr. Neal Barnard’s recent book, Power Foods for the Brain, is a good resource for folks wanting to learn more about avoiding dementia.

      • Lyra

        Thank you, Dr. Forrester! I became a vegan after reading Dr. Barnard’s book Food for Life. The B12 requirement has always been a conundrum for me, as I don’t like taking supplements or eating commercial cereals (I buy my oatmeal in bulk). At least now I know to stay away from Azomite clay! I guess I’ll just take a B12 supplement once a month. Hopefully, that’ll do the trick. You guys are great. Saludos!

      • bobcchicago

        Hello Dr. Forrester, the question has already been asked but could you tell me if cyanocobalamin comes from animals? Thank you.

      • franco

        Dr Forrester what kind of supplements are you talking about here? I have have many good results of people who suffered many conditions and they all get well on alkaline water and supplements,, i would like to know what kind of supplements…i have recommended ph mIRACLE SUPPLEMENTS which are food…of course full of trace minerals and antioxidants …good results even in people with Alzheimers disease

  • I’ve been diagnosed homozygous mthfr c677t. I’m taking methyl folate and chomping methyl b 12 and eating vegan, avoiding foods fortified with the form of b12 and folic acid my body can’t use, also avoiding sulphur foods like leafy greens, onion and garlic, since i apparently have problems with SUOX and CBS. Do you have any recommendations for a diet that would encourage b12 absobtion?

    • I’m not familiar with your diagnosis but Dr. Greger’s 5 video series running from 2/3 to 2/9/12 should give you the information that you need to insure adequate B12 intake. Of course you can test to see if you have adequate levels and this is discussed in the last video of the series. Good luck.

    • elsie blanche

      Why avoid the sulfur foods with this condition? Which leafy greens, if any, do you eat? Thanks for any info.
      Also, which tests did you run to discover this?

  • Mark

    2 types of B12 Methylcobalamin
    and Cyanocobalamin, Methyl B12 far superior – http://www.health101.org/art_methylcobalamin.htm

    • Beth P

      I’ve been told this, too. In Cornell’s Plant Based Nutrition certification program, Dr. Campbell said that methyl B12 is the better source.

    • Stephen

      Thank you for bringing this up!

      Methylcobalamin vs cyanocobalamin

      Cyanocobalamin exists only as a cheap chemical synthesized in laboratories. It doesn’t occur naturally in any living organism and also has a cyanide group, and it is an inactive form of Vitamin B12 that requires a number of metabolic processes to gain any benefit

      Cyanocobalamin isn’t something nature ever intended your body to deal with. Your body has no use for the cyano- compound itself, and has to convert any cyanocobalamin you take into methylcobalamin.

      A small amount of cyanide is released during the conversion process that must then be removed from your body by your liver.

      By taking synthetic cyanobalamin, you’re actually stealing methyl groups from your body, using up substances such as glutathione and making it do more work at the biochemical level.

      Cyanocobalamin, in summary, is a low-grade, low-quality and slightly toxic (cyanide) form of vitamin B-12 that’s used by all the cheap vitamin manufacturers. You get what you pay for.

      Methylcobalamin is a biologically active form of B12 that exists in nature. Because is pre-methylated, your biochemistry can use it immediately without any metabolic steps to make it body friendly.

      Methylcobalamin research has shown that it remains in the body for a longer period of time, with increased absorption, better retention in tissues, and at higher levels than cyanocobalamin, and of course, no cyanide!

      Pills are an inferior method of taking B12 as studies have shown that up to 99% is wasted.
      The best methods to take B-12 is injections, sublingual absorption and skin absorption.
      Because injection must be done by trained professionals, sublingual absorption and skin absorption is the most practical for most people.

      But beware that many sublingual formulas are cyanocobalamin. This is changing but you must check the label to ensure that you are getting the vastly superior methylcobalamin.

      Skin patches are available that deliver methylcobalamin released over a 1-2 day period. Again, be sure that it is methylcobalamin if you care about this difference.

