B12… Not Always Created Equally


B12 is important to build red blood cells and nerves. It also supports proper DNA development. Most individuals who are vitamin B12 deficient on lab work, have  some preexisting condition, such as gastritis, auto immune disease, take multiple medications that deplete b12 stores or are malnourished.  Vitamin B12 tests are not the most accurate way of telling how the cells are utilizing b12, or if they are utilizing it at all. So, in fact individuals with adequate numbers on lab work could actually be deficient.  In the presence of MTHFR, B12 can look adequate or even elevated on lab work but be completely depleted inside the cell where the B12 is needed most.

Experiencing any of the symptoms on this list could mean there is a B12 deficiency in the body

  • Light-headedness, tiredness and fatigue
  • Shortness of breath and elevated heart rate
  • Poor concentration and memory
  • Tingling and numbness of the feet and hands
  • Lack of coordination and balance
  • Diagnosis of persistent anemia
  • Excessively pale skin
  • Sore tongue
  • Rash around the mouth
  • Bleeding gums and easy bruising
  • Upset stomach
  • Abnormal weight loss or gain
  • Hallucinations, depression, mania and irritability

Adequately Inadequate vitamin B12 intake

For individuals with a MTHFR mutation, B12 absorption and utilization is faulty. Individuals with any issue with digestion B12 absorption are impaired. In order to make the proper amounts of stomach acid, B12 is needed as a cofactor. Without this digestion IS impaired. Vegan and vegetarian diets are deficient in B12, posing a greater risk of deficiency in individuals with MTHFR, this can lead to other nutrient deficiencies and health problems.

The best foods for boosting B12 are

  • Clams and beef liver
  • Eggs, fish, poultry, meat, milk and other dairy products
  • Nutritional yeasts, some cereals and other fortified foods

Suspect B12 deficiency with any of the conditions listed


  • Anemia with elevated mean corpuscular volume or Pernicious anemia
  • Balance issue, numbness, difficulty with walking, tingling and other neurological symptoms
  • Gastritis, Celiac Disease
  • Food sensitivities
  • Alzheimer’s disease and dementia
  • Any chronic inflammatory bowel disorder
  • Vegetarians and vegans
  • Autoimmune disorders
  • Developmental delay and autism
  • Use of “poly pharmacy” drugs such as SSRIs, Metformin and PPIs
  • Vascular disorders such as blood clots, stroke or heart attack

B12 deficiency…all B12s are not created equal

It is important to understand that treatment is not a “one size fits all” approach. Not all B12 will react the same in each body depending on SNP expression; there are the 4 Types of B12. Of course its optimal to get the bulk of B12 from the diet, however in cases of deficiency or unrelenting symptoms proper supplementation can help.

Adenosylcobalamin is naturally occurring, but, it is the least stable of the four types of B12 outside the human body and does not translate well into a tablet-based supplement. This is best for individuals who are sensitive to other forms of B12 and require a highly absorbable form of supplementation.

Cyanocobalamin is a synthetic, pharmaceutical version of vitamin B12 is created in a lab. It’s cheap and utilized most often by prescribers, who prescribe B12 for a deficiency. When it metabolizes in the body it breaks the cyano- molecule (cyanide, yes cyanide) off to be absorbed by the body.  Although the amount of cyanide is not dangerous, it does require extra energy of the body to eliminate it from the cells. Extra toxin elimination is not optimal for anyone with methylation challenges.

Hydroxocobalamin is naturally created by bacteria. Hydroxyocobalamin is the form of vitamin B12 most likely found in food; it easily converts into methylcobalamin in the body. Hydroxocobalamin is commonly used in individuals who do not tolerate methylcobalamin supplementation and as a treatment for cyanide (yes, cyanide) poisoning.

Methylcobalamin  is the most active form of B12 in the human body. It converts homocysteine into methionine, which helps protect the cardiovascular system. Methylcobalamin also offers overall protection to the nervous system. Methylcobalamin can cross the blood-brain barrier, this helps to protect and heal the brain. Methylcobalamin is essential for detoxification and as a catalyst for many of the body’s biochemical reactions.

With nearly 40% of Americans having trouble absorbing B12; selecting the proper form of B12 can be tricky business. Absorption of B12 is heavily reliant of digestive health, get digestion working properly and find a provider savvy enough to assess and prescribe the right B12 for your body.

This information is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem.  Any questions regarding your own health should be addressed to your own primary care physician or other healthcare provider.

The post B12…not always created equally appeared first on Dr. Kendra Becker.

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