What B12 Supplement Should I Take?
Question:
What B12 Supplement Should I Take?
Answer:
I get this question all the time, so I finally decided to write up a blog post to point people to.
Cyanocobalamin
Cyanocobalamin is the most common form of B12 supplement and is the form found in fortified foods. It doesn’t occur much in nature, but it is the most stable form of vitamin B12, and the cheapest. It has been the most studied form and has consistently been shown to be effective. Unless there are extenuating circumstances, I recommend that people take cyanocobalamin as their B12 supplement.
Cyanocobalamin contains a molecule of cyanide, but the amount of cyanide in cyanocobalamin supplements is so small as to be physiologically insignificant (more info).
Some people have cyanide metabolism defects, and they should not take cyanocobalamin. If you are asking yourself right now if you might be one of those people, you can assume the chances are close to zero.
People with cyanide poisoning should not take cyanocobalamin. If you have not previously suspected that you might have cyanide poisoning, then you can assume you don’t have it.
People with chronic kidney problems should probably take a non-cyanocobalamin form of B12 (more info).
Finally, cigarette smokers might want to take a non-cyanocobalamin form of vitamin B12 as they can build up cyanide in their system. This is theoretical – I have never come across a vegan cigarette smoker who reported vitamin B12 deficiency based on taking cyanocobalamin and the Institute of Medicine has concluded that “The effect of smoking on the B12 requirement thus appears to be negligible (1).” (More info.)
Methylcobalamin
Methylcobalamin is one of the two co-enzyme forms of vitamin B12, the other being adenosylcobalamin (known by many other names, including “dibencozide”). When I first got into the B12 issue, dibencozide was all the rage, now it’s methylcobalamin for some reason. The two forms have different functions in the body and both are necessary (more info).
Methylcobalamin is promoted by some alternative health practitioners and the supplement industry as superior to cyanocobalamin, primarily because it is a co-enzyme form of vitamin B12.
Based on many studies and case reports in the scientific literature in which cyanocobalamin has successfully cured vitamin B12 deficiency, it appears that the body can convert cyanocobalamin into methylcobalamin without any problem. The body also has to convert methylcobalamin or cyanocobalamin into adenosylcobalamin for B12 to carry out all of its functions. (A fourth form of vitamin B12, hydroxocobalamin, is the form typically found in animal products and B12 injections; it must also be converted into the co-enzyme forms.)
But is there any harm in taking methylcobalamin over cyanocobalamin? Probably not, but methylcobalamin is thought not to be as stable as cyanocobalamin and therefore higher doses are recommended, a minimum of 1,000 µg per day. Recommendations for cyanocobalamin are much lower (more info).
I must admit that I’m a bit wary of methylcobalamin supplements. They are not regulated with any significant scrutiny. Cyanocobalamin supplements are ubiquitous, cheap, and well-studied, while methylcobalamin is much more of an unknown entity. Unless you have a good reason to be using methylcobalamin, I recommend cyanocobalamin.
Living Food Vitamin B12
Some companies claim to have a natural, living, plant, or raw source of vitamin B12. The B12 can come from seaweed or other unstated sources. Unless a label lists the source of vitamin B12 as cyanocobalamin, methylcobalamin, adenosylcobalamin, or hydroxocobalamin, I would not rely on it.
Specific Brands of Vitamin B12
I do not have recommendations regarding any specific brands of vitamin B12 supplements. As far as cyanocobalamin goes, I assume all sublingual or chewable tablets to be effective. I do not have an opinion on B12 skin patches or sprays.
As far as methylcobalamin supplements, as I stated above, I’m not as confident about them, and I have no opinion on any specific brand name.
Are B12 Supplements Vegan?
Yes. (More info.)
References
1. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press; 2000.
December 31st, 2012 at 3:31 pm
Hi Dr Norris,
Thanks for this valuable resource, and this useful information (and for your book
Do you have any recommendations for infants and babies? None of the common multivitamins (say Pentavite) contain any B12. They all have an incredibly strong flavor – I’ve also tried Metagenics Multicare for Kids but the taste is so strong I can’t get it into my kid.
So I’ve resorted to grinding up a small amount of a regular sublingual B12 tablet, sticking it on the end of my finger and poking that into his mouth. He doesn’t mind this
Thanks again!
December 31st, 2012 at 3:34 pm
Troy,
The link in the post to the B12 recommendations gives amounts for all ages. You can mix the B12 in with your son’s food. What country are you in, btw? I’ve never heard of a multivitamin not containing vitamin B12.
December 31st, 2012 at 6:22 pm
Thanks, Jack, for the reply – sorry, my question was vague
my query is actually if you knew of a particular form that is usable for infants.
I am in Australia. Since my wife is non-caucasian, she was mildly low in vit D, so health service here suggest Pentavite (http://www.bayer.com.au/scripts/pages/en/bayerrsquos_products/index.php?aktion=details&id=349&l1=Bay) It’s easy to apply as a liquid with a little plunger to squirt into the mouth. It has a rather stark saccharine orange flavor, but it’s usable, but as mentioned, no B12. I did not find an alternative in a similar form.