      The sublingual spray form that I just discovered a few months ago is extracted from Saccharomyces cerevisiae according to the label, and is a species of yeast according to my research. (Mykind-Garden of Life). I’m sure there are others.
      I am biased as any supplements I use must be made with and from organic foods and natural sources, as well as my food as well must be organic. This is just my personal requirements and to each his own.

      • What about adenosylcobalamin? I heard that’s also easily absorbed and used by the body as well. One thing I was wondering about though concerning sublingual methylcobalamin supplements is whether they might cause problems for people with mercury fillings in their mouths.

        Some stuff I read on internet forums seems to suggest this may be the case, but I have no idea. Methylcobalamin seems like it’s kindof a new thing in the supplement world isn’t it? Cyanocobalamin supplements seem like they’re what people have been using for a long time. I wonder if it’s been studied if methylcobalamin causes a problem with mercury fillings, or if it hasn’t been investigated yet because methylcobalamin is a new development in supplements.

  • CalvinLeman1

    I may be getting all the Vit B12 from the well water I drink exclusively, mostly from the well here.

    • Alan

      I would like to know how you think you are getting Vit. B12 from your well water.

      • Wade Patton

        I too just heard Dr. Greger say that well water was a source (in a video where he is guest). I’m on a well now and wonder how to test this possibility. In the future I’ll be on a rain-water system, so I’m glad to know ahead of time that I may be losing a viable b12 source and need to take steps to replace it.

        • bigal

          I highly respect Dr Greger, but i would not trust getting my b12 from well water. The b12 supplements are cheap and easy to take and trust worthy !!!!

          • Joseph Gonzales R.D.

            I am not sure Dr. Greger ever said get B-12 from well water. He may have said it “may” be a source, (especially long ago when bacteria in water was not controlled) but there is no way that can be a reliable source! Same for dirt on plants, seaweed, and other mock-B12 sources. You’re thinking right though, take a B-12 supplement!

            For more info: Adults needs roughly 2.4 micrograms per day. In supplement form it comes in higher doses. Cheapest source of B12.

            For detailed Optimal Nutrition Recommendations: http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

            Thanks, bigal

          • Wade Patton

            I want to test my well water. No one knows what it can be relied upon without that part. I did not mean to imply that Dr. Greger suggested relying on any source. He just glosses right over the fact that millions of rural dwellers get their water from non-chlorinated sources. I’m not interested in supplements or fortified foods. I get plenty of “flex” food.

          • Wade Patton

            I would test the water before I would rely upon it, and really-reliance is not an issue as I’m “flexitarian”. But it still could be a viable source for strict eaters.

        • Joseph Gonzales R.D.

          Hi Wade. Please read my comment below. Thanks! joseph

  • Albert

    Dear Dr. Greger/Dr.Toxins :), I have an important practical question. In a place I live the only available form of B12 are 500 mcg shots (dirt cheap). What would you advise to do with them – have those shots intramuscularly (which, I get, provide way more b12 per dosage, yet I’m concerned if, say, weekly – or could those be monthly? – shots is too much for my muscle) or should I just drink – (or take sublingually?) -the contents of five shots every week? (If monthly shots of say 1000 mcg is all I need I’d probably go for that way. I remember reading somewhere, China Study maybe?, some rurally guys in Asia had a custom of monthly b12 shot – seems like an easy way to me). Also I suspect I might be quite b12 deficient based on history of my diet (no test available to me to validate). Would you advise a short course of shots to make sure the deficiency is no more there and, if so, what protocol would seem safe and sufficient?

