Cheapest Source of Vitamin B12

Cheapest Source of Vitamin B12
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Vitamin B12 (cobalamin) supplementation can cost as little as $2 a year.

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The cheapest way to get our B12 is probably one 2500 microgram sublingual, chewable, or liquid supplement of cyanocobalamin once a week. This stuff is dirt cheap. You can find a twenty-year supply online for 40 bucks. All the B12 our body needs for $2 a year! Of course, the stuff doesn’t last twenty years. It has a four-year expiration date, so share it with some friends.

For those mathematically-minded who are thinking, wait a sec. If you only need 4 to 7 micrograms a day, why do you have to take 2500 a week? Well, it’s a little complicated, but let’s do it. Our B12 receptors become saturated at as little as 1.5. So we can only absorb 1.5 at a time through our receptor system. But about 1% of the rest passively diffuses right through our gut into our bloodstream.

So, for those of you into this kind of thing, let’s do the math. When we take a 2500 microgram dose, we absorb 1.5 through our receptor system, and then 1% of the 2498.5 that’s left. So, inside our body, we now have 1.5 plus that 1%. That comes out to be about 26.5. You do that once a week, and that averages to about 4 micrograms a day. So, we should take at least 2500 micrograms once a week. We could take 3000 a week; 5000. If you take too much, all you get is expensive pee. And at a couple of bucks a year, it’s not even that expensive.

Even though it is a water-soluble vitamin, we don’t have to take it every day, because throughout our evolution, our bodies were so used to getting such tiny amounts (maybe some wooly mammoth pooped upstream or something) that our body devised an ingenious way to hold onto it. So that’s why we can do this kind of averaging over time.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is transcript contributed by Bruce A. Hamilton.

Please consider volunteering to help out on the site.

The cheapest way to get our B12 is probably one 2500 microgram sublingual, chewable, or liquid supplement of cyanocobalamin once a week. This stuff is dirt cheap. You can find a twenty-year supply online for 40 bucks. All the B12 our body needs for $2 a year! Of course, the stuff doesn’t last twenty years. It has a four-year expiration date, so share it with some friends.

For those mathematically-minded who are thinking, wait a sec. If you only need 4 to 7 micrograms a day, why do you have to take 2500 a week? Well, it’s a little complicated, but let’s do it. Our B12 receptors become saturated at as little as 1.5. So we can only absorb 1.5 at a time through our receptor system. But about 1% of the rest passively diffuses right through our gut into our bloodstream.

So, for those of you into this kind of thing, let’s do the math. When we take a 2500 microgram dose, we absorb 1.5 through our receptor system, and then 1% of the 2498.5 that’s left. So, inside our body, we now have 1.5 plus that 1%. That comes out to be about 26.5. You do that once a week, and that averages to about 4 micrograms a day. So, we should take at least 2500 micrograms once a week. We could take 3000 a week; 5000. If you take too much, all you get is expensive pee. And at a couple of bucks a year, it’s not even that expensive.

Even though it is a water-soluble vitamin, we don’t have to take it every day, because throughout our evolution, our bodies were so used to getting such tiny amounts (maybe some wooly mammoth pooped upstream or something) that our body devised an ingenious way to hold onto it. So that’s why we can do this kind of averaging over time.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is transcript contributed by Bruce A. Hamilton.

Please consider volunteering to help out on the site.

Doctor's Note

This is the third of a five-part video series this week on Vitamin B12. For why one might choose supplements and fortified foods, see Safest Source of B12. Next, I cover various daily regimens in Daily Source of Vitamin B12. B12 is one of the few Vitamin Supplements Worth Taking.

And if you’re new to the issue, see my blog post, Vegan B12 Deficiency: Putting It into Perspective, for some background. If you’re that much of a nutri-nerd to enjoy these derivations, see my nine-part video series on vitamin D, starting with Vitamin D Recommendations Changed. If you’d rather just cut to the chase, see my Optimum Nutrition Recommendations

For more context, check out my associated blog posts: Best Nutrition Bang for Your Buck, and What Is the Healthiest Meat?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

169 responses to “Cheapest Source of Vitamin B12

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  1. This is the third of a five-part video series this week on B12. For why one might choose supplements and fortified foods see yesterday’s video of the day, Safest Source of B12. Tomorrow I’ll cover various daily regimens. B12 is one of the few Vitamin Supplements Worth Taking. And if you’re new to the issue, please see my blog post Vegan B12 Deficiency: Putting It into Perspective for some background. If you’re that much of a nutrinerd to enjoy these derivations, see my nine-part video series on vitamin D starting with Vitamin D Recommendations Changed. If you’d rather just cut to the chase, see my recommendations here. As always these are just a few of the 1,500 or so topics I have videos about.




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    1. Dr Greger (I love you) this is actually not a question but it would be so amazing if NutritionFacts.org had its own online shop with products of trust like b12, amla, hibiscus, omega 3 etc. It would be so much easier for people and the site would actually benefit naturally. even if not a shop a “recommendation page” with brands and products of trust (that could be negociated for publicity) would BE SO GREAT! Thank you




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      1. It really helps to know that there is nothing for sale here except the information, and all that income goes back into the site to spread accurate nutrtional information. It’s a very good selling point for Dr. Greger’s videos and books and speaking tours, that there is no profit motive.




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      2. Its a nice thought, but then Dr. Gregor could be accused of “selling something”….he cannot risk harming his “brand” integrity, that would harm the overall goal.




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        1. I completely agree with Rick on this. Selling products would compromise the credibility of any doctor. That is also true of doctors who accept benefits from drug companies who reward doctors for prescribing their expensive proprietary drugs. That being said, when people question the fact that cyano means cyanide and wonder whether this is the healthiest option, the good doctor should and usually does explain why this is not a problem. But doctors also should not be so invested in their expressed opinions that they ignore subsequent studies and science that may require a revision of their beliefs. I have seen this be a problem for some doctors and scientists who hold so strongly to their position even when evidence is presented to the contrary (i.e. admit they may have been wrong.) I also just want to point out that otherwise vegetarian Hindus do traditionally use dairy. Ghee, yogurt, and chai for example, are very much part of a traditional Hindu cuisine. So if there is b12 in milk, (not added) they would be unlikely to develop a deficiency. That being said, treating cows poorly or inhumanely would be considered unholy. Ghandi drank goats milk regularly and he is famous for the remark that a society can be judged by how they treat animals.




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    2. In Dr. McDougall’s latest newsetter (April 2017), he recommends against taking cyanocobalamin as an option for B12 supplementation because of its trace amounts of cyanide. He recommends methylcobalamin, adenosylcobalamin, hydroxycobalamin. Do we know if Dr Greger shares these concerns or if he has changed any of his recommendations since this video?