A naturopath/nutritionist at my local health store suggested Multicare for Kids (http://www.metagenics.com.au/products/multi-care-kids-170-g-powder-orange-flavour), which comes in a powder form, intended to mix with water, suggesting I mix it into some food. Again it has a rather intense orange flavor, so I can get away with some of it in mango, but can’t really get much of it into him. (After tasting it, I can’t blame the little guy!)
He is eating solids and still breastfeeding, so I know he should be well covered, but obviously I want to be doubly sure. I put a little Vitashine D3, a little Opti3Omega in food, which is easily masked, and the crushed tablet for B12. I have been putting nutritional yeast in some things too. I may go back to the Pentavite for other coverage. I think this is about the best solution now.
January 1st, 2013 at 7:17 pm
Wow, I was literally just getting ready to purchase this: http://store.veganessentials.com/vegan-vitamin-b-12-spray-by-nutrasumma-p3221.aspx for myself and my nearly 3 year old child when I flipped tabs to read this article. The product has all three forms of b12 in it. Sorry for asking you to “hold my hand” through this, but do you think such a product would be fine for usage by my small child?
Thanks!
January 1st, 2013 at 7:58 pm
michael,
Obviously, if you read my post, you should know that I don’t think anything but cyanocobalamin is necessary. Here is a link to the amounts of B12 I recommend for people of various ages:
http://veganhealth.org/articles/dailyrecs
The supplement in question contains more than I recommend for 3-year olds for a daily dose. However, the only known harm from high dose vitamin B12 supplements are rare cases of acne-like symptoms that resolve upon ceasing the high doses.
I make a point of not telling people what products they should buy to meet the recommendations I give. In this case, the product meets my recommendations and then some.
I hope that helps.
January 4th, 2013 at 6:37 am
Thank you for this great summary.
I’m coming up on 5 years of eating vegan, and just a few weeks ago I bought methylcobalamin for the first time, after years of exclusive cyanocobalamin B12 supplementation.
I was lured in by the slick marketing text! Thank you for the reality check. My old routine was apparently more than sufficient!
January 5th, 2013 at 11:42 am
I read that some nutritional yeasts are sufficient for B12. Is this so?
January 5th, 2013 at 1:43 pm
Rochelle,
See this link:
http://veganhealth.org/b12/vegansources#yeast
January 5th, 2013 at 2:08 pm
I read that cyanocobalamin was not a good idea if you have kidney problems. Can you comment?
Thanks.
January 5th, 2013 at 2:35 pm
Thank you that was helpful. Been vegan since May and relying on RedStar nutritional yeast for B12 plus multivitamin. I believe I have much better nutrition now as I never paid attention b4, and now I must. Let alone benefits to animals and planet. But thx for sharing your knowledge. I appreciate your contribution.
January 6th, 2013 at 9:36 pm
Ilene,
I should have mentioned that. I’ll add it to the article. Here is more info:
http://veganhealth.org/b12/nocyano
January 9th, 2013 at 3:52 pm
My supplement says “Vitamin B12 (as cobalamin)” – no methyl, cyano, or anything else. What the heck does THAT mean?
January 9th, 2013 at 5:16 pm
Michelle,
As long as it doesn’t come from a “natural”, “living”, “raw”, or “plant” source, it is probably cyanocobalamin and is fine. If it comes from any of the sources I mentioned in quotes, I wouldn’t rely on it.
February 20th, 2013 at 11:43 am
Hello Jack,
I would like to ask about Minimal Risk Level for oral cyanide. I ‘ve read the reference 7.
Opinion of the Scientific Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food (AFC) on hydrocyanic acid in flavourings and other food ingredients with flavouring properties. The EFSA Journal (2004) 105.
At bullet 21, says than the dietary recommended intake is 12μg/kg which is mush lower than the 0,05mg/kg.
Which limit should we use?
What’s your opinion?
Thank you.
February 20th, 2013 at 11:48 am
Jack,
The bullet of the statement is 27
February 20th, 2013 at 7:51 pm
Konstantinos,
Is looks like they consider .05 mg/kg to be the limit for what humans should ingest on a daily basis. See bullet 29.
February 27th, 2013 at 1:54 am
Thank you Jack for your answer,
I ‘ve purchased your book and I am reading it carefully.
It’s a great, great, great book!
Congratulations for your work.
Greetings from Greece.
May 21st, 2013 at 12:37 pm
Your opinions (and that’s all they are) on methylcobalamin fly in the face of many studies on it. Do your research people, he is wrong!
May 21st, 2013 at 12:48 pm
jd,
If you know of some actual peer-reviewed clinical trials comparing methylcobalamin to cyanocobalamin that you can cite to show I’m wrong, I’d be happy to see them. I don’t know of any myself. If methyl- is better than cyano-, then I’d be happy to embrace methyl-. I couldn’t care less which is better, but I want proof, and a “Do your research” statement is less evidence than what I’m basing my opinion on.