  • Albert

    I’d also like to share an idea – unusual one – no problem if you delete this. If you are into myofascial/trigger points topic you probably know in most people calves muscles are usually quite stuffed with trigger points which cause constant pain when walking – easily harming the optimal biomechanics of both everyday and athletic movement – while some specialists even suggest tightness in calves (permanent spasm in some parts of a muscle) might cause restricted blood flow which may increase a load on heart to provide an adequate peripheral circulation, casing extra fatigue overall. So, getting to b12 now, – I found that having shots in my calves (aiming for located tender points – read Travell/Simmons book or just browse some web for more info on trigger points therapy aka dry needling) can release those trigger points quite successfully (some learning curve required to locate exact shot points to get a desired twitch/release result). After a series of shots (yet lacking any timeline so far – see my other post with a question) my calves are WAY loser – which makes a world of difference when moving around. Looks like two birds with one stone to me :)

  • David Epps

    can you compare cyanocobalamin and methylcobalamin (or is it methcobalamin) and are the two interchangeable. Also info on dosing b/t the two, please. thanks

  • Luc

    Cyanocobalamin is not a natural substance.

    Better use cyanocobalamin methylcobalamin or hydroxocobalamin those are the naturally occuring ones. Unless you need your everyday dose of cyanide that comes with the cyanocobalamin ;)

  • uv

    Dear Dr. Greger;

    I know that people need to absorb about 4 to 7 mcg of B12 per day, but because the absorption rate from B12 supplements is so low, we need either 250 mcg a day or 2500 mcg per week.

    This makes me concerned with the absorption of B12 in fortified foods.

    The soy milk I drink says it has 50% of daily B12 per cup, and the veggie-sausage in my fridge says each of them have 120% of daily B12.

    How efficient is the absorption of B12 from fortified foods? I know it’s better than from supplements, but how much better?

    Will two glasses of soy milk REALLY give me 100% of the B12 I need for the day? Or is it more like 70%? 20%? 5%? I have no idea!

    Please help! Thank you! :)

    • You can get adequate B12 from fortified foods if you do it correctly. You don’t need to worry too much about meeting daily requirements as you store B12. I would view the series of 5 videos that Dr. Greger posted in February 2012 to understand this important issue in more depth. Personally I take a 2500 mcg sublingual tablet weekly to make sure I have adequate intake but since I also consume some fortified foods like almond milk I don’t worry about the occasional weeks I forget to take the tablet. Since most of us periodically get blood work done it is easy enough to ask your physician to check your B12 level. Of course if you are having symptoms of illness you need to be checked. Good luck.

      • uv

        thank you!

  • Nikola

    Do I understand it correctly? The drug companies in my country sell pills/drops with 25µg cyanocobalamin a day and say it’s 1000% of demand. How can I get 250µg
    a day(it’d be 10 pills)? Please, can you explain it to me?

    • uv

      the website iherb sells B12 liquid drops or B12 liquid spray and it’s often 250, 500, 1000, or 2500 in each drop or spray. iherb sells supplements at a discount, no sales tax if you spend more than $20, and if you’re in the usa no shipping.

  • abeleehane

    There is a lot of confusion about the proper method for testing B12 levels in the blood. Some say the traditional method is sufficient, others claim that the latter s not accurate and that measuring Methylmalonic acid and/or Homocysteine levels is the way to go. What gives ?

  • Andrew

    Which form of supplementation is better, pills or fortified foods? A pill contain many additional ingredients that might not be of any good to our bodies, what about fortified foods, what kind of stuff is there in those, is it safer than pills?

    • Tommasina

      Andrew, you touched on a good point about whether pills or foods are best. In this case, I believe the B12 pills are just the actual cyanocobalamin, usually without additional ingredients. Dr. Greger has a video on the downfalls of multivitamins: http://nutritionfacts.org/video/should-we-take-a-multivitamin/ but between a straight B12 pill and fortified foods, I think it’s up to you as to what you’ll remember to take/eat.

