Surgical procedures in the gastrointestinal tract, such as for weight loss or to remove all or part of the stomach, can cause a complete or partial loss of cells that secrete hydrochloric acid and cells that secrete intrinsic factor [ 52, 53]. Thus, these procedures reduce the amount of vitamin B12, particularly food-bound vitamin B12, that the body absorbs [ 52, 53]. High doses (1,000 mcg/day) of oral methylcobalamin supplements appear to be as effective as hydroxycobalamin injections in normalizing vitamin B12 values in patients who have undergone Roux-en-Y gastric bypass surgery [ 54]. Carmel R. How I treat cobalamin (vitamin B12) deficiency. Blood 2008;112:2214-21. [ PubMed abstract] Bulking Agents: (mannitol, maltodextrin, gum arabic), Anti-caking Agents: (vegetable stearic acid, vegetable magnesium stearate), Cross Linked Cellulose Gum, Flavour: Natural Cherry, Vitamin B12 (as cyanocobalamin).

Solgar® Vitamin B12 delivers 1000 μg in just one nugget daily, promoting the health of the nervous system and healthy blood cell formation, and support energy metabolism.Vitamin B12 is naturally found in fish, dairy produce, organ meats, beef, pork, fortified foods and is a water-soluble vitamin. Vitamin B12 is necessary to maintain energy and general vitality and has numerous health benefits. Solgar’s Nuggets are taken sublingually (dissolved under the tongue), which means the B12 bypasses the stomach and is absorbed directly into the blood. Vitamin B12 deficiency affects between 3% and 43% of older adults. Your doctor can test your vitamin B12 level to see if you have a deficiency.Ma F, Wu T, Zhao J, Ji L, Song A, Zhang M, et al. Plasma homocysteine and serum folate and vitamin B(12) levels in mild cognitive impairment and Alzheimer's disease: A case-control study. Nutrients 2017;9:725. [ PubMed abstract]

Laird E, O'Halloran AM, Molloy AM, Healy M, Hernandez B, O'Connor D, Kenny RA, Briggs R. Low vitamin B12 but not folate is associated with incident depressive symptoms in community-dwelling older adults: a 4 year longitudinal study. Br J Nutr. 2021 Dec 13:1-22. [ PubMed abstract] In addition to oral dietary supplements, vitamin B12 is available in sublingual preparations as tablets or lozenges [ 22]. Evidence suggests no difference in efficacy between oral and sublingual forms [ 25, 26]. Actually, there hasn’t been established a maximum safe dose for vitamin B12, as vitamin B12 has low toxicity. Too much vitamin B12 is unlikely to cause side effects in healthy people. Neither from food nor supplements. Many older adults don’t have enough hydrochloric acid in their stomach to absorb the vitamin B12 that’s naturally present in food. People over 50 should get most of their vitamin B12 from fortified foods or dietary supplements because, in most cases, their bodies can absorb vitamin B12 from these sources.Watanabe F, Yabuta Y, Bito T, Teng F. Vitamin B₁₂-containing plant food sources for vegetarians. Nutrients 2014;6:1861-73. [ PubMed abstract] Limited clinical trial evidence supports the finding that higher vitamin B12 intakes might increase cancer risk. In an analysis of data on 2,524 participants in the B Vitamins for the Prevention of Osteoporotic Fractures trial who were treated with supplements containing 400 mcg/day folic acid and 500 mcg/day vitamin B12 for 2 to 3 years, the risk of colorectal cancer was significantly higher, at 3.4%, in the supplementation group than in the placebo group, whose rate was 2% [ 61]. However, high folic acid levels are potentially linked to increased risk of colorectal cancer, so the result might be due to the folic acid rather than the vitamin B12 [ 62]. Furthermore, the supplements had no significant effect on overall cancer risk.

It’s responsible for numerous functions in your body, including red blood cell formation, energy production, DNA formation, and nerve maintenance ( 1). Ho RC, Cheung MW, Fu E, Win HH, Zaw MH, Ng A, et al. Is high homocysteine level a risk factor for cognitive decline in elderly? A systematic review, meta-analysis, and meta-regression. Am J Geriatr Psychiatry 2011;19:607-17. [ PubMed abstract]Miller JW. Proton pump inhibitors, H2-receptor antagonists, metformin, and vitamin B-12 deficiency: Clinical implications. Adv Nutr 2018;9:511S-8S. [ PubMed abstract]