      Thanks




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      1. Kris Fowler: I read the vitamin B-12 article by McDougall. It makes a lot of sense. Those who follow a vegan/ WFPB lifestyle need a minimal dose of B-12 to avoid the unlikely B-12 deficiency described. I’ve researched this due to scientific literature I read that suggested overdoses of B-12 can aggravate acne in rare cases, which concerned me because my daughter suffers from this condition. She was taking this supplement daily, but was still improving significantly on a WFPB lifestyle that follows McDougall’s WFPB regimen. Therefore, I doubt this was the primary cause of her problem.

        Based on McDougall’s recommendation, I’ve suggested that she take methylcobalamin of 1000 mcg once a week (not daily) instead of cyanocobalamin. I’m not familiar with the other sources of B-12 McDougall refers to in his article.

        Normally, there is no overdose quantity of vitamin B-12, without the acne concern. There is also no known issue with cyanocobalamin that appears anywhere in the literature I’ve seen. In fact, all of the studies I’ve read were based on cyanocobalamin, not methylcobalamin.

        I believe Dr. Greger doesn’t take a position on either source of vitamin B-12. One of his videos suggested it doesn’t matter, but I’m not sure he hasn’t changed his position. I base my suggested approach for my daughter strictly on Dr. McDougall’s recommendation, due to the cyanide in cyanocobalamin. You are probably safe, in my opinion, with either form of B-12. This is just my two cents.




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      2. Kris Fowler: Sorry, I meant to say I suggested 2500 mcg of methylcobalamin a week to my daughter with acne, not 1000 mcg per week. I based the 2500 mcg per week as a minimum dose based on Dr. Greger’s advice for cyanocobalamin. This is higher than McDougall’s suggestion. The 1000 per day dose of cyanocobalamin is what she was taking.




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    3. Dr Gerger thank you.
      I have been searching for B12 Natural sources and i saw a product at Whole Food store where it claims it contains natural B12 not synthetic nor fortified . Naturally accruing. Brand name is Artisan Traditional . Could you be kind to guide me if you know the brand and agree with statement . I appreciate your assistance. Best regards . Susan




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      1. Unfermented soy products like soy milk, tofu, etc are not a safe food for anyone. It causes hormone imbalances, speeds aging, and lowers intelligence. http://tinyurl.com/cw8jecp

        Most Silk products are no longer certified organic and some are processed with hexane, a neurotoxin. And yet they can still be labeled “natural”. Some of their products may contain some organic ingredients, so the label “made with organic ingredients” is still used.




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  2. Please make this…. and EVERY VIDEO… EVERY DAY… visible on your YouTube homepage.

    Asking you to do this every day is getting very tedious.

    For many weeks this wasn’t a problem. So why now?




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    1. Mac, I think Dr. Greger wants people to visit the website, not youtube. Posting annoyingly everyday to a video is not a good approach to get your way.

      Furthermore, if people want to ask “Ask the doctor” type questions they can’t do so effectively on youtube, the comments are better controlled on nutritionfacts.org.




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      1. Hello Toxins,

        Thanks for your observations. Please allow me to clarify. I am not whining to “get my way”. I am asking for a reasonable accommodation.

        For the forseeable future, my only web access is an old Palm Centro which accesses YouTube videos by auto-launching the Kinoma player, but only at YouTube.com. The player will not launch at NutritionFacts.org.

        I do not want to comment at YT.com (nor can I due to login issues).

        Funnelling comments to NutritionFacts.org makes sense, and I believe the good doc has the option of closing off commenting at YT if he wants to.

        Thank you for your understanding.




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          1. @ hcdr I know, I know. The march of web technology continues on unabated with or without me.

            @toxins Thanks for the link. There’s no substitute for my being able to access at the doc’s YouTube homepage,though, especially for a watching a series of related videos. Since Kinoma player won’t launch here, setting up a playlist is futile.




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        1. Also, youtube can take a while to update its feeds, I’ve noticed this with subscriptions I have. It’s nothing to do with Dr Greger… you just need to be patient, that’s all :)
          (or subscribe to email alerts)




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  3. In the video “Vitamin B12 Recommendation Change,” dietary intakes of 4 to 7 ug dietary B12 were found to reduce the methylmalonic acid and homcysteine to desired levels. It seems to me then that “dietary intake” already accounts for the low absorption rate of B12, and hence I do not see why there is a need to up-adjust the recommended levels. Perhaps in the study the B12 was injected and that’s the reason for up-adjusting the recommended levels?




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    1. Ted , That is a hood observation and as we the cell cam only receive between 1.5 and 1.75 ug at a time resulting in dosage dumping (expensive urine) another misunderstood aspect of oral cyanocobalamin is the methylation of the toxic caynadide moles. this is an article about methylcobalamin and th reduction of Homo-cysteine levels When it comes to value a two month supply of Methylcobalamin ans the entire B complex for 20 some dollars is the best value out there I use Transdermal Patches from this site http://www.drhealthflex.com/apps/webstore/products/show/4490694




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  4. Ted beat me to my question, I suspect the good doctor made a mistake on this one.
    A plasma concentration of 200 pmol/L is typically considered sufficient and <150 pmol/L is typically considered deficient. There is a school of thought that to protect the most people the sufficient level should be raised to 400 pmol/L with under 200 pmol/L being considered morbidly deficient.
    In the Framingham Offspring Study (a source of data for some of the cited papers) it was found that people who consumed an average of 16.3±0.8 µg B12 per day, largely from suppliments, attained an average plasma B12 level of 398.1±7.8 pmol/L.
    In that study, even people who got just 4-5 µg B12 per day from food sources typically had a plasma B12 concentration nearing 300 pmol/L, a level most modern researchers would call sufficient.

    Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring Study:
    http://www.ajcn.org/content/71/2/514.full.pdf

    Its true, there are several mechanisms by which some people either do not absorb, can not use, or can not retain B12 well enough and thus manifest symptoms of deficiency and anyone with deficiency symptoms should be tested despite daily intake level, but for the majority it seems somewhere on the order of 16 µg B12 per day should be enough.

    As a strict vegetarian and the grandson of a pharmacist I have the habit of recompounding cyanocobalamin pills into a food ingredient so I can easily add 50 µg B12 into my food each day. There seems to be no harm to using too much B12 but I see no scientifically supported reason to alter my current practices.




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    1. Kal,

      Stay tuned for 2 more videos on vitamin b12 following this one.
      “Daily source of b12”
      “New vitamin b12 test”

      hopefully they answer your questions.




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  5. Vitamin B12 is an important topic, and I’m very grateful to Dr. Greger for making this series of videos to shed light on supplementation. My question is: How much do kids need? My kiddo eats fortified foods, but probably only once a day, so I suspect we need to be supplementing weekly. What would an appropriate weekly dose look like for a child? And are there any concerns about overdoses at any age?

