40% of Us Are Vitamin B12 Deficient. Are You?

Via Dr. John Douillard
on May 30, 2013
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If there ever was a heart-mind vitamin, then B12 is it.

Synthesizing neurotransmitters that govern mood, energy, sleep, appetite and motivation all the while supporting heart and circulatory health, B12 is a brilliant multitasker and not a vitamin to ignore.

Yet, Tufts University reported that at least 40 percent of the population is B12 deficient (1). Vegetarians, the elderly and those on long-term use of medications are at much higher risk for deficiency (2).

Moreover, many subjects who tested normal for B12 levels experienced a therapeutic effect when supplemented with B12. Could the bar for normal vitamin B12 levels be too low?

Learn how one amazing vitamin can help support your heart and mind, where to get it, how to absorb it, and how to make sure you’re getting the most active form.

B12 Supports Mind and Mood

The main function of B12 is to support the nervous system while maintaining healthy brain chemistry and synthesizing neurotransmitters like dopamine, serotonin and epinephrine. These govern mood, energy, sleep, appetite, drive, motivation, movement, cognition and numerous other brain functions.

Studies have shown that certain people with “resistant” mood issues responded well to B12, B6 and folic acid (3). One study reported that 50 percent of the subjects with mood issues were also deficient in vitamin B12.

B12 Supports a Healthy Heart

Low levels of B12, folic acid and B6 are linked to high levels of the amino acid homocysteine, which can negatively alter a healthy inflammatory response. The relationship between B12 and homocysteine is so strong that measuring homocysteine levels is considered one of the tests to measure B12 levels.

While its ability to support mood, sleep, energy and a healthy nervous system is amazing, perhaps its most valuable function concerns the heart. High levels of homocysteine may compromise heart health (4). The most active form of B12, called methylcobalamine, is essential for converting homocysteine into methionine (a naturally occurring amino acid) through a process called methylation. As B12, folic acid and B6 are required for this conversion, they work in concert to lower homocysteine levels. New studies reveal that high homocysteine levels are also elevated in the case of mood issues (5, 6).

Fruit in the shape of a heartWhy Are We Deficient?

It is difficult to detect a B12 deficiency, because the related health issues may not appear for some five to six years. Another problem is that a serum blood test for B12 is not a foolproof test. Even the most accurate way to access B12 levels is somewhat unreliable.

When you combine the facts that many people have stopped eating red meat (which is high in B12), that B12 is a large, bulky and hard-to-absorb vitamin, and that few have the digestive strength to absorb B12, you can understand why this has become a national health issue.

Some of the foods richest in B12 are meat, fish, eggs and dairy, which is why vegetarians and vegans are at such great risk for B12 deficiency. Vegetable sources do exist, but there are not many of them. Sea vegetables, brewer’s yeast, soybeans, hops, and alfalfa offer small amounts of B12 (7). It is also believed that a healthy large intestine will synthesize B12 naturally, which is why I am such a stickler for restoring optimal digestive health without relying on enzymes, laxatives or a restrictive diet.

Weak Digestion Makes For Poor Absorption of B12

Dietary B12 is released from certain foods in the stomach by hydrochloric acid (HCL). If the digestive acids are low, then B12 absorption is also low. When HCL levels are optimal, the stomach’s parietal cells produce a protein called the intrinsic factor. This protein attaches to the free B12 and carries it to the distal part of the small intestine, where it is then stored in the liver.

As we age, digestive strength typically weakens and the production of the intrinsic factor decreases, causing the utilization of B12 to plummet. While I don’t believe this necessarily has to happen, seniors are at significant risk for this reason.

What Type of B12 is Best?

Perhaps the most common form on the market today is cobalamin. While it is the most inexpensive form, it is not the most active. Cobalamin must be converted to methylcobalamin, which is the most active form.

For years, B12 injections were in fashion for boosting energy. It was understood that absorption of B12 orally in the cobalamin form was low. In fact, some studies showed that people who took cobalamin for years still tested low for B12 (8). Today, methylcobalamin exists in a highly absorbable sublingual form. This accomplishes two things that have changed the culture around B12 deficiencies:

1.    Because sublingual B12 (along with folic acid and B6) absorbs through the thin permeable mucous membrane under the tongue and bypasses the digestive system, the adequate production of the intrinsic factor—which decreases with age, poor diet and medications—is no longer an issue. Sublingual pathways provide an alternate absorption route for absorbing B12 directly into the bloodstream.

2.    In addition, adequate amounts of folic acid, B6 and a mood supportive chemical called SAMe are all needed to convert (or methylate) the cobalamin into methylcobalamin. Using the methylcobalamin form sublingually, this cumbersome process of activating the B12 is already accomplished. B12, folic acid and B6 also help increase the production of SAMe (S-adenosylmethione), which in one study was shown to support healthy moods (9). The sublingual form of B12 (methylcobalamin) is an effective delivery system for this vitamin.

Facts about Optimal B12 Levels

•    B12 supports healthy immunity and natural killer cell activity (10).

•    B12 stimulates the release of melatonin—the sleep hormone—from the pineal gland (11).

•    Patients with cognitive issues may have decreased the amount of B12 in their cerebrospinal fluid (12).

•    B12 supports antioxidant activity (13).

•    Please Note: It is best if B12, B6 and folic acid are combined in a sublingual form because they are synergistically active. Each vitamin can be toxic if taken on its own at very high levels.


