Are you vegetarian or vegan?
It is more than likely that most people aware of nutritional supplements are already familiar with B-12 – they have at least heard about it, or read about B-12 deficiency in an online article. It is even more likely that those who adhere to a vegetarian diet, or vegan lifestyle, are already familiar with B-12 and the need to supplement it due to its presence in animal-based foods.
But what about people that aren’t vegan or vegetarian? Is B-12 even a concern to those that consume dairy, eggs, or eat meat regularly? Do vegetarians need to supplement if they’re getting it from fortified foods, such as a plant-based milk? Is it even worth supplementing unless blood work reflects a deficiency?
These are all valid questions and concerns to address, as we try to understand what B-12 is, its role in the body and in physiological functions, as well as the overall importance of supplementation, particularly as we get older – regardless of whether or not one is vegetarian or vegan.
B-12 – or, cobalamin, is a very important water-soluble B-vitamin. It is utilized by the body to produce red blood cells, DNA, and assist in nerve function. Deficiency can result in anemia, fatigue, and nerve disorders – as well as contributing to clinical depression and neurological systems in those with more severe cases of deficiency. B-12 cannot be produced by the body and must be obtained by diet, or through supplementation in the case where it is not already present in the diet.
As someone gets older, B-12 also becomes more difficult to be absorbed and utilized by the body, which is why many adults (even those who consume dairy or meat regularly) are deficient in B-12 and need to rely on supplements to meet their nutritional needs. As well, pre-existing medical conditions such as Crohn’s, gastritis or lupus can make it much more difficult for this nutrient to be absorbed and utilized effectively.
While most B-12 in the diet can only be obtained through animal-based foods, it is not entirely true that it is not found in plant food at all – seaweeds (such as Nori or Spirulina) are often a fairly rich source of naturally present B-12. Unfortunately, it is just much more difficult to consume enough B-12 from the diet on a regular basis to satisfy the body’s requirements appropriately if one is depending on diet and wholefood sources alone.
One aspect that may confuse people looking to supplement B-12 is which one to choose from the many different forms readily available – is all B-12 created equal?
There is methylcobalamin, hydroxycobalamin, adenosylcobalamin, and cyanocobalamin – methylcobalamin and cyanocobalamin are likely the two you will most often encounter while searching for a B-12 supplement. There is an important distinction to be made between these two forms, despite being similar. There are different molecules attached to the cobalt ion in each – a methyl in the ‘methyl’ group and cyanide in the ‘cyano’ cobalamin group. Cyanocobalamin is synthetic – however, it is often used more because it is considered more stable and is more cost-effective when being manufactured and sold. Once ingested, it is then converted in the body into the ‘active’ forms of B-12. Methylcobalamin on the other hand is a naturally occurring active form, and the same you would find in food if you were obtaining B-12 through dietary sources.
People should not fear the ‘cyanide’ attached and associated with cyanocobalamin, as the amount in cyanocobalamin is completely inconsequential and not enough to do any sort of harm – this is something that has undergone testing for toxicity at much higher doses than what one would be taking on a daily basis and still demonstrated to be safe.
While many people seem to think that methylcobalamin is more easily absorbed and ‘better’ than cyanocobalamin, both have been shown to be easily and readily absorbed by the body, and cyanocobalamin has demonstrated easy conversion to the active forms of B-12 once ingested.
Despite this being the case, there are some studies and research suggesting that while both are effective at preventing or alleviating B-12 deficiency completely (and the subsequent symptoms of such a deficiency), methylcobalamin seems to remain in the body for a longer time than cyanocobalamin (and in a higher concentration).
Studies have demonstrated that both forms, when used for 2-3 months, have normalized vitamin B-12 levels in deficient people tested in various research groups, reduced symptoms of neuropathy (as a result of B-12 deficiency), and increased levels in those with (pre-existing) anemia. Even those experiencing symptoms of depression may find relief in supplementing with B-12, based on the role it plays in various neurotransmitter functions.
There are many benefits to supplementing with B-12 that people may not be aware of, as they think of it as solely a supplement for vegans or vegetarians.
Methylcobalamin has been implemented in benefits for more restful and deeper sleep – it seems as though methylcobalamin can assist in melatonin synthesis, and supplementing with it seems to improve quantity of sleep by enhancing melatonin secretion at night. As well, it seems to benefit the quality of sleep one experiences too.
This form – methylcobalamin, also helps convert homocysteine in the body (linked to heart disease and other conditions found in higher levels in those who consume a lot of red meat) into methionine (amino acid and antioxidant that helps produce important molecules and acts as a liver protectant). Research has demonstrated specifically methylcobalamin to have neuroprotective effects based on clinical research in those with pre-existing nerve conditions or disorders. Those with depression or neurological conditions may find some relief in a high-dose methylcobalamin supplement.
Now, what about the less common forms of B-12 – adenosylcobalamin and hydroxocobalamin?
These are the most commonly found forms already in meats, which one would get through diet. Adenosylcobalamin, like methylcobalamin, is an ‘active’ form. Adenosylcobalamin works in the mitochondria of the cell (important for production of energy), and methylcobalamin works in the cell plasma (important for blood formation, DNA synthesis, central nervous system support, fatigue support). Both are required by the body, but they also can both convert within the body to each other. In other words, when you are taking a supplement that is just ‘hydroxocobalamin,’ your body will be working to convert it into the other functional forms once consumed. It just has to work a little harder, which is why a multi-form B-12 is a good option.
For example, while cyanocobalamin does naturally convert within the body, it does have to go through various metabolic processes to do so. Therefore, we can say the ideal B-12 supplement in terms of efficacy would be a combination that contains hydroxocobalamin, adenosylcobalamin and methylcobalamin.
In lieu of this, a good-quality methylcobalamin supplement (which will be easier to find) would be just as beneficial to the average person looking for B-12.
Based on the current field of medical research and information out there (of which there is quite a large volume) – not all forms of B-12 are created entirely equal.
A cost-effective, good quality B-12 supplement in the form of ‘cyanocobalamin’ may help to alleviate any B-12 deficiency and raise the levels within a person’s body to reduce or eliminate any symptoms they may be experiencing as a result of said deficiency.
However, it will not provide all the same benefits (sleep, cognition, neurological) that a high-quality multi-form B-12 supplement will. It will also not provide the same prolonged benefit of ‘methylcobalamin’ (retained in the body for longer, circulates the body for longer, and more easily utilized by the body without having to be converted).
In general, it is always advisable to get your nutrients and vitamins from directly whole-food sources (diet) rather than supplements if possible. However, in the case of B-12 it is always a good idea to look into taking a good-quality nutritional supplement if you’re an adult, someone that adheres to a strict vegetarian or vegan diet/lifestyle, or someone with pre-existing neurological concerns.
In these cases, food-based sources will likely not be enough. B-12 is a very rigorously researched and tested supplement in terms of safety and efficacy. If one needs to take a supplement, a good general approach is to look for a supplement that contains the vitamin/mineral in the natural forms they are found in through the diet.