    Thanks so much!




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  6. Dear Dr. Greger,
    I read on the net some statements about the negative effects of high doses of vitamin C taken together with B12. Sources are not given, or taken from general encyclopaedias. I found only one reference to a scientific study, from the ’60s in Russian in an obscure Russian journal. Do you know whether this statement is correct? If yes, do you suggest to avoid taking normal doses (below 1g) of vitamin C together with B12 supplements? Do you have any reference on this subject?
    Thank you in advance.




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  7. Unlike Dr. Oz, whose shows seem more like infomercials for supplements that we can’t afford if we bought everything he recommends, Dr. Greger always considers cost when discussing supplements, and I appreciate it.




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  8. There are several forms of b12 (like 8 to date). Thus its important to understand that cyanocobalamin and cobalamin are two different forms of b12. Cyanocobalmin is toxic 1. Nutritional yeasts commonly have this form of b12(such as red star re fortification http://lesaffre-yeast.com/five-steps.html). Conversely, cobalamin found in plants can be either assimilable or not. Chorella, nori, 2 unwashed unsprayed produce 3 has the usable form while spirulina does not. Our understanding of b12 was enhanced by this study from MIT 3 a few years back which helped to solve the mystery of b12.

    1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293728/?tool=pubmed
    2 http://www.greenmedinfo.com/article/chlorella-contains-form-b12-bioavailable-mammals, http://www.ncbi.nlm.nih.gov/m/pubmed/10794633/

    3 http://web.mit.edu/newsoffice/2007/b12.html

    Thus the cheapest source may not be the best source as its always the best choice to get our nutrition from the plants.




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          1. so what do you do with the studies like the one cited that show cyancobalamin is toxic and other studies about cobalamin in chorella, nori are bioavailable?




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            1. Did you read the review link I sent? One cannot rely on chemiluminescence to determine human bioactivity. I’ve addressed cyanocobalamin elsewhere. The balance of available evidence clearly shows it is the most safe, stable, and effective form of B12. Thank you for your interest in my work.




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              1. You yourself admit that cyano-b12 is not the safest & most effective form of b12 for everyone. Common sense suggests hydroxocobalamin is superior to cyano-b12, since it has the added ability to bind cyanide which all of us can breathe in from second-hand smoke, exhaust fumes, etc. It’s so effective at binding cyanide that it’s used as an antedote in cyanide poisoning. Methylcobalamin & adenosylcobalamin also appear superior to cyanocobalamin, since they are already active and do not need to be detoxed to work for us. There are many who haven’t been able to sustain vegan eating, and maybe lack of active b12 is the reason, since most are getting their b12 as cyano-b12, either as supplements or in fortified food products. Please seriously consider altering your general recommendation on b12. Either way, thanks for all of your work!




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              2. I read both links but it still leaves most of my questions unanswered; namely is cyanocobalamin toxic as reported, how is it made, is mma testing sufficient for determining b12 levels, and if plant sources are deficient in b12 does it not prove that one is supposed to eat meat, and finally, if a herbivore (ie a cow) maintains adequate b12 levels where do they get it from if not from the bacteria on the plants ? Thankyou, in advance for you answers.




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              3. I read associated links provided (re elsewhere) and they fall short of any explanation to my questions.
                The link has not disproved aforementioned studies (re pub med) that cyanocobalamin is not toxic.
                In addition, no repudiation of the MIT study about b12 as a bacteria found on plants is the source of b12 that animals uptake but apparently humans do not for some unknown reason (though humans seem to uptake animal sources of b12 which they obtain from plants sources ..).
                The only explanation is that I cannot rely upon “chemiluminescence” to determine bioactivity . Hence the recommendation for b12 cyanocobalamin supplementation from non plant food sources (b12 is typically made from sewage).
                This only proves to me that vegans are deficient in b12 and cannot obtain it from plant sources unlike animals.
                Although I find this explanation lacking since animals obtain b12 from plant sources while apparently humans do not. Therefore are you able to address the non plant food cyanocobalamin toxicity issue and the failure of humans to uptake b12 on plants like animals can?
                You see I find it strange that animals can uptake b12 from plants though apparently humans cannot. Though there is overwhelming evidence that animal foods cause destruction of the human body’s systems that they clearly shorten human lifespan. Thus I believe that plants are the food that humans are designed to eat.
                Though this b12 issue makes no sense in that humans are unable to uptake b12 from plants. Therefore in light of the multitude of evidence that animal food causes pathological conditions to arise though humans do not uptake b12 from plant foods, this begs the question as to why humans are not getting b12 from plants.

                Personally, I theorise the the answer is three fold.
                One in that pesticides/herbicides are covering those plants preventing the bacteria from adhering to the plant or even kill them (including in the environment) .
                Two, that the artificial fertilisers etc used in modern agribusiness have destroyed/altered the microorganism environment that create the proper conditions for the bacteria to grow and thrive.(this includes water treated with chlorine, fluoride, etc)
                Three that current scientific knowledge is not sufficient to determine which form of b12 is the best form for humans to utilise including knowledge of how the human body functions as regards to b12 utilisation.

                Thus at this time there is not sufficient knowledge to understand the b12 situation properly.




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                1. Have you considered that humans were/are meant to consume lots of bugs and insects, worms, etc. that would be crawling all over their raw greens and fruit if it were not for modern day sanitation practices? And these insects, earthworms, etc. have ample B12 amounts, actually, quite high and noteworthy in crickets and mealworms, two insects that cattle and other grazing creatures in nature devour as the slurp up their greens in the fields. And maybe it isn’t that the animal foods are harming humans, it might be that the cooked animal foods/proteins are what is truly harmful, and that ingesting raw insects is something humans have been doing (and could not avoid!) for the majority of our existence. Raw insects, full of complete protein, blood, intestines, poo, pee, and B12 in large amounts, not small amounts. It is actually quite normal for all supposed non-meat eaters in nature to ingest these insects. It is who they are, and it is who humans are (were before the kitchen sink and supermarkets and recent agriculture practices.

                  Your thoughts.




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                  1. These animals/ insects are just getting the bacteria from the plants thus humans can get their b12 from plants too. Though because the water is; chlorinated, while plants are sprayed with petro chemicals (oil based ) pesticides etc, and the soil is pumped full of inorganic minerals destroying the micro flora (that create bacteria) bacteria that would normally be present with plants is destroyed. Thus eating animals/insects is like getting protein second hand from the plants where the original protein source comes from.
                    Though these sources because they are second hand are concentrated in various toxins thanks to the manipulation of crops and are concentrated sources of protein the human body reacts to by developing disease as a result. Thus the solution is not to eat the animals/insects but to figure out why bacteria is being destroyed on the plants humans eat while animals/insects are getting their nutrition from what they eat. In this way humans might learn not to destroy the environment by attempting to control it but rather to work with the environment in order to achieve a sustainable synergistic harmony with our environment.