1.  www.ars.usda.gov
2.  Balch, Prescription For Nutritional Healing. 4th Edition. Avery, 2006:p.20-21
3.  Morris MS. Nutr Clin Care. 2002 May;5 (3):124-32.
4.  Balch, Prescription For Nutritional Healing. 4th Edition. Avery, 2006:p.20-21
5.  Balch, Prescription For Nutritional Healing. 4th Edition. Avery, 2006:p.20-21
6.  Homocysteine Studies Collaboration. JAMA. 2002 Oct 23;288 (16):2015-22.
7.  Bottiglieri T, Laundy M, Crellin R, Toone BK, Carney MW, Reynolds EH. J Neurol Neurosurg Psychiatry. 2000 Aug;69 (2):228-32.
8.  Balch, Prescription For Nutritional Healing. 4th Edition. Avery, 2006:p.20-21
9.  Papakostas GI, Alpert JE, Fava Curr Psychiatry Rep. 2003 Dec;5(6):460-6.
10.  Tamura J. et al. 1999. Immunomodulation by B12.Clin Exp Immunol 116:28-32
11.  Kamgar-Parsi, et al. 1983. Sleep, 6:257-64
12.  Eastley R, 2000. Int J Geriatr Psychiatry 15:226-33
13.  Parnetti L,. 1992. Mol. Chem Neuropathol 16(1-2):23-32


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Ed: Brianna Bemel


About Dr. John Douillard

Dr. John Douillard, DC, CAP is a globally recognized leader in the fields of natural health, Ayurveda and sports medicine. Over the past 30 years, he’s helped over 100,000 patients repair their digestive system and eat wheat and dairy again. He is the creator of LifeSpa.com, a leading Ayurvedic health and wellness resource on the web with over 6 million views on YouTube. LifeSpa is evolving the way Ayurveda is understood around the world with over 1000 articles and videos proving ancient wisdom backed by modern science. Dr. John is the former Director of Player Development and nutrition advisor for the New Jersey Nets NBA team, author of six books, a repeat guest on the Dr. Oz show, and has been featured in Woman’s World Magazine, Yoga Journal, the Huffington Post and dozens of other publications. ----------------------------------------------------------------------------------------------------- Receive his valuable health reports in your inbox - sign up for free! ----------------------------------------------------------------------------------------------------- For information on Dr. John's newest book, Eat Wheat, please visit eatwheat.lifespa.com, LifeSpa.com and connect with Dr. Douillard on Twitter, Facebook and YouTube. ----------------------------------------------------------------------------------------------------- Eat Wheat is now available in bookstores. It can be ordered from Amazon, eatwheat.lifespa.com and all major booksellers.


12 Responses to “40% of Us Are Vitamin B12 Deficient. Are You?”

  1. Erin says:

    Can you get the sublingual b12 over the counter?

  2. Platofish says:

    Yes, its common in any pharmacy that carries a range of vitamins, or even in places like Costco.

  3. Ellen says:

    At age 41 I began having parathesia from my hips down, and lost proprioception so needed canes to get around and could not drive as I could not feel the pedals under my feet. A neurologist diagnosed me with MS, which was frightening. My blood showed no signs of pernicious anemia so he refused to consider B12 deficiency. My husband and I researched and found a description of combined system disease – neurologic symptoms of B12 deficiency without blood evidence. Our family doctor was amenable to giving me injections as "it can't hurt" and my neuro symptoms disappeared. We learned from another doctor that the hypersegmented neutrophil test is another way to diagnose B12 deficiency. When tested, mine was 24% (<10% is normal). 23 years later, with supplemental B12, I am doing well.

  4. Kate says:

    You say 40% of us are Vitamin B12 deficient, but you don't tell us what an optimum level of this vitamin is. Or what is a deficient level.

  5. Tanya says:

    In injection form what is the difference between cyanocoblamin, Hydoxocobalamin. methycobalamin?
    Which in your opinion is the best. Thank you for a reply.

  6. Anna says:

    I had my ACTIVE B12 tested and it was 69 pmol/L, would this suggest my B12 is normal, and not to blame for my burning feet? Can you say what a normal ACTIVE B12 level is?

  7. Susan says:

    Yes, Jameson makes it. I have trouble swallowing pills so this is perfect. I can get it at the supermarket.

  8. Susan says:

    I googled it and found this from Medline plus "Values of less than 200 pg/mL are a sign of a vitamin B12 deficiency. People with this deficiency are likely to have or develop symptoms. Older adults with vitamin B12 levels between 200 and 500 pg/mL may also have symptoms."

  9. Charlotte says:

    Not sure if this helps or you are interested but I recently heard about a new oral prescription alternative to the injections called Eligen B12. I read that it works even if you don't have intrinsic factor (so even if you don't have normal gut absorption). Apparently it came out a month or two ago

  10. Charlotte says:

    For those struggling with B12 deficiency, I recently heard about a new oral prescription alternative to the injections. Has anyone heard of it, it's called Eligen B12? Apparently it works even if you don't have intrinsic factor (so even if you don't have normal gut absorption). I think it came out a month or two ago

  11. Lonnie D. Chasteen says:

    We may have to face various diseases if we become deficient of vitamin B12. We may face diabetic, anemia, psoriasis or many other diseases both mentally and physically. Weakness, fatigue, pale skin is the most common symptoms of being deficient of vitamin B12.

  12. Rachel says:

    I also want to know the answer to what a normal ACTIVE B12 Level is as I have a level of 66 but still have all the symptoms of B12 deficiency