B12 — one of the most talked about nutrients!
Before vitamin B12 even had a name scientists knew there was a nutrient in food that joined with something in the stomach to help it’s absorption. They named these two substances intrinsic factor (created in our stomach) and extrinsic factor (from food), known as B12. B12 is extremely important for energy, growth, blood formation, cell division & function and essential for a healthy nervous system.
In order for B12 to be absorbed in the intestines, it needs to bind with intrinsic factor in the stomach so intrinsic factor and digestive health is of utmost importance. It’s not surprising that B12 is one of the most common nutritional deficiencies based on the number of people who have poor digestive health.
Due to the fact I have many clients come to me with low B12 I wanted to interview an expert on this topic. So I interviewed the awesomely smart and sassy Dr. Lisa Knapper of 360 Health Care on the importance of B12.
Here’s what she shared with me (this was a phone interview so it’s in my joyous words, not quoted directly from her):
Who is at risk of B12 deficiency?
Vegans and vegetarians tend to be most at risk if they are not supplementing because most food sources of B12 are animal products. That being said, many meat-eaters also have B12 deficiency if their digestion isn’t working properly or they are eating poorly.
What are some of the symptoms of low B12?
- weakness, tiredness or light-headedness
- rapid heartbeat and breathing
- pale skin
- sore tongue
- easy bruising or bleeding, including bleeding gums
- stomach upset and weight loss
- diarrhea or constipation
If the deficiency is not corrected, it can damage the nerve cells. If this happens, vitamin B12 deficiency effects may include:
- tingling or numbness in fingers and toes
- difficulty walking
- mood changes or depression
- memory loss, disorientation, and dementia
What are some of the reasons for low B12?
- Poor diet, not eating enough foods that contain B12
- Low stomach acid, low intrinsic factor
- Long-term use of acid-reducing drugs
- Conditions affecting the small intestine, such as Crohn’s disease, celiac disease, bacterial growth, or a parasite
- Excessive alcohol consumption
- Stress
- Food sensitivities
- Birth control pill
Should you take a supplement with B12?
Yes, if you are a vegan or vegetarian it is recommended, or if you have low B12.
What is the best form of supplementation and how much is recommended?
The two best methods are injection (Dr. Knapper does this) or sublingual lozenges (under the tongue) so you don’t have to worry about absorption in the gut. Methylcobalamin one of the best forms. In terms of dosage recommendation, it’s individual to your needs. It is also helpful to take a B-complex as folic acid can have very similar symptoms of B12 deficiency. It’s very safe to take a B-complex ongoing. For those who live in Canada, Dr. Knapper and I both like this brand: AOR, Advanced B Complex.
Dr. Knapper also stressed the importance of getting the gut back on track and I couldn’t agree more. Getting your levels up via an injection is helpful to correct deficiencies and bring your body back into balance. However, the root cause of the deficiency must be addressed and starting with improving digestive health is essential.
Food sources of B12 include: Eggs, meat, chicken, dairy products, oysters, fish, cheese, nutritional yeast, fortified food products, some cultured and fermented foods (ie. tempeh, make sure you buy organic non-gmo), dulse. Spirulina is not a reliable source of B12 despite what you may have otherwise heard. (I do not suggest you start slurping back the cow dairy or chowing on heaps of cheese). Whether you choose to be vegan, vegetarian or an omnivore, keep lots of variety in your diet, full of nourishing and delicious foods!
Also, keep in mind that B12 helps keep levels of homocysteine in check which is an amino acid that may increase heart disease. Since it’s heart health month, I’m doing a webinar next Thursday at 6pm EST on “3 Steps to a Healthy Heart“. Be sure to register!
Lisa Knapper, ND lives and practices in Toronto. She studied at the Canadian College of Naturopathic Medicine, and is a member of the OAND and CAND. Lisa loves blending Eastern and Western medicine to guide people into optimal health. In her practice she focuses on stress management, balancing the mind and body, healthy eating and teaching sustainable healthy lifestyle habits. She is passionate about sharing her knowledge of health and preventative medicine. In her spare time, she can be found strolling around the east end with her dog. Lisa is co-owner and Naturopathic Doctor at 360 Health Care. For more information visit: www.drlisaknappernd.com










Great article. Joy/Lisa I was wondering if either of you had any opinions on the root cause of pernicious anemia? Without my methyl b12 injections my levels drop… I do lack the intrinsic factor you mentioned but I’m wondering if there is any hope of reversing this? I’ve been this way for over ten years now.
I was taking that exact brand of Bcomplex and really liked it. Unfortunately I’m travelling in Australia and they don’t carry that brand. Are there others you would recommend? Or do you know of any websites that shipped internationally for this product?
Have you tried iherb.com??
I eat a healthy omnivore diet (emphasis on plants and very little meat and dairy), however, I take a b-complex. Mostly for mood and assurance. Is this completely unnecessary?
You probably do not need to take B12 alone. A B-complex is very safe and a good insurance policy.
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Joy, this was such a helpful article. I almost never eat meat, and I only eat dairy about once a week. I had assumed that I was getting enough B12 through my soy milk, and other fortified foods, but this made me realize that I probably wasn’t. I had no idea that things such as stress and the birth controle pill would effect my amount of B12. Thank you for being such a great resource!