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      1. I seem to recall that the type recommended for supplementation was methylcobalamin. I am confused now. Is CyanoCobalamin better than MethylCobalamin? What is the difference between the two?Thanks.




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        1. yes, we use transdermal patches that have 5 mg worn for 24 hrs twice a week . An integrative nutritionist in Canada has had success with B-12 transdermal patches and autistic children. The parents have reported it helps keep them less agitated .




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  9. Dr. Greger. Most of the cyanocobalamin on the market is recovered from activated sewage sludge or chemically produced. How can we tell if it’s from sludge or not. In this light, methylcobalamin seems a safer choice.

    Also I would hope that you would warn people off of vegetable sourced B-12.
    It’s an analog which blocks the uptake of true B-12, the result being that the body’s need for B-12 actually increases!




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    1. As I understand it, the claim that most cyanocobalamin is extracted from activated sewage sludge is just an internet myth.
      If you have any credible evidence to the contrary, I’d be interested to see it. By credible I don’t mean some quack, charlatan or crackpot with a website but a professional journal etc.

      If you are a full vegetarian, you don’t eat dairy because it comes with too much baggage – transfats, saturated fats, cholesterol, hormones and antibiotics. It’s far safer to just take a B12 supplement.




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      1. Thank you for your response and the information on spirulina. I was unaware of it.
        I often take a chlorella supplement so I’m concerned of it affecting my B12 absorption.




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  10. There are many conflicting reports as to the safety of high doses of B12. Some (like you) say it is perfectly safe. Others (like the Mayo Clinic) say it must be used with care in people who have dermatologic, urinary, gastrointestinal, hematological, and other issues. How can one tell who is right?




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    1. B12 supplements totally screwed with my body. Totally threw off homeostasis. Never been the same. Amnesia from
      methylcobalimin, heart stoppage from cyanocobalamin. Other issues as well. I am not the only one. How long have
      humans been popping a pill with no long-term health record, and a pill that contains an amount of B12 that the immune
      system has never had to register, up until this century?

      Read the research/comments (google) regarding horrible reactions to B12 supplements.




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  11. What are your thoughts for those of us vegans near & over 50? More than 2,500 mcg of B12 per week? Use the Hydroxo or Methyl forms? Are you a fan of either the Hydroxo or Methyl forms over the standard Cyano form? I would appreciate your thoughts. Thanks




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  12. I am over 50 and have a B12 absorption issue. I felt as if I had lightning bolts up and down my legs. My doctor recommended 5000mcg B12 every day. Is this over kill? It stopped the pains. Now I have a bunion that can become quite painful. Taking 10,000mcg every other day settles it down.

    Is this crazy or am I actually helping the nerve pains go away? Thanks!




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  13. Dr. Greger, you must know that I love the way you teach us. If you had been one of my professors in the university, be sure, that I would never have miss one of your classes, no matter if I were in labor. Margarita Sandoval.




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  14. Dear Dr. Greger,
    I’ve been vegan for the last 1.5 years and reciently got tested for B12 levels in blood. Turns out they came up pretty low, 250 pg/ml.
    I was wondering how much cianocobalamin should I take to boost B12 levels, and for how long.
    The cianocobalamin I could get comes in tablets (5 mg of cianocobalamin + vit. B6 and B1).
    Always following your amazing work.
    Thank you.
    Victoria.




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  15. Doc ,interesting video, however cyanocobalamin has two cyanide molecules that once bound to IF are routed to the liver for methylation-conversion to methylcobalamin the bioavailable form. Synthetic B-12 is actually harmful as it is synthetic B-9 folic acid. Those who suffer with MTHFR can’t process these synthetic vitamins and those who can are robbing from the methyl groups when they have a heavy load already due to our ever increasing toxic environment. Cyanocobalamin is actually banned in some foreign countries such as the UK. I love your videos on estrogen from animals so keep
    up the good work.




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    1. Is the methylcobalamin form of B12 something you consider as synthetic, and does this methyl-form of B12 also rob from the methyl groups, as you claim the cyanocobalamin form does? Thanks for feedback on this.




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  16. Hi, I have read pratically all the post, but I have not find good URL for cheap B12, I mean large supply for 1 years and up. Presently I use Jamieson B12 2,500 mcg sublingual and cost me about 20$ for only 60 capsules.

    Anyone can help me to find where to buy in bulk online ?

    Thank you !




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  17. i noticed in that diagram above, the gallbladder also has a part to play in the absorption process. does one have to up the b12 dosage or frequency of taking b12 tablets, if the gallbladder has been removed?




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    1. This should not be a problem. The only time the dosage needs to be adjusted up is when you have problems making intrinsic factor. Pernicious Anemia is an autoimmune condition which causes the loss of gastric cells which make intrinsic factor which gives us the 1.5 part of the equation in the video. Given individual variation it is always easy enough to get your B-12 level checked with other blood work.




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  18. I’m about to re-stock my Vitamin B-12 stash, and wanted to find out more about the cyanocobalamin vs methylcobalamin issue first. Since every one of Dr. Greger’s informative B-12 videos and articles seem to contain at least one question about the difference, efficacy, safety, etc, between the two types, I thought I’d share this except from an article on B-12 by Dustin Rudolph (the “Plant-Based Pharmacist”) that I found very helpful (the original article cites sources & includes links to additional info, which are not included here):

    “Cyanocobalamin is a synthetic version of vitamin B12. After ingestion, cyanocobalamin is broken down into the two active forms of B12 known as methylcobalamin and 5-deoxyadenosylcobalamin. The active form methylcobalamin is an essential co-factor in the production of healthy red blood cells. The other active form, adenosylcobalamin, is an essential co-factor in the maintenance of healthy nerve cells and healthy red blood cells. Because cyanocobalamin is broken down into both active forms of B12, it is the preferred supplement for use in healthy individuals.

    There have been concerns brought up by some individuals that during the metabolic breakdown of cyanocobalamin, cyanide is released as a byproduct. Cyanide can be toxic to the human body in large amounts. However, the amount of cyanide contained in a B12 supplement is not physiologically toxic to the human body. The only possible theoretical exception might be in patients who have kidney disease. Keyword emphasis on the word might. These patients have an impaired ability to clear cyanide, which could lead to elevated cyanide levels over time. A better option for those with kidney disease may be methylcobalamin due to this.”




