What is vitamin B12?

Vitamin B12 or Cobalamin performs several important functions in the body, including production of red blood cells, DNA in regenerating cells, and myelin synthesis for our nerve cells.
B12 is made in the soil by bacteria with a mineral called cobalt. Unlike other B vitamins, B12 is not available in plant foods. Previously found naturally in animal-based foods (such as meat, fish, eggs, and dairy), the decline in soil quality and change in farming methods means that now even animals are given B12 supplements!

What if I don’t get enough vitamin B12?

Deficiency in the general population is high at 40% and can cause a wide range of problems:

• Anaemia
• Extreme tiredness or lack of energy
• A sore red tongue or mouth ulcers
• Nerve damage causing muscle weakness or unsteady gait
• Blurred vision
• Poor memory, judgement or understanding
• Low mood or confusion
• Heart and vascular disease, including stroke, heart attack

Am I at risk of vitamin B12 deficiency?

Risk factors for deficiency are caused by poor intake or poor absorption:

• Vegetarian or vegan diets contain low levels of Vitamin B12
• Eating disorders
• Age 50 yrs + (reduced production stomach acid leads to poor absorption)
• Pernicious anaemia (autoimmune condition prevents production of intrinsic factor which is necessary for absorption)
• Gastritis (stomach inflammation reduces acid production and leads to poor absorption)
• Overweight
• Alcohol
• Medications reducing stomach acid (Lansoprazole, Omeprazole, Ranitidine) or Metformin for treating Diabetes.
• Intestinal disease (Coeliac, Crohn’s, IBS, regular diarrhoea)
• Intestinal surgery

How much should I take?

The recommended Daily Intake (RDI) is 2.4mcg per day in the USA. To prevent deficiency, supplementation is recommended for everyone through either fortified foods, oral supplements, or intramuscular injections.

Eat fortified foods daily, including yeast extract, fortified non-dairy milks, and cereals.

Oral supplements 10 mcg per day or 2 mg once weekly will prevent deficiency if the body is able to absorb it, though this method is often unreliable.

Intramuscular vitamin B12 is the best treatment for those with deficiency, poor absorption or forget to take supplements.

Hydroxocobalamin is retained longest in the body, a dose of 1mg every 2-3 months will keep your stores topped up.
Please note, these doses will not adequately treat a diagnosed deficiency. If you have symptoms or signs, you will need a review with your GP and a full set of bloods, as dosing in these instances can be much higher and will be guided by your blood profile.

What are the benefits of Vitamin B12?

• Prevents anaemia
• Improved energy if your levels were low
• Better cognitive focus and mental clarity
• Improves mood, anxiety and depression
• Healthy skin, hair, and nails
• Lowers homocysteine levels, thereby reducing risk of vascular or heart disease
• Improves metabolism, may help weight loss

What to expect

Consultation
At consultation, we will discuss your dietary concerns and the treatment options available, including common side effects and possible complications. After checking your medical health history, if treatment is safe for you, we will sign a consent  form and go ahead with planned treatment.

Treatment

At treatment, a needle is used to inject the vitamin solution intramuscularly into the top of the bum cheek or arm. It can be sore for a couple of days.
Treatment can be repeated every 2-3 months to prevent vitamin B12 deficiency.

Are vitamin injections safe?

Vitamin B12 is generally considered very safe. It is a water soluble vitamin, this means your body excretes any extra it does not need in your urine.

TREATMENT SHOULD BE AVOIDED IF:

Allergies to cobalt or cobalamin
Leber’s disease (hereditary optic nerve atrophy)
Chronic liver or kidney disease
Low potassium levels
Irregular or fast heartbeat

SIDE EFFECTS

All medicines can cause side effects in some people but not everyone gets them.
Common side effects include redness, swelling, and tenderness at the injection site.
Uncommon side effects or adverse reactions include infection, allergic reactions, transitory exanthema (widespread rash), urticaria (itchy hives), palpitations, nausea, diarrhoea, worsen acne and rosacea (with very high doses).

Precare & aftercare advice

Keep injection site clean and dry
No additional supplements required for 3 months
Call 999 or attend A&E if you develop signs of a serious allergic reaction:
Skin rash with itchy, red, swollen, blistered or peeling skin
Tightness in the throat or chest, wheezing
Trouble breathing or talking
Swelling of mouth, lips, tongue, throat