Vitamin b12 anxiety

Neuropsychiatric manifestations in vitamin B12 deficiency

. 2022;119:457-470.

doi: 10.1016/bs.vh.2022.01.001. Epub 2022 Mar 3.

Prashant Sahu¹, Harish Thippeswamy², Santosh K Chaturvedi³

Affiliations

¹ Prospect Park Hospital, Berkshire Healthcare NHS Foundation Trust, Reading, Berkshire, United Kingdom.
² National Institute of Mental Health & Neurosciences, Bangalore, India.
³ Leicestershire Partnership NHS Trust, Leicester, United Kingdom. Electronic address: [email protected].

PMID: 35337631
DOI: 10.1016/bs.vh.2022.01.001

Prashant Sahu et al. Vitam Horm. 2022.

. 2022;119:457-470.

doi: 10.1016/bs.vh.2022.01.001. Epub 2022 Mar 3.

Authors

Prashant Sahu¹, Harish Thippeswamy², Santosh K Chaturvedi³

Affiliations

¹ Prospect Park Hospital, Berkshire Healthcare NHS Foundation Trust, Reading, Berkshire, United Kingdom.
² National Institute of Mental Health & Neurosciences, Bangalore, India.
³ Leicestershire Partnership NHS Trust, Leicester, United Kingdom. Electronic address: [email protected].

PMID: 35337631
DOI: 10.1016/bs.vh.2022.01.001

Abstract

Vitamin B12 deficiency can have distressing neuropsychiatric symptoms. It can have an etiological role in clinical presentations like depression, anxiety, psychosis, dementia, and delirium, requiring screening of at-risk populations. Few mechanisms that underlie the neuropsychiatric manifestations of B12 deficiency include alteration in one-carbon metabolism, genetic vulnerability, and alteration in folate metabolism. Maintaining a high serum B12 level in elderly can be protective against Alzheimer's disease (AD). In an established AD, its deficiency is associated with higher cognitive decline and risk for delirium. The other mental changes associated with B12 deficiency include apathy, agitation, impaired concentration, insomnia, persecutory delusions, auditory and visual hallucinations, and disorganized thought-process. Besides serum vitamin B12, plasma methylmalonic acid (MMA) and homocysteine helps in diagnosis. The chapter focuses on early recognition and effective treatment of these neuropsychiatric manifestations of vitamin B12 deficiency.

Keywords: Alcoholism; Anxiety; Delirium; Dementia; Depression; Management; Neuropsychiatric symptoms; Psychosis; Somatoform disorders; Vitamin B12 deficiency.

Cited by

Blood levels of circulating methionine components in Alzheimer's disease and mild cognitive impairment: A systematic review and meta-analysis.
Zhao Y, Dong X, Chen B, Zhang Y, Meng S, Guo F, Guo X, Zhu J, Wang H, Cui H, Li S. Zhao Y, et al. Front Aging Neurosci. 2022 Jul 22;14:934070. doi: 10.3389/fnagi.2022.934070. eCollection 2022. Front Aging Neurosci. 2022. PMID: 35936764 Free PMC article.

MeSH terms

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Does B12 Help With Anxiety

Home Health A Lack of B12 Can Trigger Anxiety. Can Getting More Make You Chill?

Here’s what the research shows.

Fast Facts

Some research shows links between a vitamin B12 deficiency and anxiety.
Vitamin B12 is important for red blood cell production, nerve functioning, and DNA production, all of which are linked to mood.
Research hasn’t proven that supplementing with vitamin B12 improves anxiety, but if you are deficient, talk to your doctor about supplementation.

Anxiety can be isolating, but if you’ve been dealing with spiraling thoughts, constant stress, or a feeling of impending dread you’re not alone: One in six Americans reported a recent bout of anxiety in 2019 (1). During the first year of the pandemic, that number leaped to more than one in three. There’s lots of ways to tackle anxiety, including a veritable smorgasbord of supplements, including vitamin B12. But does B12 help with anxiety?

Several studies have shown that people experiencing anxiety have lower vitamin B12 levels. One 2000 study found that men with vitamin B12 deficiency who recently lost a loved one reported higher levels of anxiety and depression (2). Another found that people who regularly eat yeast-based spreads like Vegemite—which are often fortified with B12—were less anxious than those who don’t eat them (3). And in a 2017 study, more than half of the participants with depression and anxiety had a vitamin B12 deficiency, even though their average age was under 60, a population that usually has only a 4 percent rate of deficiency (4).

