Diet/NutritionB12 Shots: Should You Get One?Markham HeidFor more, visit TIME Health.More and more, ours is a worn out, sleep-deprived, distracted nation. It’s no wonder a shot of energy and focus would appeal to many of us. And that’s exactly what B12 injections deliver—literally—for those who lack sufficient stores of the nutrient.“B vitamins are essential for proper cellular respiration,” explains Dr. Roxanne Sukol, medical director of Cleveland Clinic’s Wellness Enterprise. Without adequate supplies of B12, most of the cells in your body will struggle to take in enough oxygen, which can affect everything from your energy levels to your mood and concentration, Sukol says. Classic symptoms of a B12 deficiency also include diarrhea or constipation, pale skin, and shortness of breath, according to the National Institutes of Health.The nutritional necessity of B12 explains why it’s such a popular supplement, and also why some celebrities have touted B12 injections as the magic ingredient in their health regimens.
The vitamin’s links to increased energy have also made B12 popular among some dieters and weight loss clinics—the thinking being that more energy will translate to more exercise.“But unless you have a B12 deficiency, there’s really no role for it,” Sukol says of B12 shots and supplements. Put simply, more isn’t better. And even if you’re low on B12, there’s no evidence injections of it will help you lose weight, says Dr. Brent Bauer, director of the complementary and integrative medicine program at Mayo Clinic. “Everybody’s looking for a shortcut,” he says. “B12 supplementation has its benefits, but it’s not a solution for weight loss.”So weight loss is out, but B12 shots have been associated with other conditions, too. In fact, there’s some solid research on B12 injections for the treatment of fibromyalgia and myalgia encephalomyelitis.Food sources of the vitamin include eggs, meat, and dairy products. People who eschew those foods are at elevated risk. “When I test vegans for B12, they’re usually on the low side—if not deficient,” Sukol says.
Some gut-related diseases like Crohn’s or Celiac—as well as most types of weight loss surgery—can also limit the amount of B12 your system absorbs, she adds.But figuring out if you’re low on B12 is trickier than you might suppose. A much-cited 2000 study from the American Journal of Clinical Nutrition found nearly 40% of the population have B12 levels that fall at or below what experts consider the low end of normal. While you might assume anything in the “normal” range means you’re in good shape, Sukol says that’s not always the case.“Blood tests are not always black and white the way we’d like them to be,” she says. “If I have a patient taking a lot of naps and complaining about poor concentration, I might recommend B12 supplementation even though the blood tests look normal.”You’ll notice she says “supplementation” and not “injections.” Unless you have one of the above conditions that prevent your gut from breaking down and absorbing the vitamin, a B12 pill is as effective as a B12 poke, research suggests.
“For many people, an oral supplement is just as good [as an injection].”Finally, when it comes to the safety of both B12 injections and oral supplements, you don’t have much to worry about. “B12 is water soluble, and it’s generally safe even at very high doses,” Bauer explains. “You put a needle in your arm and there’s always the risk of swelling or pain at the site, but in the complementary medicine realm B12 is probably one of the safest things you could take.”If you’re often worn out or foggy brained, even after a good night’s sleep, “take a B12 supplement for a week or two and see how you feel,” Sukol advises. If your fatigue persists, have your blood tested for nutrient deficiencies.A B12 shot may be just what your doctor orders.Vitamin B12 (cyanocobalamin) is an oxygen carrier; it decreases blood cholesterol; Vitamin B12 is essential in humans for healthy nerve tissues. Its deficiency is associated with heart palpitations. check your overall health status
identify any nutritional deficiencies have a doctor review your case (optional) The term "Vitamin B12" refers to a group of cobalamin compounds, of which the most frequently used is cyanocobalamin. All vitamin B12 found in nature is made by microorganisms (bacteria essentially), and none is found in sterile plants. In the early to mid 1800s, an unrecognized vitamin B12 deficiency was referred to as pernicious anemia because it was almost always fatal. It was not until 1948, though, that researchers finally isolated the active principle in liver now called vitamin B12. The isolation used a charcoal filter that added the stabilizing effects of cyanide, thus cyanocobalamin is one of the major stable forms used today for supplementation purposes. Food Sources of Vitamin B12. Those who don't like taking supplements can eat fortified foods, including fortified soy milks and rice milks, breakfast cereals, fake meats, sea weeds, one type of nutritional yeast (Red Star Brand Vegetarian Support Formula) and so on.
