NutritionFacts.org

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

Answer:

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?

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Dr. Michael Greger

About Michael Greger M.D.

Michael Greger, M.D., is a physician, author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial. Currently Dr. Greger proudly serves as the Director of Public Health and Animal Agriculture at the Humane Society of the United States.

View all videos by Michael Greger M.D.

  • http://www.facebook.com/DD.LoveDove Didi Nour

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

    • http://www.facebook.com/people/Louis-Paitson/100000607803821 Louis Paitson

      Pretty sure its created by bacteria

  • 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.

    • http://www.DonForresterMD.com/ Don Forrester MD

      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!

  • http://www.facebook.com/betsy.gaines.50 Betsy Gaines

    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?

    • http://www.DonForresterMD.com/ Don Forrester MD

      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.

  • 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.

  • CalvinLeman1

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

  • 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! :)

    • http://www.DonForresterMD.com/ Don Forrester MD

      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.

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