But while those studies showed links between B12 and anxiety, they haven’t yet proven that supplementation improves anxiety.

Here’s what we know so far—and how to evaluate if your body (and brain) could benefit from a vitamin B12 boost.

B12 and Anxiety: The Basics

Some studies have found people experiencing anxiety have lower levels of vitamin B12, and that people with anxiety and depression at more likely to have a vitamin B12 deficiency.

How Might Vitamin B12 Affect Anxiety?

Otherwise known as cobalamin, vitamin B12 plays an indispensable role in many bodily functions, including the formation of red blood cells, nerve function, and DNA production (5). All of these are linked to mood.

Nerve Function

Vitamin B12—which is found in a wide variety of animal foods like fish, meat, poultry, and dairy— contributes to the production of myelin, the fatty substance that insulates neurons. This coating enables your nerves to communicate with each other.

If your B12 is lacking, your mental processing speed can slow down, says Lina Begdache, Ph.D., an assistant professor at Binghamton University, who studies the link between diet and mental health.

A sluggish brain may struggle to calm itself when anxiety strikes. “The communication is slower,” explains Begdache. “So people may not be able to control that emotion. It becomes a vicious cycle. One thought would trigger more anxiety, and more anxiety would trigger more negative thoughts.”

Brain Health

Vitamin B12 also helps turn an unusable amino acid, called homocysteine, into a usable compound. Without adequate B12, homocysteine levels rise.

“Homocysteine is very prone to oxidation,” the same process that occurs when metal rusts, says Begdache. “So it actually destroys our proteins, our cells. It destroys brain chemicals.”

In a study of 6,000 people in the Journal of Nutrition, elevated homocysteine wasn’t linked to anxiety, but it was correlated with depression (6).

According to the Anxiety and Depression Association of America, nearly 50 percent of people diagnosed with depression are also diagnosed with an anxiety disorder (7). “Anxiety is a prerequisite of depression,” says Teodoro Bottiglieri, Ph.D., co-author of Homocysteine: Related Vitamins and Neuropsychiatric Disorders. “Before you get to the point of clinical depression, there’s typically—not always, but in many cases—a period where [people] are very anxious.”

DNA and Red Blood Cell Production

Vitamin B12 is needed to create red blood cells, which deliver oxygen to the brain. That means B12 deficiency can lead to a decline in your healthy red blood cell count—which equals lower levels of oxygen being delivered to your brain. B12 is also needed for DNA production. If your body isn’t able to make enough high-quality DNA, new cells might lack the genetic material they need, says Begdache. “When [you] don’t have enough of the precursors to produce the brain chemicals needed”—including mood-regulating dopamine and serotonin—“then [you may have] heightened anxiety,” says Begdache.

Health

B12 and Mood

Vitamin B12 is necessary for several important functions in your body that have been linked to mood, including the formation of DNA, nerve function, and red blood cells.
If your B12 levels are low, your body may not be able to carry out these key processes well.

Can Supplementing With Vitamin B12 Ease Anxiety?

Despite the clear role of B12 in our brains, conclusive research on supplementation to treat anxiety is lacking. In an Australian study, for example, stressed-out workers given a vitamin B-complex supplement didn’t report any changes in anxiety after three months (8). In fact, they fared no better than those who took a placebo. But the supplement only contained 30 micrograms of vitamin B12—a dose much lower than is typically given therapeutically—and the researchers didn’t assess whether the study participants were deficient before starting supplementation.

A 2019 meta-analysis (9) concluded that taking B vitamins can help reduce stress, but have no beneficial effect on anxiety. (Stress is typically triggered by something outside yourself, while anxiety persists even when there’s no external stressor.) But take a peek at the study population, and you’ll see that, on average when measured, the participants’ B12 levels were adequate and that those with mood disorders weren’t included.

In other words: studies haven’t shown that supplementing with vitamin B12 will calm anxiety. But one thing that is clear is that severe vitamin B12 deficiency can cause neuropsychiatric symptoms—including anxiety.

Vitamin B12, now available from Hone, may boost your energy, reduce stress, and support your brain. Connect with a doctor to see if it’s right for you.

What Are The Symptoms of Low B12 Levels?