  • Ada

    Dr I’m very concer about my allergys can you suggest me some changes in my life styles I was vegetarian all my life and 10 months ago I changed to vegan practicing 70/30, but I can’t eat strawberries mine favorite fruit or any nuts including sprouted, I feel I have no life/fun my face get red pimples and looks like I’m a pre teens and I have 55+ old what can I do, please help. Thank you. Ada

  • Sara Edwards Connor

    Based on Dr. Greger’s recommendation, I have stopped taking spirulana, but I noticed that the DHA I take lists Algal Oil as the main ingredient, and I’m wondering if that is the same as spirulana and/or is just as potentially dangerous. Thanks for your help.

    • Thea

      Sara: I’m not an expert in this area, but I have a thought for you.

      I think the algae that the oil comes from is not spirulana. But even if the factories are growing spirulana to make the oil, they are growing that stuff in sterile, fully controlled environments. They are not gathering the algae from wild/open places. Since the spirulana only seems to be a problem when it is *contaminated,* (ie, the spirulana itself is no the problem), then the stuff grown in vats in a factory should not be a problem.

      Also, I would bet that Dr. Greger keeps an eye out for this kind of information. If there were any evidence at all, even a case study, that someone got sick from the DHA algae pills, I would expect that Dr. Greger would do a video about it and have warned us. He has done so for other substances…

      Hope that helps.

  • Donald Griffing

    I take Vitamin b 12 sublingual. It’s the easiest way to absorb the b12 into the system as it is directly infused into the body.

  • Christine Weller

    Michael, in your opinion, is taking spirulina counter-productive when also taking a vitamin B12 supplement? As a relatively new vegan I have been researching supplements and some sources indicate that the B12 in spirulina is in an analogue form which blocks absorption of true B12.

  • Ben

    Could Dr Greger comment on the comment below stating that B12 Methylcobalamin is superior to B12 Cyanocobalamin?

  • bluesky

    >> eggs and dairy may bring along as baggage saturated fat, cholesterol, and hormones >>

    Do you make much distinction between “factory eggs” and free range eggs, in terms of hormones and overall benefits?

    Before discovering this site, I’d learned that free range eggs have up to FOUR times the omega 3 fatty acids. In addition, according to “Mother Earth News” (see link below; no idea how solid it is as a source, but I’ve seen simliar info elsewhere), free ranges eggs have:
    * 1/3 less cholesterol
    * 1/4 less saturated fat
    * 2/3 more vitamin A
    * Three times more vitamin E, and
    * Seven times more beta carotene

    Read more: http://www.motherearthnews.com/natural-health/free-range-eggs-zmaz09fmzraw.aspx#ixzz3MGpUcFeQ

    So – is much of the rap on eggs mostly against “factory eggs” or do you attribute all the negative stuff I’ve read here to regular, old-fashioned free range eggs as well?

    I love my plant-based diet, but kind of miss eggs once in a while.

    • Thea

      bluesky: 1/3 less cholesterol, etc – that’s still a WHOLE LOT of cholesterol, saturated fat, etc. Plus other problems with eggs that exist regardless of how the mother of the egg was raised…

      I understand missing eggs every once in a while. I really, really do. I don’t know if you already know about “black salt”, but you may want to research it. It does a great job of making some dishes really taste egg-y. (It is a natural salt that has sulfur in it.) It’s not 100% the same. But it can help to fill that hole.

      Good luck.

    • Laloofah

      Sandy, I know your question is five months old, but I just came upon this article yesterday and thought you might find it very helpful: Incredible Vegan Versions of Every Egg Dish. (The article also has links to more info about what eggs really are and why “backyard chickens” are not an ethical answer, plus it contains more info about kala namak, the “black salt” Thea mentioned that imparts an eggy aroma and flavor to dishes).

      • Thea

        Laloofah: Just wanted to let you know that I really appreciated your link. That link was cool just by itself, but then it led me to learn about the Gentle Chef and oh boy have I had some fun getting one of his cookbooks and exploring his blog recipes. Very cool. Thank you!

        • Laloofah

          That’s great to hear, Thea, thanks! I’m glad you’ve been enjoying it! :-)

  • Sandy

    Are there any studies than compare the efficacy of Methylcobalamin vs Cyanocobalamin?

