VITAMIN B12 dosing strategies – 3 examples (and what I recommend)

Why is there such a range of doses in B12 supplements? Why do they often provide tens of thousands of percent of the RDA? Is this safe? Why is it so hard to find more conservatively dosed supplements? How much should you take?

And do you really need to take thousands of micrograms of the vitamin to get enough?

It is important to remember that the pros of ensuring a good B12 status far outweigh the potential negatives associated with how we must dose it to achieve this status. That being said, there may now be value in using a little more finesse in our dosing strategy and determining a dose that will provide enough B12 without ingesting thousands of micrograms unnecessarily.

Today we'll be exploring the relevant aspects of B12 absorption and how you can use them as a starting point to work out a conservative dosing strategy that still has a high probability of achieving adequacy, including three examples of regimens to make this topic a little easier to understand.

Please note that the strategies discussed in this video apply to healthy people with no known absorption issues. High-dose B12 supplements exist for a reason and are very effective for acquiring and maintaining a good status in some people with B12 problems, which are very common. In this case, the benefits of high-dose B12 supplementation far outweigh any potential drawbacks and you should persist with the regimen prescribed by your healthcare provider.

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References: 6:20

The information provided on this YouTube channel is not intended to replace professional medical advice, diagnosis or treatment. The content presented is for informational purposes only. Always seek professional medical advice before starting any new health care regimen, treatment, exercise program or diet and never disregard professional medical advice or delay in seeking it because of something you saw on this YouTube channel. Always seek the advice of your doctor with any questions you may have regarding a medical condition.

[DrDesHarrington]

Hope this video helped clear up some of the confusion about B12 dosing! Let me know if there was something that wasn't clear or anything you'd like me to address in the next B12 video!

REFERENCES:

Qiang Y, Li Q, Xin Y, Fang X, Tian Y, Ma J, Wang J, Wang Q, Zhang R, Wang J, Wang F. Intake of Dietary One-Carbon Metabolism-Related B Vitamins and the Risk of Esophageal Cancer: A Dose-Response Meta-Analysis. Nutrients. 2018;10(7).

Brasky TM, White E, Chen CL. Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort. J Clin Oncol. 2017;35(30):3440-3448.

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies). Scientific opinion on dietary reference values for cobalamin (vitamin B12). EFSA Journal 2015;13:4150.

Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998.

[alexanderlindquist]

To prevent a b12 deficiency from occurring, you need to get 50–100 µg per day via supplements or 1000 µg twice a week via supplements.

[KennethWayne]

Exactly what I was looking for. Thank you.

[losg]

Thank you for the information
I have a question I was recently diagnosed with b12 deficiency my has been given me shots once a month and said I should take 1000mg a day ...so my question is how long does it take for the deficiency to go away 😕??

[PetrilloCinema]

What study refers to increased cancer risk due to excessive B12 intake? I saw one on WebMD that really isn't convincing. It found that people over-supplementing with folate and B12 got lung cancer, but all those patients had smoked in their lives. So I gather nothing from that.

I'm really wondering if my body is more efficient on the day to day if I ingest B12 daily as opposed to once a week. I would think that if I take it once a week, the B12 I ingest on day 1 runs out by the end of day 2 (cause it's water soluble) and then I have to draw on my liver stores. Then it's a question of whether having to draw on the liver stores will eventually deplete the liver stores, or if there's enough restocking happening because of the copious amounts of B12 I'm ingesting on day 1 (assuming 2000 mcg). Please help

[nickmeale]

I have an interesting question. What if I have a 1000mcg sublingual cyano tab and cut it into 4 pieces and take 1/4 a day?

[gagan]

Great Video Doc.

Does taking B12 empty stomach/after food effect the rate of absorption through passive & specific diffusion in any manner?

And what should be ideal Weekly/Daily dose for maintenance of other Vitamins B like Folic Acid B9, Niacin B3, as they are generally given and packed along in the B12 supplements, which are also required daily as are not expected to be stored in liver?

[joakimpedersen]

Great video! How big dosage do you recommend for daily sublingual dosing?

[jovanstrezovski]

Hi, i took 2500 mcg b12 .Now i found that daly take should be 2.4 mcg.Should i worry? Why they said that we need one tablet from 1000-2500 mcg per dey when this is too much? Thanks

[mikesargent]

So glad that I found this video. Clear and informative. Good information to know.

[Suna]

I personally use a mix approach, I take a weekly 1000mcg cyanocobalamin supplement and I regularly consume fortified food (like a daily spoon of nooch).
But another great way of including B12 in your daily routine is fortified toothpaste: doi: 10.1007/s40520-019-01125-6

[keithwinston]

Many thanks for this well informed video, and others too - excellent all around! Quick question: can you comment on the other forms of B-12, i.e., "adenosylcobalamin" & "hydroxocobalamin"? (as represented in Swanson Ultra brand "Activated B-12 Complex", for instance, among others...).

[kaspermller]

What's optimal the dosage if you take a combination of methyl and adenosylcobolamin?

[SuperEddie]

Never heard of high amounts of Vitamin B12 causing cancer. Is this for the cyanocobalamin or methycobalamine

[Radjehuty]

I never really did the math and I just take 500mcg every few days. But I did wonder if I should even bother because everything I cook has either fortified milk or nutritional yeast. I've been getting between 275% and 375% b12 daily just from fortified food every meal. I always wondered if this was sufficient without supplementation

[bookemchristy]

I am very anemic ( just had a blood transfusion) and I need to take B12 along with my iron pills. So I was prescribed to take 2 tablets of 500 MCG a day. Which form is best to take though? Liquid under the tongue or tablets?

[panes]

Thank you for this video. Firstly, I have the brand Nature Provides which was recommended to me via a GP because my MCV levels were out of whack. Cyno B12 wasn't working it would seem on it's own. Cynoc at 50 mcg a day which seems very low. So I started taking Nature Provides daily at 3000mcg for 6 weeks and my B12 levels shot back up into the middle of the reference range.

But my question is this. I have been taking the sublingual B12 which is methyl and adeno by Nature Povides" is 3000 mcg. So is this too much a day? I did make the dropper reduced to 1000 mcg (just by judging it by eye I might add) and taking that every x days but is that too much too. My teenage kids taking 1000 mcg roughly x2 a week but that's with me judging the Nature Provides drops by eye.

We also take fortified foods in milks and nutritional yeast. But that's it for fortified.

Can you help?
What should I do. I am confused.

[tomson]

Nice video. I have fairly low B12 levels despite supplementing with B12 (cobalamin through various, well-known brands) diligently. I assume I must have absorption issues. I have FUT2 gene, but I'd guess there must be more to it(I've tested for autoimmune disorders, but I didn't have any). I would like to increase my B12 levels as I understand it might improve my leukopenia. My leukopenia on the other hand is probably responsible for not clearing my HPV infection despite having it for over 2 years at this point.

2 questions.
1. If there are absorption issues which type is more likely to not be working correctly - the specific or passive absorption?

2. How long do I have to wait to be able to absorb another 1.5-2ug through specific absorption?

[olgazamurovic]

My B12 complex contains 350 μg of adenosylcobalamin and methylcobalamin. How often would you recommend taking it?

[reem-ksde]

can you talk about 1000mcg sublingual tab . why we cannot take it more than 2 months .
and how you get the stored dose