The main thing to remember if you rely exclusively on fortified foods is that you have to eat them at least twice each day. Some people prefer this method because it is the most natural. For example, one might have some B12-fortified cereal or soy milk for breakfast, and for supper also a serving of something with B12 in it, like another cup of fortified soymilk or a teaspoon of B12-fortified nutritional yeast. The best sources of B12 are animal-derived: liver, meat, salt-water fish, oysters, milk, eggs, aged cheese such as Roquefort, and fortified brewer's yeast. Vitamin B12 occurs naturally in the soil and on the surface of unwashed fruits and vegetables. Those on an animal-free diet may wish to eat unwashed, organic produce whenever possible. There is debate over the reliability of non-animal sources of Vitamin B12. It was found that people on vegan diets had lower levels of serum B12 levels than the general population. In particular, infants breast-fed or fed a macrobiotic diet directly are at a great risk of developing B12 deficiency.
Non-animal sources which claim to have significant amounts of B12 such as tempeh, micro-algaes (spirulina, chlorella), miso, tamari, and sea vegetables (nori, arame, kombu, wakame) have been found to have negligible amounts, or B12 analogues that show up on lab tests, but don't have the activity of real B12. It should be noted that there are different techniques for measuring the B12 content of foods. Furthermore, the B12 content in fermented foods, such as tempeh, may be different due to varying production techniques. In Indonesia, traditionally-produced tempeh is loaded with B12-producing bacteria which grow on the molds commonly growing on the food. In the U.S., however, large scale production and improved sanitation decreases the mold and bacteria and the subsequent B12 content of the food. The most reliable non-animal, but natural, source of B12 seems to be fortified brewers yeast. Like most of the vitamins, B12 is required as a cofactor for various enzymes.
Every DNA-synthesizing cell requires vitamin B12. It facilitates the cyclic metabolism of folic acid, which is essential for thymidine (one of the four DNA bases) synthesis. It also transfers a methyl group from methylfolate, helping to convert homocysteine to methionine. Because plants have no appreciable amounts of B12, vegetarians are often at risk of slowly developing vitamin B12 deficiency. Vitamin B12 is an excellent energy booster. It plays an important role in the burning of fats and carbohydrates to produce energy, as well as in the formation of healthy red blood cells, and the maintenance of the myelin sheaths that protect our nerves. For these reasons, a B12 deficiency can cause symptoms ranging from mild fatigue to severe exhaustion to peripheral neuropathy. There appears to be some confusion among practitioners of natural medicine about whether oral, sublingual or intramuscular administration is preferable for patients requiring vitamin B12 therapy.
Blood levels of B12 indicate that sublingual B12 becomes available as early as 15 minutes after administration and are still elevated at 24 hours, suggesting that a once-daily dose of 2,000-4,000mcg would be an effective preventive measure. – Presentation at the 43rd Annual Meeting, American Academy of Allergy and Immunology, 1987] A year's supply of 1,000mcg vitamin B12 tablets costs under $20, which is less than the cost of going to the doctor's office for injections. On the other hand, patients who are likely to be noncompliant with oral therapy should be seen regularly by a doctor and treated with intramuscular injections. The current US RDA for vitamin B12 is 6mcg, but less for children and more for nursing and pregnant women. For those suspected of having low B12 levels, 2,000mcg once a day for two weeks sublingually should replenish stores. Those with problems absorbing B12 should continue taking their B12 sublingually. When vitamin B12 is being used for its pharmacological effects, as in the treatment of fatigue, Bell's palsy, diabetic neuropathy, subdeltoid bursitis, or asthma, intramuscular injections appear to be preferable to oral administration.
Although there is little published research in this area, clinical observations suggest that orally administered vitamin B12 is not particularly effective against these conditions. It appears that very high serum concentrations are usually needed for vitamin B12 to exert its pharmacological effects, and that these serum concentrations can be achieved only with IM administration. B12 supplementation is especially important for those who consume few or no animal products – vegetarians, vegans and raw-food vegans/fruitarians. There are two basic ways to use supplements – weekly or daily. Probably the simplest method is to chew up one B12 supplement containing 2,000mcg or more once a week. The reason you should ideally chew or let it dissolve under your tongue is to enhance absorption. For some people it is hard to remember to take something once a week and they may prefer to get into the habit of taking something every day, which is more physiologically natural. If you take your B12 supplement every day then you can take much less – you only need about a 100mcg a day that way.