Some of the most common symptoms of low vitamin B12 include:

Fatigue
Faintness
Shortness of breath
Loss of appetite or weight loss
Heart palpitations
Pale skin
Sore tongue
Mouth ulcers

Severe, prolonged vitamin B12 deficiency can lead to neurological symptoms including:

An inability to feel vibrations (particularly in your legs)
Headaches
Difficulty balancing
Tingling hands, feet, and limbs
Cognitive and psychological changes

You won’t necessarily experience the minor symptoms first. “[People] may not even know they’re B12 deficient until they start manifesting some more severe symptoms, which may initially present as just agitation and anxiety,” before progressing into more serious psychiatric disorders, says Bottiglieri.

And not all patients have the same set of symptoms—some deficient folks don’t have any symptoms at all.

“You could have somebody who has a B12 deficiency of approximately the same level, but may present with hematological problems and not neurological—or vice versa,” Bottiglieri says. “But ultimately if you leave them untreated, they will develop both.”

Vitamin B12 deficiency can cause neuropsychiatric symptoms—including anxiety

How Can I Find Out if I am B12 Deficient?

Unfortunately, determining whether you’re getting enough of the nutrient isn’t totally straightforward.

“The sensitivity of measuring B12 in the blood is not great,” says Ralph Green, M.D., a professor of medicine at U.C. Davis.

Complicating matters is that the amount of vitamin B12 in your blood doesn’t reflect how much is in your tissues. “You may test for B12 in the blood, and you have enough B12,” says Begdache. “But how are your cells—your brain—using B12? That may be the issue.”

If you have a genetic variation that affects the proteins delivering vitamin B12 to your cells or the receptors enabling it to enter, you may not effectively utilize the micronutrient, even if your blood levels are adequate. “It’s a very complex process, and that may explain the differences in research results,” says Begdache. Studies can’t always capture the intricacies of how vitamin B12 is being used in our bodies—no matter what your blood levels of the vitamin seem to say.

Your move: If you’re experiencing symptoms of low vitamin B12, ask your doctor for a blood test that measures total vitamin B12, along with the following compounds: methylmalonic acid (MMA) and homocysteine. Both compounds are elevated when you’re vitamin B12 deficient and are more sensitive predictors of deficiency than your serum level of the vitamin.

“If you have an elevation in both homocysteine and MMA, we’re 95 percent sure that it’s a B12 problem,” says Bottiglieri. (Homocysteine is also elevated in folate deficiency, so if you’re only going to test one, opt for MMA, which only increases with vitamin B12 deficiency.)

Another test to ask your doctor about: holotranscobalamin, sometimes called active vitamin B12. This test assesses the B12 that’s available for your cells to use, so it may provide a better sense of how well your body is utilizing the vitamin, says Begdache.

Testing for B12 Deficiencies

Blood tests can assess whether you are deficient in vitamin B12.
If you have symptoms of low B12, you may want to ask your physician about testing your levels of MMA and homocysteine, compounds that are elevated when vitamin B12 levels are low.

I Have Anxiety. Should I Test My B12 Levels?

Anxiety alone doesn’t mean you have low B12 (although it could feasibly be your only symptom). But if you have an elevated risk of deficiency, it’s worth investigating with the blood tests mentioned above.

At-risk groups include vegans and vegetarians (since most dietary sources of vitamin B12 are animal products), or people whose bodies may not absorb enough of the vitamin due to:

Age (60+)
Gastrointestinal diseases (like Crohn’s, ulcerative colitis, or celiac disease)
Pernicious anemia
Bariatric surgery
Long term use of proton-pump inhibitors or h3 blockers

“If people in these groups have noticed a change in their mood recently, they may want to investigate B12,” says Begdache.

Should I Take Vitamin B12 for My Anxiety?

If a test shows that you’re deficient, dose up on vitamin B12 regardless of your anxiety’s origin, since some of the neurological effects can be irreversible. If your mood improves, don’t discontinue any prescription medications, like anti-anxiety drugs or antidepressants, without consulting your doctor.

If you’re not short on the stuff (and have none of the conditions that predispose you to deficiency), there’s no strong evidence to suggest that vitamin B12 supplementation will ease your anxiety.

Low B12: Are You at Risk?

People more at risk for vitamin B12 deficiencies include those over the age of 60, those with G.I. diseases or pernicious anemia, people who have had bariatric surgery, and people who have used PPI medications for long periods of time.

