Category: Energy
Vitamin B12 (cobalamin) is essential for myelin synthesis, red blood cell formation, and mitochondrial energy production via the methylmalonyl-CoA pathway. Deficiency, common in vegans, older adults, metformin users, and PPI users, produces fatigue, neurological symptoms, and megaloblastic anaemia that can take months to develop but is fully reversible with supplementation.
1. IMPORTANT: Get a blood B12 level tested before and after supplementation. Normal range is 150–900 pmol/L — deficiency symptoms typically appear below 150 pmol/L but functional deficiency can occur below 300 pmol/L. 2. Choose methylcobalamin rather than cyanocobalamin if you have MTHFR gene variants, kidney issues, or want the active form. Both are effective for most people. 3. Sublingual tablets (dissolved under the tongue) bypass gastric intrinsic factor, making them the best choice for those with absorption issues (metformin users, older adults, achlorhydria, PPI users). 4. Take 1000mcg daily to correct deficiency. Maintenance dose is 500–1000mcg daily for ongoing prevention in high-risk groups. 5. If you take metformin: B12 deficiency develops gradually over months to years. Annual monitoring and supplementation is strongly recommended. 6. Neurological symptoms (tingling, weakness) from B12 deficiency may take 2–6 months to fully resolve even with adequate supplementation — be patient.
B12 cofactor for myelin synthesis (methionine synthase) and mitochondrial energy (methylmalonyl-CoA mutase)
Neurological symptoms may take 2 to 6 months to fully resolve
Not the right fit if any of these apply to you: Leber hereditary optic neuropathy (cyanocobalamin form). When in doubt, check with your pharmacist or GP first.
both
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