Choosing a Supplement

Choosing a B12 Supplement

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There are a bewildering array of vitamin B12 supplements available on the market, and choosing which one to buy can be difficult and confusing. Simple tablets or injections? What about fortified foods? What dosage do you need? Should you just get a multivitamin and leave it at that? Are the big brands worth the extra money? Hopefully this page will make everything clear!

If you’re not sure whether you need a B12 supplement in the first place, take a look at this article. As for the type of vitamin B12, we always recommend methylcobalamin over the other forms. You can find out why here, or read more about the different types here.

Tablets Or Patches Or Shots Or…?
To simplify things, for now we’ll assume you just want an individual B12 supplement. There are still plenty of options to look at, and we’ll consider multivitamins later on.

Oral Tablets
Oral tablets are one of the most common ways to take supplemental B12, as they’re readily available and very convenient. Large doses administered orally will give almost everyone as much of the vitamin as they’ll ever need.
This even includes people with impaired B12 absorption, as very high doses will generally allow your body to obtain enough B12 through passive diffusion in the gut.

If you want a different way to get your B12 orally, there are so many products available that it’s now even possible to buy vitamin B12 lollipops!

B12 LollipopSublingual Tablets
Another possibility is to get your B12 sublingually i.e. under the tongue. The original reasoning behind this was that it should be more readily absorbed in this way. It’s certainly true that sublingual B12 can be highly effective, but this is now thought to be almost entirely due to the large doses typically involved.

There’s no strong evidence that sublingual pills are better than oral pills, but some people are still working on outdated information, and others just prefer getting their B12 under the tongue. As a result, there are a variety of sublingual products on the market.

B12 Shots/Injections
B12 shots are sometimes used by doctors as a first line of treatment for patients suffering from vitamin B12 deficiency. Its popularity is however waning, especially when it comes to simply maintaining healthy levels.

B12 InjectionThis is because it no longer seems necessary when such effective high dose oral and sublingual products are available, and most people would of course prefer to take a pill than inject themselves or be injected. Still, intravenous or intramuscular B12 injections are very much a viable alternative, and are regularly used to treat pernicious anemia.

Nasal Gels
Nasal gels are an interesting possibility. They’re much harder to find than simple oral or sublingual supplements, and it’s even less likely that you’ll find a methylcobalamin-based nasal gel.

Many people are also put off by the way it sounds just a little bit too much like a gimmick designed to con people out of their money. Nevertheless, it does seem to be fairly effective, even if it can be quite expensive.

Sprays
Another less orthodox but increasingly popular option is to use methylcobalamin sprays. These are as simple to use as mouth freshener – just a quick spray and you’re done. And don’t assume that it will automatically taste bad – there are plenty of flavored products like this vegan raspberry spray.

Skin Patches
Now we come to vitamin B12 patches. These patches are very small and should be placed behind the ear. You will probably only need to use one patch per week. Some patches will claim on the packaging that they should be taken every 24 hours, but a single 24 hour dose is usually large enough to keep your body healthy for a much longer period of time.

The biggest benefit of patches is that they release B12 gradually and over a longer period of time than injections. They also bypass the digestive tract, which is hugely important for anyone with impaired B12 absorption, one of the leading causes of B12 deficiency.

Fortified FoodsGranola Breakfast
The final option is to eat foods that have been specially fortified with B12. This should work well for most vegans and vegetarians who can’t get enough B12 in their diets, but it won’t be enough for people with impaired absorption.

Going down this route will also require a fair amount of time reading labels to work out exactly how much B12 you’ll actually be ingesting – this varies significantly from product to product and from brand to brand. However, this is nevertheless a very popular choice.

Fortified foods are perfect for anyone who doesn’t want to swallow pills or use any of the other alternatives. And these days there’s a good range of products available e.g. granola, porridge oats and protein bars.

What Dosage Do I Need?
The Food and Nutrition Board at the Institute of Medicine set the recommended daily allowance (RDA) of vitamin B12 at 2.4μg (micrograms) for healthy adults. Pregnant women need around 2.6μg, or 2.8μg during lactation.

What If I Have A B12 Overdose?
Higher doses are not considered harmful. Several studies have found no adverse effects on subjects given many times the recommended amount on a daily basis for years at a time.

Vitamin Pills or SupplementsThis isn’t true for all vitamins, but the toxicity of B12 is so low that taking too much is rarely a real concern. It’s also worth noting that allergic reactions to B12 are exceedingly rare.

