Vitamin B12 Problems?

Is It From Diet Deficiency or Poor Absorption?

by Doc Don Davis

There are many health problems that aB12re linked to Vitamin B12 levels but most doctors assume that it’s a matter of deficiency. In reality, at least in North America, it is much more likely an issue with absorption. It’s thought that about 30% of people over 60 are affected by low B12 levels (aka hypo-cobalaminemia).


B12 is vital for proper brain and nerve health and so it’s linked to many brain and energy maladies like memory loss, anemia, cardiovascular disease and numbness, tingling, depression and loss of cognition that can be the beginnings of dementia.


Years ago it was believed that B12 deficiency was due to dietary intake because of the predictable deficiencies that can occur with vegetarian/vegan diets and the problems in developing countries. While it is true that this presents a problem, we find that even people with adequate meat in the diet are prone to this condition.

Contrary to popular belief, not only strict vegetarians (vegans) are at high risk of vitamin B-12 deficiency.

Am J Clin Nutr February 2009 vol. 89 no. 2 693S-696S

Since dietary intake is usually adequate, that leaves poor absorption as the major reason for B12 deficiency. This is by far the most common reason for low B12 and the subsequent declining brain dysfunction and anemia.

Stomach acid and Vit B12?

graphAbsorption of B12 occurs in the intestines but must have a healthy stomach that produces stomach acid and intrinsic factor tomake this happen. Unfortunately, stomach acid declines with age which affects the level of intrinsic factor and then the B12 levels start to plummet. This can be helped and actually reversed with supplemental hydrochloric acid (HCL).


Intrinsic factor can also be lowered when you have a condition called Pernicious Anemia that can cause fatigue, lethargy and weakness. This is an auto-immune condition where the body attacks the cells that make intrinsic factor. In this case, treatment must include the immune system as well as the low levels of hydrochloric acid.

How about inflammation?

There are other reasons for decreased B12 absorption, like bacterial overgrowth, intestinal inflammation and gluten sensitivity. Inflammation can make it difficult for micronutrients like B12 to pass through an inflamed and damaged gut lining into the bloodstream.


These conditions can be treated successfully by testing for the cause of the inflammation and then treating with proper gut repair and restoration.

Should I take extra B12?

Should I need an extra B12?B12 has low toxicity but it’s not wise to take B12 without testing to see if you are deficient. You should also work with a qualified health care practitioner to determine the correct dose. The best and most absorbable form of B12 is called methyl 12 or methyl cobalamin. This form is more active neurologically and helps in the liver detoxification process reducing inflammation.


B12 isn’t something that we can ignore. Studies show less brain shrinkage and cognitive decline when B12 is at high levels. So make sure that you know your B12 levels and find a doctor that can help you with the possible causes of low B12.



  1. Jana Kolc, M.D. November 11, 2016 at 7:48 pm - Reply

    Thank you, for a great article.
    I the old days, it was not uncommon to give IM shots to make patient feel better.
    Now our knowledge of benefits
    Is getting better.
    I would like to read more, know what brand is the best and the dosages.
    I have enjoyed your article.
    Thank you, Dr Kolc

    • admin November 22, 2016 at 4:38 am - Reply

      Hi Dr. Kolc,

      Thanks for the kind words. As you know it’s possible to be deficient in B12 and eat meat, so the kind of meat is important. Liver, sardines, and salmon are very high in B12 and should take care of most problems. I usually run a methylmalonic acid, homocysteine to get a better idea if this is a possibility. MCH, MCHC and RDW tests can also indicate the need.

      I use a sublingual methylcobalamin when indicated because it will bypass the GI tract on the first go around and so absorption is much better.

      Dose: 1mg. Jarrow Formulations Methyl B12 is good source.

      Take care,

      Dr. D

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