How To Choose The Best B-12

medicine Apr 04, 2016

Some vitamins can be taken easily in pill form and you don’t have to worry about whether it’s going to absorb that way or not. There are others where absorption can be more tricky. Vitamin B-12 is in the latter category. Since there are a few types of vitamin B12 on the market, I thought I’d write a little about how to choose the best B-12 for your health.

There are two main considerations when it comes to choosing a B-12. The first, as I just mentioned, is absorption. B-12 does not absorb well when taken in oral supplement form, meaning taken as a tablet or capsule. So regardless of the type of B-12 used, a pill form is not going to give your body the highest levels.

The ideal way to get B-12 into the body is through injections. These can be intramuscular, generally given in the shoulder (deltoid) or buttocks (glutes); or they can be subcutaneous, given via insulin syringe just 2-3 millimeters below skin level. B-12 shots give the body the best rate of absorption.

The down side of the B-12 shots is that they are not readily available to everyone. While many integrative doctors and clinics administer and/ or prescribe them, and some health food stores offer them onsite, the injections are still not accessible to everyone.

B-12 given by injection also has to be prescribed or administered by a health care professional. We do have several patients who give themselves B-12 shots at home, but we still prescribe it for them and a compounding pharmacy ships it to them. The subcutaneous form can be shipped in pre-filled syringes, so it’s pretty easy and convenient for people to administer themselves at home.

The second best way to get B-12 is a sublingual form. These are usually tablets or lozenges that dissolve under the tongue. This is still a better route than swallowing a pill, as the B-12 can absorb through the mucous membranes of the mouth into the bloodstream. Sublingual B-12 is readily available online or in health food stores. My favorite is Jarrow brand MB-12 lozenges.

The other consideration with B-12 is which form to take. Cyanocobalamin is the most basic form – it is the cheapest and probably the least beneficial in terms of absorption. Hydroxocobalamin is in between – it will be better than cyanocobalamin, but still must be converted in the body to the active forms methylcobalamin and adenosylcobalamin.

I recommend methylcobalamin (MB-12) to the majority of people. It is the active form of B12, so the body doesn’t have to facilitate too many other steps to put it into usable form and get benefit from it. The other important factor is that methyl-B12 also supports methylation pathways. These are biochemical pathways in the body that influence many different functions, among them detoxification, immune health and neurotransmitter production. Many people have defects in their genes that make methylation work less efficiently in their body. We overcome that by providing “methyl donors” – molecules that can provide the chemical constituents that the body needs to turn that pathway on; much like we use oil to make an engine turn over more efficiently.

B-12 is an important vitamin for the body, and many people experience an increase in energy and well-being when they supplement with it. It is important to get the best form that provides the best absorption. Methyl-B-12 shots are the best option, but sublingual forms of B-12 can also be a great way to optimize B-12 stores within the body and get the benefit of it.