Getting vitamin B12 through Hone. You can have an asynchronous visit with a doctor to determine if it’s right for you.

How Much B12 Should You Take?

If you’re vitamin B12 deficient due to low dietary intake (e.g. you’re vegan or vegetarian), you can replenish your stores with a daily oral dose based on your doctor’s recommendation.

If you’re unable to adequately absorb B12, due to age or an underlying health condition, your best bet is B12 injections, which bypass your gut and send the micronutrient directly into your muscle.

What Are The Side Effects of Taking B12?

While there are no known serious side effects from vitamin B12 supplementation, high doses may lead to:

Headache
Nausea/vomiting
Diarrhea
Fatigue
Weakness
Loss of appetite
Tingling in the hands and feet

Vitamin B12 shots can result in injection-site soreness, redness, and swelling.

The Bottom Line

While there have been documented links between vitamin B12 deficiency and anxiety, experts still aren’t sure about the mechanisms behind the association, or whether supplementation will help treat anxiety, especially if you’re not vitamin B12 deficient.

References:

1. Emily P. Terlizzi, M.P.H., and Maria A. Villarroel, Ph.D. (2020) Symptoms of Generalized Anxiety Disorder Among Adults: United States, 2019. https://www.cdc.gov/nchs/products/databriefs/db378.htm

2. Baldewicz TT, et al (2000). Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men.

3. Kathleen Mikkelsen et al (2018). Yeast based spreads improve anxiety and stress.

4. Lindsay H Allen, (2009). How common is vitamin B-12 deficiency?

5. Vitamin B12 [Fact Sheet]. Mayo Clinic.

6. Helga Refsum, et al (2006). The Hordaland Homocysteine Study: A Community-Based Study of Homocysteine, Its Determinants, and Associations with Disease.

7. Anxiety and Depression Association of America.

8. Stough C, et al (2011). The effect of 90 day administration of a high dose vitamin B-complex on work stress. https://pubmed.ncbi.nlm.nih.gov/21905094/

9. Young LM, et al (2019). A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals.

10. Firth J, et al (2019). The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials.

11. Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review.

biological significance, ways to eliminate deficiency

Vitamin B12 or cobalamin is one of the vital trace elements responsible for many processes in the body. It ensures the normal functioning of the brain, is necessary for energy production, blood formation, body cleansing, proper functioning of the immune system, is responsible for performance, memory and good mood.

The biological significance of vitamin b12 is determined by the following clusters:

metabolism of fats: lipoproteins, cholesterol, short chain fatty acids
hematopoiesis: involved in the formation of erythrocytes - red blood cells
synthesis of DNA, RNA, phospholipids of cell membranes and cell structure
hormonal metabolic processes
neuroprotective and neurotrophic effects
regulation of the methylation cycle
energy production by supporting the metabolism of amino acids, fats and carbohydrates
detoxification
mood and sleep regulation through neurotransmitters.

Vitamin B12 prevents the occurrence of pernicious anemia, heart attack and stroke, helps in the treatment of nervous diseases, relieves anxiety, irritability, relieves depression, hypertension and sclerosis, and is even able to eliminate pain. It is especially useful for children, as it is responsible for the growth and development of all organs. Helps to concentrate and memorize large flows of information.

Biochemically, vitamin B12 is the generic name for the vitamer compounds known as cobalamins. Various forms (vitamers) of B12 have a deep red color due to the color of the cobalt-corrine complex. The term "B12" is used to refer to cyanocobalamin, the main form of B12 found in foods and supplements.

This compound was first synthesized in the laboratory in 1973. This was preceded by in-depth studies and clinical observations of a special form of anemia - malignant, which was considered deadly for a long time. In the 60-70s of the XIX century it was found that this disease can be successfully treated with raw liver, which contains some element that affects a certain component of gastric juice. Dedicated at 1934 from beef liver, vitamin B12 (cobalamin) turned out to be the same healing factor.

Where is vitamin B12 found in foods

B12 vitamin is the only one not found in fruits and vegetables. Cattle, eating grass, produce it with the help of bacteria in their own digestive system. That is why a lack of B12 is observed most often only in vegans. Vegetarians who consume dairy products suffer less from this.