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      1. our methyls groups are already being taxed to failure due toxins in food, environmental toxins, depleted glutathione levels, why pile on more work for the methylation groups, and this is not even addressing those with SNPs- Methylcobalamin is as cheap and in the form of transdermal applications higher in efficacy without the risk of dosage dumping.The other area Jack does not address is the Lock and Key fitting of synthetic vitamins.Methyl is the bioavailble form. By supplementing with transdermal nano patches you do not have to be concerned with problems in binding with IF (Intrinsic Factor) Many medications as well as PPI interfere with this so even if you are eating foods high in B-12 you still may suffer from malabsorption.




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      1. RD Jack Norris in fact makes a salient point that our methyls groups are already being taxed to failure due toxins in food, environmental toxins, depleted glutathione levels, why pile on more work for the methylation groups, and this is not even addressing those with SNPs- Methylcobalamin is as cheap and in the form of transdermal applications higher in efficacy without the risk of dosage dumping.The other area Jack does not address is the Lock and Key fitting of synthetic vitamins.Methyl is the bioavailble form. By supplementing with transdermal nano patches you do not have to be concerned with problems in binding with IF (Intrinsic Factor) Many medications as well as PPI interfere with this so even if you are eating foods high in B-12 you still may suffer from malabsorption.




        0
    1. This is perhaps an over simplification, the body is already under assault from environmental toxis and the vast majority of people are low on glutathione so to rob unnecessarily from the methyl groups by ingesting cyanocobalamin is at lt best counter production and at worst ( for those with polymorphism MTHFR) unhealthy.




      0
  19. Aloha Dr. Greger and Nutrition Facts Folks,
    We just heard Wednesday’s video (July 15) on B-12 and read all the comments beneath and we came away wondering about a few things. The B-12 that we take we buy from Dr. Goldhamer at TrueNorth. It is 1,000 mcg capsules of methylcobalamin – we wonder where does the methylcobalamin come from? Our understanding is that it is a bacteria – is this correct? What is the bacteria source? Also interesting to us was the discussion regarding blood levels of B-12 and whether that B-12 is actually being assimilated. Is there some reliable method for finding out whether your B-12 is adequate and whether it is being assimilated? And finally, are there food sources of B-12? Since the absence of B-12 seems at least in part to be caused by the fact that our plant food supply is overly sanitary wouldn’t organically grown mushrooms that aren’t “cleaned” be a source of B-12? We have other questions but this is a good start.
    Thanks,
    Jeff and Karen HaySanta Cruz, CA




    0
    1. Aloha Jeff and Karen! Thanks for reposting. B12 is super important. Adults needs roughly 2.4 micrograms per day. In supplement form it comes in higher doses. Any brand is fine and you can find cheap sources. Dr. Greger talks about exactly what B12 is in this video. You are right it’s a soil bacteria. Many people believe we obtain some from dirt but there is no strong proof of this, if any. From dietitian Jack Norris’s post: “Vitamin B12 is a complicated vitamin with a unique absorption mechanism and a number of inactive analogues (molecules that appear to be active B12, but actually are not) that possibly interfere with its function. Vitamin B12 is generally found in all animal foods (except honey). Contrary to the many rumors, there are no reliable, unfortified plant sources of vitamin B12, including tempeh, seaweeds, and organic produce.”

      We have tons of videos on B12, including the safest source where it mentions how we actually do produce B12 it’s just too far downstream to be absorbed.

      Check out more on Dr. Greger’s Optimal Nutrition Recommendations. And let me know when you have more questions so many folks here have solid answers and suggestions.

      Thanks,
      Joseph




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    1. How do you know it does not rob from the methyl groups? I appreciate your statement and the
      time you have taken to provide this, but I see no data or science that proves it either does or
      does not. Is this simply a theory of yours, and others? Thanks.




      0
        1. Just read it. Wondering what your thoughts are on hydroxocobalamin. I know people who have had real bad reactions to methylcobalamin, some who claim it might have irreversibly made their body worse. Who knows that high dose vitamin supplements can trigger, alter, change, in some people. We are not all the same, and our immune systems and homeostasis, in my opinion, can be altered/sensitive to these high dose and different forms of vitamins, methlcobalamin included. I did get better sleep with the methyl B12, but then it went in the other direction and things got way worse. Cyano form caused my heart to stop beating.

          Hydroxocobalmin is somewhat tolerable, at best, but none of these supplements have lowered my homocysteine and methylmalonic acid levels. Only shellfish have done that. Frustrating. You have any experience with the hydroxocobalamin B12?




          0
          1. Elsie , what dosage were you taking and how often? B-12 will remain in the liver for a period of time, My patients wear a transdermal patch one day a week. Those who have been tested with high Homocysteine levels have had reductions as well. Are you sure you do not have MTHFR? It might not be a bad idea for you to use Nano patches Because the patches bypass the hepatic pathway the efficacy is higher with safer smaller doses. These patches are used in clinics all over the world by Integrative and functional med docs. They resolve the dosage dumping issue by using a time release function. My email is dehealthflex@gmail.com http://www.drhealthflex.com/apps/webstore/products/show/4490694




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            1. Have tried all different doses, methods of administration, products/companies of methylcobalamin. I was open to trying out the supplement you suggested but I see it has a lot of other “not-natural” vitamins added to it. Thanks for your efforts.




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          2. Transdermal nano Patches have a higher efficacy with a smaller dose by virtue of bypassing the hepatic pathway and the time release function means you do not over saturate cell receptors giving you small doses through out the day, All our test have shown lower Homocysteine levels and methylmalonic acid.




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  20. Elise I produce transdermal patches with both forms- Methyl and Hydrox- Clinical evaluations have shown a much greater efficacy with Methyl




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  21. Dear Mister Greger and Team,
    an issue spinning around in my head for
    months now. It’s about vitamin B12. As an vegan I supply vitamin B12 of
    course but and this is the question, I never heard that people from
    India, Pakistan or Africa are supplying vitamin B12.
    Is there any study available?
    Or how do this people make sure that the not suffer from to less of it?

    I know that a bacteria living in a healthy earth is producing the vitamin B12, so when we eat some vegetable without washing we get enough vitamin B12. Unfortunately most of the earth ground is not healthy nowadays, because the farmers attitude to use them – no biological farming and more…
    also, where get the people there vitamin B12?
    And second question, could it be that the issue with vitamin B12 is the same as for example Vitamin C, that we have to have a lots of moire daily take in because the Vitamin is not natural? I read some studies that the body by himself decide how much vitamin he assimilate from the nutrition offer (for example from a apple the vitamin C) and it takes a lot of mote intake, when we use chemical vitamins???
    I hope you understand my “kauderwelsch Englisch”….




