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  • Charity Lawson, Nutritionist

To B12 or Not to B12

Vitamin B12 is an essential vitamin. Meaning, we must get this nutrient from our diet since the human body cannot manufacture it. Vitamin B12 is critical for proper neurological, cardiovascular, digestive, and immune function. It is also involved in energy production, red blood cell synthesis, and decreasing inflammatory responses. B12 works with folate in the methylation cycle to reduce homocysteine, a known risk factor for cardiovascular disease and inflammation.

Our nerves are surrounded by a myelin sheath which plays a critical role in proper nerve conduction. In Multiple Sclerosis, for example, this myelin sheath is attacked by a person’s immune system. Vitamin B12 is critical for the maintenance and repair of the myelin sheath. A vitamin B12 deficiency can mimic symptoms of multiple sclerosis.

Vitamin B12 Deficiency

As you can see, having a deficiency would have serious negative effects on the body. Deficiencies have been linked to Alzheimer’s and dementia. They have also been linked to autoimmune disease, cardiovascular disease, cancer, and neurological disorders. The most common causes of deficiency are inadequate dietary intake, malabsorption, and genetic mutations called single nucleotide polymorphisms. Vegans are especially at risk of a vitamin B12 deficiency since this vitamin is found only in animal products. Those over the age of 50 are also at an increased risk of deficiency. Proper absorption of vitamin B12 requires a low pH and since stomach acid decreases as we age, less of the vitamin is absorbed. Taking antacids also reduces the absorption of B12 since these medications decrease the pH of the stomach. Those with malabsorptive disorders from celiac disease, leaky gut, Crohn’s disease, chemotherapy, gastric bypass surgery, antibiotics, and inflammatory bowel disease are also at risk of deficiency.

Role of B12 in Methylation

Vitamin B12 is critical in the methylation cycle which is one of the most essential metabolic functions in the body. Methylation is an important process involved in DNA and RNA replication, cell growth, hormone balance, neurotransmitter synthesis, nerve myelination, and numerous other vital body processes. Impaired methylation is associated with infertility, neural tube defects, cleft palate, depression/anxiety, impaired growth and tissue repair, impaired detoxification, poor cognition, neurological disorders, cardiovascular disease, impaired estrogen metabolism, increased inflammation, diabetes, and reduced muscle mass. Those with genetic mutations (MTHFR & MTRR) need to supplement with the proper form of vitamin B12 for adequate absorption.

Symptoms of Vitamin B12 Deficiency

  • Low energy/fatigue

  • Poor cognition/memory loss

  • Depression/anxiety/mood disorders

  • Muscle pain


Vitamin B12 also goes by the name cobalamin of which there are 4 major forms: methylcobalamin, hydroxycobalamin, adenosylcobalamin, and cyanocobalamin. When it comes to supplementation, these forms are not created equal.


This is the most active form in the human body. It serves as a coenzyme for the conversion of homocysteine to methionine which protects the cardiovascular system. As a supplement, it is easily absorbed into the cells and across the blood-brain barrier to serving in its neuroprotective roles.


This is naturally found in food and is synthesized by bacteria. It is not bioactive but can readily convert to methylcobalamin especially when given in injection form.


This is the other bioactive form of vitamin B12, however, due to its unstable properties outside the body is not recommended for supplement form. It plays an essential role in energy metabolism.


This is the synthetic form of vitamin B12 (yep, it's created in a lab) and is not bioavailable. Unfortunately, because it is cheap to produce is used in many supplements. It also produces a cyanide molecule (WHAT???) that must be detoxified by the liver.

If you are wondering whether you might have a B12 deficiency, some tests can help determine if you are deficient. Knowing if you have a genetic mutation linked to poor methylation can also be a very helpful tool for your health journey. If you want to learn more about testing for a vitamin B12 deficiency and what type of supplement you may or may not need, we are here to help you. The clinic also offers a full line of supplements as well as vitamin B12 injections. For more information call us at (830) 992-3042.

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