B12 is a crucial vitamin responsible for many important functions. Essential for brain, nerve function and red blood cell production.

More than 80 Million Americans

It has been estimated that vitamin B12 deficiency is present in about 20% of the general population of industrialized countries.[1] 39% of 2,999 subjects in the Framingham Offspring study, were found to be B12 deficient. If this is true of the rest of America, more that 80 million adults may have B12 deficiency - a condition that may be undetected or unrecognized.[2]

Common causes of b12 deficiency in people who may have special dietary needs.

Vegans & vegetarians

Because B12 comes from animal source foods, vegans and vegetarians have been shown to have the lowest dietary intake. It has been reported that between 70% and 80% of vegans have a B12 deficiency and need supplementation.[3]

Gastric Bypass Surgery

Over 200,000 gastric bypass surgeries are performed in the US every year. The most popular type of surgery removes part of the stomach that makes Intrinsic Factor which can cause lifelong B12 deficiency. [4]

Autoimmune Diseases

Antibodies produced by the body in the progression of autoimmune disease, can destroy Intrinsic Factor or the cells in the stomach that make it. This process is known to cause severe B12 deficiency and is called Pernicious anemia. [5]

Medications like Metformin for Diabetes and Antacids for Acid Reflux disease

Many diabetics who take metformin develop vitamin B12 deficiency. Antacids , PPIs or H2 blockers used for GERD or acid reflux reduce IF production. This also happens when the stomach lining gets thinner as people grow older (>50 years) and this leads to reduction in B12 absorption. [6,7,8,9]

global B12 Deficiency

Effects of b12 deficiency

Severe B12 Deficiency May Cause Many Clinical Abnormalities Including...

Neuropathy

Numbness, tingling, shooting pains in feet and poor balance

50%
...of diabetics have neuropathy and B12 deficiency triples the risk [10]

Anemia

Pallor, low energy, light-headedness and weakness

50%
...of women in many parts of the world are anemic due to B12 and folate deficiency [11]

Heart disease

Higher risk for heart attacks, heart failure and stroke

84%
...of Indian population have high homocysteine levels - a risk factor that doubles the risk of cardiovascular disease. The B12 deficiency is associated with a high prevalence of a vegan or vegetarian diet in this population[12]

Dementia

Memory, attention and cognitive decline

80%
...relative risk increase for Alzheimer's when homocysteine levels elevated due to B12 and other Single Carbon nutrient deficiency [13]

Depression

58%
... of depressed subjects in a randomized clinical trial had low to low-normal B12 levels.[14]

Osteoporosis

90%
...increased relative risk of fractures when homocysteine levels are very high due to B12 and Single Carbon nutrient deficiency [15]

a healthy pregnancy needs b12

Folate, B12 and choline are very important during early pregnancy to promote healthy fetal development. Adequate intake (400mcg per day) of folate by pregnant women may reduce the risk of serious birth malformations like Neural Tube Defects (e.g. spina bifida). These nutrients are especially important to promote normal brain development.[16][17]

Other important nutrients for a healthy pregnancy

Folate

Choline

DHA

Iron

Current Options for Addressing b12 deficiency

  • B12 Injection by prescription
  • Nasal Spray by prescription
  • Oral Supplements
  • Sublingual Supplements

Limitations with these solutions?

Most current options give massive doses (500 - 5,000mcg) of B12 when the body can only use about 5 mcg/day. The large excess is not only wasted, but has been associated with increased risks of cancer and other serious problems. [18]

  • Injections doses of 1000mcg are usually excreted by the kidneys within 2 days and besides being way too much, do not last the week, let alone the month.[19]
  • Only 8.9% of the nasal spray version can be absorbed through the nasal mucosa as compared to intramuscular injection, but expensive and red (B12 is red) dripping from the nose is an unpleasant side effect.
  • Oral supplements are also usually in huge doses of which only about 1% can be absorbed. [20]
  • Sublingual supplements do not offer any advantage over oral supplements and are absorbed as poorly as over the counter supplements.[20]