However, for many years vegans have been debating the lack of vitamin b12 in their favorite plant foods, claiming that it can be obtained from spirulina, nori, tempeh, barley grass and other such superfoods. However, after 60 years of detailed study of this topic, this theory collapsed. Numerous studies have proven that the only non-animal way to replenish a deficiency of this important nutrient is to supplement with vit b12, as well as to include fortified grains or fortified dairy products, such as soy, oat and rice drinks in the diet.

b12 deficiency symptoms

Hypovitaminosis b12 is a fairly common phenomenon, especially in older people, since over the years the percentage of animal food in their diet is significantly reduced, and the ability to assimilate it from food is also deteriorating. Those at risk include those who have had surgery to remove the part of the intestine that is responsible for the absorption of this micronutrient, those who take the drug metformin for diabetes, long-term antacids for heartburn, and those who follow a strict vegan diet.

Symptoms of deficiency in the “red vitamin” may manifest themselves over the years with various diseases or clinical symptoms, but diagnosis is not always successful. For example, cyanocobalamin deficiency is often mistaken for a lack of folate in the body.

Symptom complexes may include hematological, neurological, gastroenterological, mental and cardiac disorders. Often this is expressed by chronic fatigue, glossitis, lack of appetite and a sense of taste, bad mood, persistent headaches, dizziness, impaired cognitive and intellectual functions, visual impairment, dysphagia, unsteady gait, and speech difficulties. A persistent deficiency of vit12 can even lead to mental disorders: depression, memory loss, dementia, psychosis. External signs of its lack of receipt by the body are also ulcers on the mucous membranes and seborrheic dermatitis.

The main symptoms of B12 deficiency are:

1. Pale or icteric skin

People who do not get enough of this vitamin often look pale or have a slight yellow tinge to the skin and whites of the eyes. Paleness is caused by problems with the production of erythrocytes - red blood cells, and yellowness - an excess of bilirubin, which is generated by the liver when old blood cells are destroyed and gives the skin and eyes a yellowish tint.

2. Weakness and fatigue

These symptoms are due to insufficient amounts of vitamin B12 in the body to produce red blood cells that carry oxygen throughout the body. In the elderly, this type of anemia is often caused by an autoimmune condition known as pernicious anemia.

3. Tingling sensations all over the body

One of the most serious side effects of prolonged B12 deficiency is nerve damage. This may occur over time as this compound is an important participant in the metabolic pathway that produces the fatty substance myelin.

Myelin surrounds the nerves as a form of protection and isolation. Without B12, myelin is produced differently and the nervous system cannot function properly. One of the common signs of impaired myelin production is paresthesia - a sensation of tingling of the extremities with small needles. It has been established that these neurological symptoms very often occur together with anemia. Thus, vitamin B12 plays an important role in the production of myelin, which insulates nerves and is critical for the nervous system.

4. Changes in mobility

If left untreated, damage to the nervous system due to B12 deficiency leads to impaired musculoskeletal function. This can affect balance and coordination, making the person more prone to falling. This symptom is often observed with an undiagnosed B12 deficiency in the elderly, since people over 60 years of age are more prone to its hypovitaminosis. This symptom may also be present in young people with severe, untreated deficiency. Preventing or correcting cobalamin deficiency can improve mobility.

5. Glossitis, mouth ulcers and loss of appetite

Glossitis is a term used to describe an inflamed tongue that changes color and shape, becoming painful, red and swollen. Glossitis can also make the tongue smooth, as all the tiny bumps on it that contain taste buds stretch and disappear. This disease not only causes pain, but also affects the process of eating and speech functions.

Studies have shown that a swollen and inflamed tongue with long straight lesions and loss of appetite may be an early sign of vitamin B12 deficiency. In addition, some people with hypovitaminosis may experience other oral symptoms such as ulcers, a burning and itching sensation in the mouth, or a feeling of pins and needles in the tongue.

6. Shortness of breath and dizziness

In anemia caused by a lack of cobalamin, a person may feel short of breath and dizzy, especially when exerting himself. This is due to the fact that the body lacks red blood cells, which are necessary to obtain enough oxygen in the cells of the body. However, these symptoms can have many other causes that require a detailed analysis by the attending physician.

7. Impaired vision

One of the symptoms of hypovitaminosis B12 is blurred or impaired vision caused by damage to the optic nerve nervous system. Due to the deficiency of the microelement, a violation of the nerve signal passing from the eyes to the brain occurs, and vision deteriorates. This condition is known as optic neuropathy and is treated with vitamin B12.

