The federal government’s 2020–2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. ... In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy)." Anemia makes you feel weak and fatigued. Severe cases can even damage the heart and nervous systems. These lozenges contain 1,000 mcg of methylcobalamin each. They are lemon flavored and also contain xylitol, a sugar alcohol, for added sweetness. Though the small amount in these supplements will likely not pose an issue, some people find that sugar alcohols do not sit well with them. Overall, the available evidence suggests that supplementation with vitamin B12 alone or in combination with other B-vitamins does not reduce the risk of CVD or of CVD-related death. Dementia and cognitive function

Cost: The price per serving can vary widely across products, so consider how the one you choose will fit into your budget. B-complex supplements contain most or all of the B vitamins in one pill. A well-chosen B-complex vitamin can help you ensure that in addition to B12, you get enough of the other B vitamins as well. Thorne is a trusted company in the world of supplements. They do extensive testing and support research to ensure high quality products. Bhargava R, et al. (2016). A randomized controlled trial of omega 3 fatty acids in rosacea patients with dry eye symptoms. Depending on the definition used, between 3% and 43% of community-dwelling older adults, especially those with atrophic gastritis, have vitamin B12 deficiency based on serum vitamin B12 levels [ 41, 42]. The deficiency rate at a cutoff of less than 211 mcg/L (156 pmol/L) at admission to a long-term care facility, according to one study, was 14%, and 38% of these older adults had levels lower than 407 pg/mL (300 pmol/L) [ 42]. Vitamin B12 is available in multivitamin/mineral supplements, in supplements containing other B-complex vitamins, and in supplements containing only vitamin B12. Multivitamin/mineral supplements typically contain vitamin B12 at doses ranging from 5 to 25 mcg [ 22]. Vitamin B12 levels are higher, generally 50–500 mcg, in supplements containing vitamin B12 with other B-complex vitamins and even higher, typically 500–1,000 mcg, in supplements containing only vitamin B12.

Conditions associated with vitamin B12 inadequacy include pernicious anemia, present in about 15% to 25% of older adults with vitamin B12 deficiency [ 43]. Atrophic gastritis, an autoimmune condition affecting 2% of the general population but 8%–9% of adults age 65 and older, decreases production of intrinsic factor and secretion of hydrochloric acid in the stomach and thus decreases absorption of vitamin B12 [ 43, 44]. A third condition associated with vitamin B12 deficiency in older adults is Helicobacter pylori infection, possibly because this bacterium causes inflammation that leads to malabsorption of vitamin B12 from food [ 45]. Individuals with pernicious anemia However, studies on the association between vitamin B12 intake and risk of CVD have had negative results. Two meta-analyses—one of 11 prospective cohort studies in 369,746 individuals who developed 5,133 cases of coronary heart disease and one of 12 prospective (mostly cohort) studies in 389,938 participants who developed 10,749 cases of stroke over 4.2 to 19 years (including 10 reports that evaluated the association between dietary vitamin B12 intake and stroke risk)—found no significant association between vitamin B12 intakes and risk of coronary heart disease [ 74] or stroke [ 75]. Additional clinical trials are needed to better understand the effects of vitamin B12 supplementation on cognitive function and cognitive decline. Energy and endurance

Vitamin B12 has the potential to interact with certain medications. In addition, several types of medications might adversely affect vitamin B12 levels. A few examples are provided below. Individuals taking these and other medications on a regular basis should discuss their vitamin B12 status with their health care providers. Gastric acid inhibitorsA variety of foods and their vitamin B12 levels per serving are listed in Table 2. Table 2: Vitamin B12 Content of Selected Foods [ 20] Food If you’re not a fan of pills and tablets, you might want to consider Vitamin B12 in spray form. Since vegans will need to supplement with B12 throughout their life, a spray can be a convenient and easy addition to your routine. The estimated bioavailability of vitamin B12 from food varies by vitamin B12 dose because absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12) [ 16]. Bioavailability also varies by type of food source. For example, the bioavailability of vitamin B12 appears to be about three times higher in dairy products than in meat, fish, and poultry, and the bioavailability of vitamin B12 from dietary supplements is about 50% higher than that from food sources [ 17-19]. Additionally, there is currently no evidence that one form of vitamin B12 supplement, such as capsule or liquid, is better absorbed than another.

If you choose to take vitamin A, avoid taking more than 10,000 IU to prevent toxicity. Since the nutrient is fat-soluble, it can build up in your body. Vitamin A toxicity can cause: Slot WB, Merkus FW, Van Deventer SJ, Tytgat GN. Normalization of plasma vitamin B12 concentration by intranasal hydroxocobalamin in vitamin B12-deficient patients. Gastroenterology 1997;113:430-3. [ PubMed abstract]

2. Key facts

People taking certain medications: There are particular medications that can increase your risk of vitamin B12 deficiency. This includes the drug metformin, taken for prediabetes and diabetes, as well as proton pump inhibitors. medicine – certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs Still, multiple studies have also found oral vitamin B12 supplements to be safe and effective ( 33, 34, 35, 36). People who have had intestinal surgery: If you have had stomach or intestinal surgery, you may not make enough hydrochloric acid and intrinsic factor, which are needed for B12 absorption.