What patient demographic benefit most from the best B12 vitamin supplements?

One of the best B12 vitamin supplements, it is one that also contains folic acid and biotin as it may provide better effects

During a session, your patient reveals that they are interested in taking a vitamin B12 (cobalamin) supplement. But first, they want to know what you think are the best B12 vitamin supplements in regard to bioavailability (as patient education has made great strides), and additional B vitamins that can provide a benefit at the same time.

Let’s start with the best B12 vitamin supplements and their health benefits:

B12 health benefits

In its fact sheet for health professionals, the Office of Dietary Supplements (ODS) shares that vitamin B12 is required for central nervous system development and function. It also serves as a cofactor for two enzymes that play a role in amino acid processing and breakdown:

• methionine synthase
• L-methylmalonyl-CoA mutase

Many patients take vitamin B12 supplements in an attempt to boost their energy levels. One possible explanation for this effect is the role this vitamin plays in lipid metabolism.

A 2020 review reports that an important relationship exists between B12 and metabolic syndrome, putting people with low levels of this nutrient at greater risk of being obese. Results of a 2019 study in Frontiers in Endocrinology seem to confirm this notion as subjects with higher serum B12 levels had lower incidences of obesity.

While more research is needed, one narrative review published in Pain Physician adds that clinical evidence supports B12’s ability to help treat low back pain and neuralgia. An article in GSC Biological and Pharmaceutical Sciences further suggests that it may also aid in the treatment of COVID-19 based on the hypothesis that this virus interferes with the metabolism of cobalamin, causing patients to experience the same symptoms as if they were B12 deficient.

The best B12 vitamin supplements and bioavailability

Vitamin B12 is found in animal-based foods, some of which include beef liver, clams, tuna, and salmon. However, its bioavailability varies by food source. Research reveals that the absorption of B12 can also change based on other factors, such as:

• Having a genetic or acquired disease that reduces intrinsic factor production
• Having a gastrointestinal disease that leads to nutrient malabsorption
• Using medications that suppress gastric acid, thus impairing the release of B12 from food

This research stresses that getting an adequate amount of vitamin B12 isn’t always enough. The body also must be able to absorb and process it for effective use. This requires improving its bioavailability through mechanisms designed to aid in B12 absorption.

Technologies that can help enhance B12 absorption include both active and passive options. Some to consider are:

• Formulating the supplement with enhancers
• Encapsulating the B12 so it can survive until it hits the small intestine
• Using alternative routes of administration

An option that falls into the latter category is sublingual delivery.

Studies show that sublingual delivery of B12 is effective for increasing serum concentrations, restoring them to adequate levels in individuals with slight deficiencies. In this study, subjects’ serum concentrations increased after 90 days of supplementation.

Who could benefit from a vitamin B12 supplement?

Based on B12’s numerous potential health benefits, anyone interested in optimal central nervous system function, a reduced risk of obesity, lower rates of back pain and neuralgia, or a desire to ease symptoms that linger after having COVID-19 may benefit from taking a supplement.

A supplement may also be beneficial for individuals who are at the greatest risk of being vitamin B12 deficient. The ODS states that this includes:

• older adults
• people with pernicious anemia
• people with a gastrointestinal disorder, such as celiac disease or Crohn’s
• people who’ve had gastrointestinal surgery, such as gastric bypass
• people who follow a vegetarian diet, including infants breastfed by vegan mothers

A blood test can either rule out or confirm a vitamin B12 deficiency. It can also provide insight into the amount of B12 that should be taken in supplemental form to ensure that adequate intake needs are met.

If one is recommended as one of the best B12 vitamin supplements, it is one that also contains folic acid and biotin as it may provide better effects. This is because folic acid helps enhance B12 effectiveness while biotin supports metabolism. Learn more here.