    0
  22. Hi Doctor Greger :) I have a question that might seem pretty darn obvious: Why can we not re-create or somehow emulate the conditions we had in the past when B12 was in our diet….? I mean, we have probiotics for when intestinal flora need a reboot…why cant we do the same for B12? Doesn’t B12 reside long-term in the liver? Thank you for your time!
    (I try to take a B12 at least once per month, and I have 1-2 Tbsp of nutritional yeast almost every day on my salad.)




    0
  23. Can someone please tell me were to buy a product that meets this recommendation?

    Cyonocobalamin, 2500 Mikrogramm, sublingual tablets.

    thanks




    2
  24. Dr. Greger,
    I started taking the B12 from nutrabulk.com and began having acne breakouts. Will you please consider doing a video comparing the different cobalamins and B12 supplements?




    0
  25. my bad,I may have mistaken this video with another, but in this video Dr Greger very clearly lays out correct dosage where as i guess some labeling is intended for those whos meat /dairy diet permits a much higher intake of B12 and therefore require a much lower level of supplementation .




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  26. Hi, I am Patrick Ritchie, from Montreal (Canada). What brand would you recommend? I found two available here: Land Art and SISU. Someone told me that Land Art has conservatives in it. I am open to suggestions :) Do you recommend a specific brand (available in Canada)? Thanks in advance!




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  27. In his book, How Not to Die, Dr. Greger’s recommendation for Vitamin B12 as cyanocobalamin is 250 mcg daily or 2500 mcg weekly for people under 65 years of age. For people over age 65, the recommendation is 1,000 mcg daily. Is there a weekly dosage for people over age 65, e.g., maybe 5,000 mcg — or should people over age 65 always take the daily dosage?




    0
  28. Hello Dr. Greger! I am in research mode since having an ah ha! moment and thought maybe you and your team could help me. I previously went vegan for 2 years and stopped after having severe acne breakout all over my face, neck, and chest. I had food intolerance testing done and found I was “allergic” to most things vegan (quinoa, almonds, legumes, soy, etc) and thought I couldn’t be vegan anymore. I went on a Paleo/Candida diet for 3 years – my skin wasn’t perfect, but my neck and chest acne was mostly non existent. Last year I just couldn’t take it anymore and went vegan again – regardless of the state of my skin, I just couldn’t eat animal products anymore. I eat a high carb low fat vegan diet as this allows me to stay away from my “allergens” and be vegan. Problem is I go through times of bad acne again – face, neck, chest. I have been bad for supplementing B12 here and there – would order transdermal patches then forget to order more, recently I have purchased injectable B12 and have been giving myself 1000 mcg IM, every week. I have just realized that my bad acne corresponds to when I take B12! I googled it (I know! thats why I need you) and found articles that show that acne bacteria metabolize it and create porphyrins that create inflammation, and can cause acne. So I have a dilemma of wanting to be healthy internally and take B12 (especially since I have Celiac Disease) versus being acne free and not being depressed and want to be a hermit. So I wonder if there is something I am missing – is their research to show that different types of B12 (cyan, methyl, etc) effect the acne bacteria differently? Or would taking smaller doses on a daily basis be better, etc.?
    Thank you for all that you and your team do! I wish I could find a doctor like you.




    0
  29. Hello — Dr. Greger mentions a 20 year supply of vitamin b-12 dosed weekly at 2500 mcg. At the time of the suggestion, he said it was around $3 a year.
    Can you please recommend a good source for 2500 mcg b12?




    0
    1. Today I came across this Nature’s Bounty B12 supplement from cyanocobalamin containing 2500 mcg in each tablet, just as Dr. Greger recommends. There are 75 tablets, which will last you a year and a half for less than $9. The formula is vegetarian/vegan. You can get it from iherb regardless of where you live.




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  30. Hey Dr. Greger,
    this b12 topic did not really had my attention for a long a time. I’m vegan for 2 1/2 years now and used to take some tablets but I stopped the package was finished, because I read so many controversial comments. Then when I thought I had a deficiency I wanted to try shots, as I wouldn’t have to take them daily and they will be absorbed to a higher percentage (at least what they told me). I did this and I think it worked, but every time I inject my 1000µg of b12 I get horrible breakouts, many little and bigger deap read spots on my forehead. People told me it’s because I have to much b12 and there is no other way for it to get out of the body then the skin.. But I’m not sure. When I took the tablets I didn’t have this problem. I think I ordered Methycobalamin for the shots.. can you help? Maybe the shot is not a high quality one or I just can’t deal with it?!




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  31. Dr greger. Thanks for what you -your videos have been an immense help to make my family responsible vegans! I have decided to take b12 supplement and was about to purchase cyancobolamin but then came across an article on natural news website about methylcobolamin being the best b12 and cyancobolamin containing cyanide. Can you clarify which one is best? Thanks. Elaine




    0
    1. I believe there is not much evidence suggesting methyl is any better. Cyano is much cheaper and more common, and because most people can easily methylate it and convert to the active form, it performs similarly in clinical trials, and hence there isn’t yet strong peer-reviewed, scientific data available yet for a methyl advantage for most people. http://nutritionfacts.org/questions/which-type-of-b12-is-best/

      I have also read (for example here- http://www.ncbi.nlm.nih.gov/pubmed/25117994) that Methycobalamin is not sufficient as a singular source of B12 as unlike hydroxocobalamin and cyanocobalamin, which can be split by the body into methylcobalamin and adenosylcobalamin, methylcobalamin is not converted into adenosylcobalamin.

      Other good reads here-
      http://www.veganhealth.org/articles/vitaminb12
      http://jacknorrisrd.com/what-b12-supplement-should-i-take/
      http://nutritionstudies.org/12-questions-answered-regarding-vitamin-b12/
      http://www.veganhealth.org/b12/rec




      0
  32. Dr. Gregger, in How Not to Die you state “there is insufficient evidence to support the efficacy of other forms, like methylcobalamin” and you recommend cyanocobalamin. I checked the references you provided and none mentioned cyanocobalamin or methylcobalamin (only cobalamin). Dr. Furhman’s daily supplement contains methylcobalamin and I wrote to him about it and their response was “it is the physiological form as opposed to cyanocobalamin.” What I have read about cyano- versus methyl- seems to confirm this. Can you please comment on cyano- versus methyl-. Thank you for all your great work! – David




    0
    1. I believe the main issue is that cyano is much cheaper and more common, and because most people can easily methylate it and convert to the active form, it performs similarly in clinical trials, and hence there isn’t yet strong peer-reviewed, scientific data available yet for a methyl advantage for most people. http://nutritionfacts.org/questions/which-type-of-b12-is-best/

      I have also read (for example here- http://www.ncbi.nlm.nih.gov/pubmed/25117994) that Methycobalamin is not sufficient as a singular source of B12 as unlike hydroxocobalamin and cyanocobalamin, which can be split by the body into methylcobalamin and adenosylcobalamin, methylcobalamin is not converted into adenosylcobalamin.