Patients suffering from vitamin B12 deficiency are often given a few very large doses (often in the form of shots) to boost blood levels of the vitamin quickly, and there is no evidence to suggest this is harmful. Similarly large doses can be given in oral form or sublingually (see below) for patients who cannot absorb B12 normally. These large doses do not appear to cause any damage at all, but can provide sufficient B12 through the process of passive absorption in the gut.

How Often Should I Take A B12 Supplement?
Luckily vitamin B12 is a very convenient supplement to take as it doesn’t really matter if you forget one day. Just take a double dose the next day and you’ll be none the worse, as the vitamin is retained in the body for long periods of time. Many people choose to take a single large dose once a week for the same reason.

SupplementsWill I Get Extra Benefits From Taking More B12?
As a general rule (assuming your body can process B12 normally), you can absorb around 50% of your B12 intake for dosages up to around 1μg. This then declines on a sliding scale to roughly 0.5% when the dose reaches 1mg or more. So unless you have a condition that prevents you from absorbing it properly (like pernicious anemia, for example), there’s probably not much point in taking huge amounts of B12.

If you do suffer from pernicious anemia or another condition that impairs B12 absorption, a single large dose of about 2mg, administered once per week, is thought to be most effective.

The Multivitamin Choice
Whether or not you should use a multivitamin to supplement your B12 intake depends on who you are.

If it’s not just B12 that you want, then a multivitamin will generally be the most convenient option. And multivitamins are good for your health anyway. Multivits will also work out cheaper than taking lots of individual supplements, but B12 tends to be relatively inexpensive compared to some other vitamins anyway.

Multivitamins For Vegans And Vegetarians
If you only need a B12 supplement because you don’t eat meat or animal products, then most multivitamins will give you all the B12 your body needs. If you’re still not convinced you’re getting enough, then periodically boosting your intake with an individual B12 supplement is an easy solution. And this way, you still get all the health benefits associated with multivitamins too.

Finding vegetarian/vegan supplements isn’t very difficult either – they’re widely available online and in health stores. For example these multivitamins are vegan (and organic, gluten-free and non-GMO!), and these sublingual B12 tablets are also vegan.

The Danger Of Multivitamins
The only general warning is that while you probably don’t need to worry about taking too much B12, not all vitamins have such low toxicity. So if you try to get a large dose of B12 by taking loads of multivitamins, you risk suffering from problems caused by ingesting too much of other vitamins.

Multivitamins For People With Impaired B12 Absorption
If you can’t absorb B12 properly from your normal diet (a very common condition in people over the age of 50), then a multivitamin isn’t going to cut it. You’ll need a far larger dose as you’ll be relying on passive diffusion in the gut to absorb B12 into your system, which requires a high concentration.

Some multivitamins are specifically designed for older people, and these tend to include a bit more B12. But an individual supplement is recommended for anyone over the age of 50 if you want to be sure you’re getting enough of this extremely important vitamin.

Medical CaduceusWill Multivitamins Cure B12 Deficiency?
Nope, sadly not. Self-medicating patients sometimes make this mistake, but if you have vitamin B12 deficiency, then a multivitamin isn’t going to be enough. In this case a very high dose, possibly given intravenously, is likely to be the best course of action, but you should of course consult your doctor first.

If you want to read more about getting your B12 through a multivitamin, please take a look at our dedicated article here.

Are Brand Names Worth It?
Supplements of any kind tend to be a bit more expensive if they’re made by a well-known brand such as Thorne Organics or Garden of Life. Because the names are widely recognized, they keep selling as everyone assumes they’re the best. However, this might not always be the case.

A study a few years ago found that in many cases the products from the  big brands were outperformed by supplements produced by lesser  known companies, or sometimes even by supermarkets. The only  downside is that very small or new businesses are more likely to have  problems with their products, but the industry standards are so high that  even this is unlikely. And of course, the situation could have changed  since the study was conducted.

If you want the most bang for your buck, it normally just comes down to reading the label and checking that you’re going to get exactly what you want. This is especially true if you’re looking for vegan, gluten-free, organic or non-GMO supplements. You can see the methylcobalamin products we recommend here.


From top to bottom, images are courtesy of nixxphotography, jscreationzs, Serge Bertasius Photography, Getideaka, Paul, Mister GC, all at FreeDigitalPhotos.net.

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