8. Mood changes

People with B12 deficiency often report mood changes. Low levels of the vitamin have been linked to mood and brain disorders, including depression and dementia. The “homocysteine depression hypothesis” has been proposed as a potential explanation for this association, which suggests that high homocysteine levels caused by low B12 levels can damage brain tissue and interfere with the movement of signals in and out of the brain, leading to mood changes.

Research shows that in some people with B12 deficiency, taking the vitamin can reverse symptoms and improve mood. However, it does not replace other proven medical treatments for depression or dementia.

9. High fever

A very rare but occasional symptom of cobalamin deficiency is high fever. It's not clear why this happens, but some doctors have reported cases of fever that returned to normal after treatment with low levels of vitamin B12. It is important to remember that high temperatures are most often caused by illness, not B12 deficiency.

10. Memory loss and difficulty thinking

It has been established that cognitive decline in old age occurs against the background of long-term b12 deficiency. Very often diseases such as Alzheimer's disease, schizophrenia and bipolar disorder can be associated with this. Studies of people who died due to these diseases have shown a significant lack of this compound in the brain. Severe hypovitaminosis of cobalamin can lead to deep depression, paranoia and delirium, memory loss, urinary incontinence.

11. Frequent constipation and unreasonable weight loss

One of the significant causes of hypovitaminosis B12 is atrophic gastritis on the background of chronic Helicobacter pylori infection or autoimmune origin. With this disease, the gastric mucosa sharply becomes thinner, and the glands atrophy. Everything can be accompanied by constipation, diarrhea, weight loss, even with a normal diet.

Due to disruption of the internal factor of the stomach, vitamin B12 is not absorbed, which leads to its deficiency and the development of megaloblastic anemia. At the same time, the risk of adenocarcinoma of the stomach increases by 3 times. Treatment is by parenteral administration of vitamin B ₁₂ .

Daily value of vitamin B 12

The daily requirement of vitamin B12 depends on age. For an adult, it averages 2–3 mcg, for children 0.3–1.4 mcg, adolescents - 2.0 mcg, for pregnant and lactating women, the vitamin norm should be more - 2.2–7.6 mcg. An upper acceptance limit has not yet been set. Expenditure on a traditional diet is 2-5 micrograms per day, which may be higher than normal intake, although studies have shown that 6 micrograms of vitamin B12 per day is sufficient to maintain normal plasma levels. Regular food contains 5-7 mcg of cobalamin per day, which completely covers its daily requirement.

The daily content of vitamin B12 can be obtained from the following products:

Stuffed Beeing liver - 20 g
Hot Salmon - 40 g,
Hot processing beef - 100 g
turkey - 110 g
boiled eggs boiled eggs - 130 g
cheese - 140 g,
cottage cheese - 550 g,
milk - 750 g. Indications for the use of food supplements and vitamin complexes containing vitamin B12 are pregnancy and lactation, old age, and vegetarianism. However, you should check with your doctor before taking B12 supplements, as some medications can make it less absorbable by the body.

Food additives

The National Health and Nutrition Survey found that 3.2% of adults over 50 have severely low B12 levels, and up to 20% may be borderline deficient.

Severe vitamin B12 deficiency can be corrected by taking standard multivitamin supplements containing 6 micrograms of the nutrient, which is more than enough to meet the body's daily requirements.

Dietary supplements with cobalamin are recommended for people with dietary restrictions, vegetarians and vegans, pregnant and lactating women, and people over 60 years of age, as there is a decrease in gastric acidity with age, which impairs the absorption of the vitamin.

The European Food Safety Authority (EFSA), which provides scientific advice to leading companies in the industry, has approved the consumption of vitamin B12 supplements.

When choosing a vitamin supplement, you should pay attention to the manufacturer and the composition of the product. Some of the best drugs in this category include the products of the leading American company Country Life, which produces vitamin B12 in the form of lozenges with methylcobalamin, chewing sweets, capsules, and also as part of special vitamin complexes for pregnant women and the elderly (support for brain functions).

Prescription drugs

Naturally occurring vitamin B12 (usually in the form of cyanocobalamin) is ingested in the diet in protein-bound form. In the stomach, due to the activity of hydrochloric acid and pepsin, it is released, binding to R-protein - a protein in saliva and gastric juice.