  • gypsyjudy

    I’ve been vegan for 7 years and never felt better – not even a cold during that time. However I have been on B12 supplements since my mid 20’s due to a lack of intrinsic factor, which pulls B12 into the body from the gastrointestinal tract. I had monthly injections for many years, then discovered that taking a large supplement orally daily/weekly would do as well, since some B12 enters the body directly without the need for intrinsic factor. Of course a lot of the ingested vitamin is wasted – but it’s not an expensive vitamin. I get my bottles of B12 from Costco – the vitamin comany uses a vegan.vegetarian source for their B12 so I am not harming animals.

  • Donna

    Can you take to much B12 5000mcg sometime I take it twice a day, and also the bottle says take daily..

    • Stephen

      No, because b12 is water soluble so the excess is simply eliminated through your urine.

  • Brux

    Is there a problem with Methylcobalamin ???? Most of the B12 I see is in this form? Is that OK?

    • Stephen

      No, Methylcobalamin is the natural biologically active form of B12 that exists in
      nature. Because is pre-methylated, your biochemistry can use it
      immediately without any metabolic steps to make it body friendly.

      Cyanocobalamin is chemical synthesized in laboratories. It doesn’t occur naturally in any living organism and also has a cyanide group.

      Your body has no use for the cyano- compound itself, and has to
      convert any cyanocobalamin you take into methylcobalamin. This also releases a small amount of cyanide in the process.

  • Dani

    Some websites say you should take methylcobalamin rather than cyanocobalamin. Are they accurate or just trying to sell a particular kind of supplement?

    Vitamin B-12 warning: Avoid cyanocobalamin, take only methylcobalamin
    Learn more: http://www.naturalnews.com/032766_cyanocobalamin_vitamin_B-12.html#ixzz3yKVs5xPq

    • Thea

      Dani: Dr. Greger answers this question here:

      In his new book, How Not To Die, Dr. Greger provides a slightly different reason for the same answer: that cyanocobalamin is preferred, because other types, like methylcobalamin have insufficient evidence to support their efficacy. In other words, we know *cyanocobalamin* works. You are paying more for methylcobalamin and we don’t even know if it works as well.

      Between these two answers, what do you think? If your source still compelling to you?

  • vanrein

    I’m a little surprised by the advise to take weekly high doses of B12. This seems more disruptive than a gentle flow of B12 entering our blood streams; and indeed, B12-fortified foods are mentioned as the most reliable method of getting enough B12.

    What I am considering is to take a 100 mcg tablet, dissolve it in a liquid and drink that throughout the day. Or perhaps prepare a number of liquids that can be used up in their own pace, over a number of days. In effect, this would be making our own B12-fortified liquids. As I understand it B12 is water-soluble, very stable, and can even withstand high temperatures, so there should be many opportunities.

    Given our body’s wish for 1.5 mcg doses 3-4 times a day, one such 100 mcg tablet could easily serve an entire family for a full day. All we would need to care about is entering just a little into the 1% overshoot beyond 1.5 mcg, at least most of the time. Is there a reason why this approach isn’t advised here?

  • Lisa

    Cyanocobalamin CONTAINS CYANIDE! Methylcobalamin DOES NOT.
    So Why would Dr Greger recommend B12 with Cyanocobalamin vs B12 with Methylcobalamin?
    See link below for details on both B12.


    • Thea

      Lisa: As near as I can tell, the page you linked to does not give a single reference to back up anything it says. Here’s what Dr. Greger said on the topic when he did his Reddit day:

      “As far as I’m aware, nearly all documented B12 deficiency reversal in those on plant based diets has been done on cyanocobalamin. In fact the only study I know of with methyl was one in which one out of the three treated didn’t completely resolve! So better safe than sorry I say, until we have more data.”

      from Reddit day, December 10, 2015

      That’s a pretty strong argument in my opinion.