Vitamin B12 Everything you need to know

Vitamin B12,  also called cobalamin, is a water-soluble vitamin with a key role in the normal functioning of the brain and nervous system, and for the formation of blood. It is one of the eight B vitamins. It is normally involved in the metabolism of every cell of the human body, especially affecting DNA synthesis  (our genetic material) and regulation, but also fatty acid synthesis and energy production. It is the largest and most structurally complicated vitamin and can be produced industrially only through bacterial fermentation-synthesis.

As important as vitamin B12 obviously is, there are several important facts about this nutrient you need to know that the New York Times article did not mention. Here are some of the most important points:

1.    NEVER take vitamin B12 alone as it can cause imbalances including deficiencies of many other nutrients that can cause or worsen other health issues.

2.    THERE ARE SEVERAL TYPES (FORMS) of vitamin B12.  The best form is methylcobalamin.  Other types of B12 include hydroxycobalamine adenosylcobalamin and cyanocobalamin; each has its unique and common properties and should be carefully chosen based on the health condition one is using it for. Methylcobalamine is, overall, the best type of B12 because it is “methylated” or activated.  Taking the non-activated form causes more stress on the body to activate it. However, there are times when taking another form of vitamin B12 may be more appropriate. For example, if someone has a cyanide toxicity then the best form of vitamin B12 is definitely the hydroxycobalamin; if a person is suffering from nerve pain (neuropathy) then the methyl-B12 form is usually best.

3.    IT IS A MISTAKE to take B12, no matter the form, without the appropriate nutritional synergists such as B1, B2, B3, B5, and B6 and folic acid. Too much B12, and this is a relative term, can cause imbalances or outright deficiencies of these B-vitamins; resulting in neurological problems.  Also if a person has a malabsorption disease or a certain type of bacterial stomach infection B12 deficiency will often result – the problem must be fixed otherwise supplementing with any form of vitamin B12 is virtually useless.

4.    YOU MIGHT NEED B12 EVEN IF YOUR BLOOD TEST IS NORMAL! A blood test will only tell you if you have had low intake of B12 for a few days and cannot distinguish if B12 intake has been low for months or years.  A look under the microscope by a trained nutritional practitioner is one of the very best ways to tell if vitamin  B12 is needed and when the deficiency is fixed. Large cells known as macrocytes will appear when a vitamin B12 deficiency is longstanding and will resolve once the deficiency is resolved.

5.    IMPORTANT tests that tell us whether or not we use vitamin B12 and it’s important nutritional partners include: homocysteine, methylmalonic acid, serum folic acid, red blood cell folic acid, serum B1, microscopy and a few others.  These tests should be performed along with whatever tests are determined as important by us. If these are done alone they are just reflecting a small “slice of the pie” of nutritional problems.

6.    CAUSES OF VITAMIN B12 deficiency must be found!  Deficiency or improper use of B12 can be caused by malabsorption syndromes (celiac disease, intrinsic factor antibodies, parietal cell antibodies, parasites, eating disorders, cancers, many autoimmune disease and even by medications .


8.    THE BEST WAY TO GET B12 LEVELS BACK TO NORMAL – is to find out the cause of vitamin B12 deficiency in the first place. Is your diet deficient in it? Do you have a stomach acid deficiency (stomach acid is required to separate B12 from proteins in foods)? Do you have an immune disease as B12 problems are often a result of autoimmune diseases? Do you have a parasite? There are many other causes of deficiency.

9.    VITAMIN B12 TAKEN UNDER THE TONGUE, otherwise known as sublingual administration, is not necessarily the best way to fix a deficient vitamin B12 level.  The quality of the vitamin B12 supplement matters in terms of absorption (how it is manufactured), the type of vitamin B12 matters (i.e., methylcobalamin vs. cyanocobalamin, etc) and the extent of the deficiency and its cause(s).   Just because you place vitamin B12 under the tongue does not mean it will correct a deficiency. Laboratory tests are important to check results (see above). If you have been deficient in this vitamin for many years shots of vitamin B12 AND SEVERAL OF ITS NUTRITIONAL SYNERGISTS) should all be given at once.

10.    BIG MISTAKE that many of our patients make is that once we recommend vitamin shots (containing B12 as one of perhaps ten other supplements all together) they go to their regular doctors and ask for a B12 shot. WE NEVER GIVE VITAMIN B12 ALONE BECAUSE IT MAKES NO BIOCHEMICAL AND NUTRITIONAL SENSE?  Other nutritional imbalances will occur with this practice.

Please forward your questions about vitamin B12 to the Blood Detective, Dr. Michael Wald at or call 914-552-1442.

You can also read this New York Times article on Vitamin B12 by going to:

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*DISCLAIMER: Dr. Michael Wald is a doctor of chiropractic with a masters degree in nutrition. He is also a Certified Dietitian Nutritionist and a Certified Nutritional Specialist and Sports Nutritionist. Dr. Wald is certified to provide acupuncture in several states, but not New York. Dr. Wald has two board certifications in nutrition. Dr. Michael Wald earned his MD diploma, but did not complete a residency and is thus not licensed to practice medicine. The information on this site is intended for educational purposes only and is not to substitute for sound medical or health advice. Information contained within this website may change at any time without prior notice. The information on this website is under copyright, 2021.