For the treatment and prevention of hypovitaminosis B12, parenteral and oral forms of administration are used. Sometimes hydroxocobalamin is used in the form of injections. The duration and treatment regimens are set individually.

Parenteral cyanocobalamin is administered intramuscularly or intravenously to eliminate the deficiency. For treatment use 1 mg daily for 1-2 weeks, maintenance dose - 1-2 mg from 1 time per week to 1 time per month, for prevention - 1 mg 1 time per month.

However, it has been proven that oral intake of B12 is absolutely not inferior in effectiveness to intramuscular administration, even in old age or with pathology of the digestive tract. The possibility of achieving and maintaining long-term remission when taking vitamin B12 orally is achieved in high daily doses up to 1000 mcg. Since this vitamin can be stored and is not toxic, it makes sense to drink or inject it not constantly, but in courses.

B12 side effects

Vitamin B12, like most vitamins, is water soluble. In the body, it can persist for 5 years, the excess is excreted in the urine. Numerous observations have shown the absence of unwanted side effects with an overdose of even 1000-5000 mcg, since the body itself gets rid of the excess.

However, despite all this, some studies have shown side effects in the form of skin rashes and rosacea from the use of large doses of cyanocobalamin in injections. Nutritionists say that excess B12 can manifest itself in the form of allergies, a tendency to clot formation, and even lead to heart ischemia and stroke. It is believed that significant amounts of the microelement are one of the reasons for the progression of kidney disease that arose against the background of diabetes, namely diabetic nephropathy. In addition, taking high doses during pregnancy has been associated with a risk of developing autism spectrum disorders in children.

However, it has been absolutely established that the use of 2 mg of the “red vitamin” per day is absolutely safe and most effective in treating a deficiency of this element.

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What foods are rich in vitamin B12

Vitamin B12 is an essential vitamin that the body cannot produce on its own. It plays a critical role in DNA synthesis and energy production, as well as maintaining normal nervous system function and metabolism. And since we can't produce it ourselves, it's important to remember to include foods rich in this vitamin in your diet.

Ekaterina Belchikova

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Replenishing the daily requirement of this vitamin is very simple, you just need to find a couple of favorite foods for yourself

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Symptoms of vitamin B12 deficiency may include pale yellow skin, pain and redness of the tongue, irritability, depression, blurred vision, mouth ulcers and tingling. However you should not self-diagnose yourself , if you notice strange symptoms in yourself, it is better to consult a doctor. And to avoid vitamin deficiency, you can simply follow the right diet.

So what foods are high in vitamin B12?

Beef

A 190g steak contains about 11.2 micrograms of vitamin B12, which is about four times the daily value (3 micrograms for adults)! In addition, beef contains other nutrients needed to maintain health. For example, iron, zinc and selenium, as well as other B vitamins.

Iron plays an important role in the production of red blood cells, which carry oxygen throughout the body, while zinc helps our bodies create new cells and is important for wound healing. Selenium is essential for a healthy immune system. Doctors and scientists do not advise getting involved in red meat, but you should not forget about it completely.

Nutritional Yeast

Nutritional yeast is often fortified with vitamin B12. They are indispensable for those who follow a vegan diet or other diet based mainly on plant foods. You will be surprised, but they are perfect for sprinkling pasta, salads and risotto! It's all about the taste, which resembles something between nuts and parmesan.

Dairy products

Vitamin B12 is found not only in milk, but also in other dairy products such as cheese and yogurt. A cup of skimmed milk contains 1.1 micrograms of vitamin B12, which is just under half the daily value. It is important that dairy products also contain a lot of calcium, which is good for muscle function and blood clotting.

Egg

Chicken egg is not only a good source of protein, but also one of the key sources of vitamin B12. One egg contains an average of 1.4 micrograms of vitamin B12, which is about half the daily value of vitamin B12. Thus, a couple of eggs for breakfast will help ensure your daily recommended amount of vitamin B12. Eggs are also good sources of other vitamins and minerals, including vitamin D, selenium, and choline.
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Vitamin b12 anxiety

Neuropsychiatric manifestations in vitamin B12 deficiency

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References:

1. Emily P. Terlizzi, M.P.H., and Maria A. Villarroel, Ph.D. (2020) Symptoms of Generalized Anxiety Disorder Among Adults: United States, 2019. https://www.cdc.gov/nchs/products/databriefs/db378.htm

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Beef

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Dairy products

Egg