      Other good reads here-
      http://www.veganhealth.org/articles/vitaminb12
      http://jacknorrisrd.com/what-b12-supplement-should-i-take/
      http://nutritionstudies.org/12-questions-answered-regarding-vitamin-b12/
      http://www.veganhealth.org/b12/rec




      1
  33. Some on various internet forums say it’s not safe to use sublingual methylcobalamin supplements if you have mercury fillings. Is this true or false?




    0
  34. I read an article that said cynocobalamin is the cheap synthetic form and is actually bound to a cyanide molecule and that methylcobalamin is actually better. I found it disturbing since you said just the opposite in your book, can you help clarify this for me please?




    0
  35. I’m having such a hard time understanding the amount needed. If I buy a bottle of b12 pills that says “1200mcg” on the bottle, does that mean that the whole bottle contains 1200mcg of supplements, or each pill? Do I need to take two whole bottles per week? I really don’t get the conversion or what the measurement on the bottle means.. can someone please help me out?




    0
    1. Hello,

      1200 mcg per pill is what is almost always listed, I have never seen a supplement list the entire dosage from consuming the entire bottle. 1 pill every 2-3 days would be sufficient.




      0
  36. Well, the argument that cyanocobalamine is the cheapest may be true in U.S, but in France, for example, pharmacies propose you a bottle of 24 gelules of 250mcg B12-cyanocobalamine for more than 9€ (> $10)… Less than a month worth. Big pharma in Europe clearly doesn’t seem to make it easy for plant-based diet experimenters who have to find their supplements abroad.




    0
  37. Isn’t a combination of combination of Methylcolabamin and Adenosylcolabamin or Hydroxocolabamin a better choice of syntesized B12, rather than Cyanocolabamin? which isn’t an active form of B12 like the first two (aside from the cyanide component..)?




    0
    1. Hello Bogdan,
      I am a family physician in private practice, and a volunteer moderator for this website. Your question about which form of Vit. B-12 is the “better choice” needs to be qualified. Dr. Greger recommends cyanocobalamin because he is convinced it gives the “best bang for the buck”. The other forms you mention may well be better absorbed and more active than cyanocobalamin on a mcg for mcg basis, but they are FAR more expensive.

      I looked up “comparison B12 supplements” on PubMed to try to find articles addressing your question. I found this article, which studied elderly British patients, and found that fairly high doses of cyanocobalamin (1000 mcg per day) were needed to be sure to have effective levels of cobalamin in the blood (they used urinary methylmalonic acid concentration as their marker of effectiveness). But using these high doses was completely effective, and there were NO adverse effects noted in giving high doses. Had they used methylcobalamin (or another form), they probably could have used lower doses, but the cost would be way higher.

      I hope this helps to answer your question.




      1
  38. Dr Greger,

    Does it matter which brand or how the B12 is sourced for the tablets? i.e. is there any advantage of organic or ‘pure’ b12 synthesis? Alternatively, any 2500mcg cyanocobalamin tablet will suffice?

    Thanks,
    Derek.




    0
  39. Does anybody have an idea why one might get tired a few hours after taking a B12 supplement for a full 24h? As far as I know B-Vitamins in general decrease fatigue and tiredness or is it possibly triggering a sleep deficit which would need to be balanced out to return to the ‘normal’ effect B12 should have? The supplement I’m using is the synthetic version and contains 25 micrograms if that might have anything to do with it. Also, is it true that B12 can be stored for up to 3 years in the body when there was a constant supply before?
    Thanks in advance for your help, Steven




    0
    1. Hi Steven: To my knowledge, B12 should not make you feel tired. Are you certain it’s related to taking the supplement? Is there anything else going on that would make you feel this way?
      A few things that come to mind:
      Are you getting plenty of sleep?
      Managing stress well?
      Consuming a healthy diet?
      Getting adequate exercise?
      Staying hydrated with water?
      If you’re still concerned, it’s best to discuss with your doctor to determine if there’s any underlying condition that might be making you feel fatigued. For reference, Dr. Greger recommends 2,500 mcg of vitamin B12 (cyanocobalamin) at least once a week.




      0
  40. I am seeing a lot of articles on the net saying spirulina is rich in B12, I haven’t found any sound articles on this though?




    0
  41. In Dr. McDougall’s latest newsetter (April 2017), he recommends against taking cyanocobalamin as an option for B12 supplementation because of its trace amounts of cyanide. He recommends methylcobalamin, adenosylcobalamin, hydroxycobalamin. Do we know if Dr Greger shares these concerns or if he has changed any of his recommendations since this video?

    Thanks




    2
  42. Once we take a B12 supplement, how long does it take for our receptors to absorb the 1.5 mcg of B12 and be available to absorb another dose again?




    0
    1. Hello Nicole! Im a nutritionist and a moderator of NF team. Our body can only absorb 1.5 mcg of B12 each meal. Takes few hours to absorb it. The best way to take B12 is by large doses 2000-2500 mcg each week.




      1
  43. Hello,

    This is an amazing resource. Thank you, Dr. Gregor for your dedication to health!

    Question – Is it safe to ingest B12 pills that contain silica? it’s difficult to find 2500 mcg doses of B12 ( I am standing in front of a wall of vitamins at sprouts groceries in so cal and majority of B12 pills come in 2000 or 1000 mcg doses) and the one bottle of 2500 mcg B12 that I can find contains silica.

    Your expert advice is much appreciate!




    1
    1. Hello, Yang!

      This is not Dr. Greger himself, I’m just a moderator :) Silica is used in supplements to prevent the ingredients from sticking together. It has a low bioavailability, meaning your body will only absorb just a small amount of it. And there is already small amount in the supplements. It’s totally safe to ingest. Actually, it’s found naturally in many plants! The only danger could be in inhalind it ().

      Have a nice day!




      0
    1. The recommended daily dosage for 3 years old kid is 0.9mcg and 1.2mcg for 5 years old. It’s always a good idea to consult these things with your doctor.




      0
    1. Hey John,

      it may be because of some additive in the supplement you are taking. It could also be side effect of the B12 itself, but nausea usually occurs with cyanocobalamin injections.




      0
  44. I need to get a B12 supplement since I am vega, I thought i was getting enough through my fortified soymilk, but it appears i am not. I got on-line to look for B12 supplement but there is so much out there. I don’t want with lots of stuff like mannitol, sorbitol, etc. What do you recoomend- are there a few products that have the least amount of stuff added?




