Vitamin B12: What you should know (for your everyday life & your health)

Vitamin B12 is a small vitamin with a big effect and is one of the most common deficiency vitamins, especially in older people, vegetarians and vegans. Here you can find out why B12 is so important and what you should look out for when taking it.

What do you need vitamin B12 for?

Vitamin B12 is essential for:

• Formation of red blood cells (protection against anaemia)
• Function of nerves and brain
• Energy metabolism and DNA formation

A prolonged deficiency can lead to tiredness, concentration problems, tingling in the hands and feet and, in the worst case, permanent nerve damage.

Who should pay particular attention to their B12 status?

General screening of all people is not necessary, but certain groups are considered at-risk patients:

• Vegans and strict vegetarians
• People over approx. 50-60 years of age (absorption from the intestine decreases)
• People with gastrointestinal diseases or after gastrointestinal surgery (e.g. bariatric surgery)
• Long-term use of:
  • Metformin (from approx. 4 months)
  • Gastric acid blockers such as PPI or H2 blockers (over 12 months)

If you belong to one of these groups, it makes sense to have your B12 status checked by a doctor.

How can you take vitamin B12?

About nutrition

Natural sources are almost exclusively animal productsMeat, fish, eggs, dairy products. Plants provide practically no usable B12 without fortification - which is why vegans need a supplement or regular B12-enriched foods.

About food supplements

For healthy people who want to supplement their requirements (e.g. vegans), the following typically applies:

• daily about 50-100 µg to prevent a deficiency in a plant-based diet
• Preparations with ≤ 20 µg/day are normally in the „supplement range“ and do not trigger any medicinal effects

Important: The body can only actively absorb a small proportion of large individual doses; the rest is hardly utilised. Therefore Regular, rather moderate doses usually makes more sense than rare „megadoses“.

When should high doses be administered by a doctor?

With proven defect or clear symptoms (e.g. anaemia, neuropathies):

• High oral doses (1-2 mg/day) can be as effective as injections
• Injections are often started in cases of severe symptoms or intestinal absorption disorders

Such therapies should always be supervised by a doctor - they are not a „do-it-yourself“ strategy.

Which form is suitable?

In the pharmacy you will mainly find cyanocobalamin, methylcobalamin, hydroxocobalamin and adenosylcobalamin.

All of them can be effective, but they differ mainly in their Stability and processing in the body. For you as a patient, it is usually more important that:

• the preparation Taken regularly becomes,
• it is sensibly dosed (neither extremely low nor unnecessarily high) and
• You it well tolerated.

Storage tips: Vitamin B12 is sensitive to light and heat. It should therefore be kept dry, cool and protected from light. Tablets should not be stored in loose doses in the sun.

Can B12 also do harm?

B12 is considered Very safe, because most of the excess is excreted. Nevertheless, there are points you should pay attention to:

• Very high doses (≥ 200 µg/day) already act like a drug and should be accompanied by a doctor to treat a deficiency.
• Although allergies to vitamin B12 are rare, they can occur, especially with long-term injection therapy. A doctor should be consulted immediately in the event of a skin rash, shortness of breath or swelling.
• The unnecessary and uncontrolled continuous intake of high doses „for safety's sake“ is not sensible and promotes overmedication.

Practical tips at a glance

Situation	Recommendation in brief
Vegan diet	Take 50-100 µg orally every day, permanently
Age > 50 years	Consider fortified foods or supplements, especially for high-risk medications
Proven defect	Medical therapy, usually high doses (oral or injection)
Normal status, mixed diet	A balanced diet is usually sufficient; moderate dose of supplement if uncertain (≤ 20 µg/day)

Overview of typical situations and B12 recommendations.

What the Hasen Apotheke can do for you

We offer you an assessment of whether you belong to a risk group. You will also receive support in selecting a suitable dose and dosage form. Our counselling service will also inform you about possible interactions with your medication.

Book your free consultation appointment in the category „Health advice > Vitamins & supplements”.

Important: If a deficiency is suspected, a blood test should always be carried out at the doctor's surgery instead of resorting directly to dietary supplements.

This way you use vitamin B12 in a targeted way - and not „on the off chance“.