    0
  45. Hi Sharon,

    I am a volunteer for Dr. Greger. Thank you so much for your question. I agree that a lot of the supplements out there have a lot of junk in them. They use fillers because 2,500 mcg of vitamin B-12 is an incredibly small amount (about the size of 4 tiny little grains of sugar). The pills would be too small. However, even the pills that do contain those fillers, are usually in very small quantities that it won’t make much of a difference anyways. I don’t know of any brands that use only healthy ingredients as fillers, but since the quantities are so small, I wouldn’t worry much about it. But if you do find a good brand, feel free to let us at NF.org know!




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  46. If Dr. Gregor is all about promoting a vegan lifestyle, he needs to make it very clear what the best forms and manner of taking b12 would be. You can see many questions have been asked and not definitively answered with regard to this issue. Most people are less concerned about cost than effectiveness, and safety. Patches, methyl. Cyano, hydroxy, etc? Because of the dangers associated with B12 deficiency is of primary concern when adopting a vegan diet, Dr. Gregor and his associates need to be very clear on the best sources and manner of supplimementation. I would like to see more definitive, research-based information as to what forms and amounts are most effective for reduction of homocysteine levels. If we are biologically and evolutionarily wired for a vegan diet, why the chronic deficiency problem from not using animal products. I am curious whether gorillas, as vegans, for example, suffer from B12 deficiency.




    0
    1. Hey, Rolf,

      I think it’s safe to take a B12 supplement. Please note that more than 3,200 of the men involved in the study were current smokers, 139 of whom already had lunch cancer. Also the D’Ambrosio, of Dietetic Directions and spokesperson of Dietitians of Canada, said this: “The researcher I would say is a low-grade cohort study, and again we’re at no place to state that vitamin B12 or B6 causes lung cancer,” so don’t smoke and don’t exceed dose 20 miligrams of B6 and 55 micrograms of B12 per day and you should be fine :) High doses of B6 should be avoided anyway, since they could lead to nerve damage. So it may be similar to betacarotene. Betacarotene increase the risk of getting lung cancer if you are a smoker. Yet we don’t consider betacarotene to be dangerous.

      Hope this helped,

      Adam P.




      1
      1. Hi Adam,

        in this study 55µg/day od B12 is considered a high dose.
        Dr. Greger recommends taking at least 2500µg per week, which is 357µg/day, which is 6.5 times more than what is considered a high dose.
        Also the study says, the lung cancer risk is doubled for non-smokers.
        So I think this is highly relevant. I would appreciate a reply or video of Dr. Greger on this topic.

        Best regards,

        Rolf




        1
        1. I am also highly concerned about this study, Rolf. As you point out, not only is The recommended dose by Dr. Geller much higher than that used in the study, the study cannot be dismissed based on the fact that some were smokers, because incidents of lunch cancer were higher among non-smokers taking b12. There is a worrisome trend on this site to quote only studies that agree the beliefs put forth, and poo poo studies that contradict claims. Surely any reliable site has to honor new and contradictory studies, rather than stubbornly defending stated positions. I also would very much like to hear from the doctor directly concerning this new study rather than being referred to statements made by Dr. Geller prior to this study. Is there ever going to be an admission that prior statements may have been incorrect? If no, I can hardly consider there to be a respect for developing science with regard to vegan health. And since many people who are not vegan are subjected to foods fortified with b12 this is a risk to everyone. If the study is flawed, let’s hear how?




          1
        2. I just read details of the study…it is not correct that non smokers had a greater risk…and the risk did not extend to women. There seem to be too many variables in this study…smoking, nine smoking, other vitamins with b12…and it says high doses…I’m not sure what you stated is accurate, Rolf.




          1
          1. Hello Susan,

            where did you read that non-smokers had no higher risk of lung cancer?
            I read that both, smokers and non-smokers had a higher risk of lung cancer, but the increase in risk for smokers was higher.

            Best regards,

            Rolf




            1
            1. I misunderstood what you said…you said non smokers where twice as likely to get cancer and I interpreted that to mean twice as likely as smokers, but I think you meant those non-smokers who take vitamin b12 were twice as likely as non-smokers who didn’t take b12 to get cancer. Is that a correct restatement of what you meant. What I read did not include the actual dosage, it just said extremely high dosage, but you said only 55 micrograms which doesn’t strike me as high, especially when bioavailable b12 would be much lower due to metabolization. I’ll try to find a more detailed description of the study. Thanks.




              1
    2. Results
      Use of supplemental vitamins B6, folate, and B12 was not associated with lung cancer risk among women. In contrast, use of vitamin B6 and B12 from individual supplement sources, but not from multivitamins, was associated with a 30% to 40% increase in lung cancer risk among men. When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline. In addition, the B6 and B12 associations were apparent in all histologic types except adenocarcinoma, which is the type less related to smoking.




      1
  47. I switched from Paleo to WFPB and am just getting started. Your research is very compelling so I’m expecting very good results. Regarding the B-12 I was checking out my B-12 vitamins and the ingredient was Methylcobalamin, not Cyanocobalamin. I did a google search and it said that the former is the better version. what are your thoughts?




    1
    1. Christine Wilke: Dr. Greger once wrote the following: “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.”

      Dr. Greger also has an ‘Ask The Doctor’ page on B12 on this topic:
      https://nutritionfacts.org/questions/which-type-of-b12-is-best/

      Good luck with your journey!




      1
    2. Thanks for your question,

      Like Thea stated, I agree.

      “To meet the daily requirement of Cbl, one oral dose of 50–100 μg daily or 2000 μg weekly divided into two oral cyanocobalamin doses could be sufficient to meet the needs of 2.4 μg/day for healthy vegetarian adults, taking into account the efficiency of absorption and the passive route.(…) Cyanocobalamin is the most economical—and historically the most used form—rendering it suitable for safe daily use [45]. There were no apparent substantial differences between the absorption of sublingual and oral forms [152,206]. However, oral dissolution could be critical in the secretion of the salivary R-binder and its subsequent bond. Since the Cbl would not be dissolved, about 88% could be not absorbed [54]. Since the development of a Cbl deficiency can also be observed among the LOV, the use of a supplement is necessary, regardless of the type of vegetarian diet” (see here).

      Hope this answer helps.




      1
  48. Yes: wrong conclusion. This was one study and most of the subjects were smokers. B12 is only needed for those eating a WFPB diet (or others that are deficient). The other issue is that the increase in cancer risk was for supplementation over something like 55mcg per day. You can’t absorb this much B12, so you can do what I do: buy liquid B12 and dilute it down so you’re taking less than 55 mcg per day.

    Dr. Ben




    0
    1. I would like to hear a recommendation of a doctor, not of a moderator of an internet forum. I would highly appreciate it, to get a response from Dr. Gregor.




      0

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