Introduction to Vitamin B12 Injections
Vitamin B12 injections can benefit many, providing a quick and effective means of restoring adequate vitamin levels and preventing debilitating symptoms such as fatigue, weakness, and neurological issues. B12 shots are often necessary for those with a compromised digestive system or lack of high-B12 foods in the diet, and those diagnosed with pernicious anemia, scenarios that all decrease the ability for B12 levels to be maintained through diet or oral supplements. That said, B12 is one of the most prevalent vitamin deficiencies for many due to the more modern lifestyle: changes in our diet (lack of quality foods, lack of food variety), poor digestive health, medication use, chronic stress or illness, and environmental toxicants can all contribute to low B12 levels.
Are you Deficient in B12?
Conventionally, adequate B12 values are placed between 200 pg/mL and 1200 pg/mL. This is an incredibly wide window of “normal” and many are incorrectly told they don’t have a B12 deficiency because they are within this range. However, just because you are within “normal” range does not mean you have adequate B12 levels. Clinically, Dr. Bull looks for values above 400mcg and from a functional (optimization) perspective, she looks to see values >600 pg/mL. The next time your doctor tells you your B12 level is “normal”, look at your value yourself. Additionally, keep in mind that a recent IV, injection, or supplement may cause your levels to come back elevated; always abstain from supplemental B12 at least 72 hours prior to a blood draw.
Common Causes of Low B12
Dietary Causes:
- Low or no red meat intake
- Poor quality red meat intake (grass-fed/pasture-raised animals have higher B12 levels)
- High alcohol consumption
- Older age
Digestive Causes:
- Digestive compromise: GERD/frequent heartburn, history of gastritis or ulcers, food sensitivities, SIBO, H.pylori, etc. Additionally, if you are not having a well-formed, easy to pass bowel movement at least once daily, you likely have digestive issues inhibiting your ability to adequately absorb nutrients and are also at risk for low B12 and other vitamins.
- Gastric bypass/sleeve surgeries: decreased surface area for nutrient absorption and the lingering inflammation from this surgery will put you at risk for nutrient deficiencies.
- IBD or Celiac: I hope everyone with an IBD or celiac diagnosis knows they are risk for nutrient deficiencies – this should be disclosed by every doctor making this diagnosis. The inflammatory state of these diagnoses cause disrupted nutrient absorption and the medications used to treat these diagnoses can also disrupt nutrient absorption.
Medication Causes:
- Use of heartburn medications: these medications are designed to block stomach acid, but stomach acid is needed to adequately digest the foods you are eating extract nutrients for you to absorb. PPIs are well documented to cause decreases in B12, iron, zinc, magnesium, calcium and other nutrients, but this is rarely discussed by most doctors.
- Use of metformin: metformin is another medication well-documented to cause low B12 levels by disrupting a protein that helps with absorption of B12.
- Colchicine (gout medication)
- Oral Birth Control
Other
- Pernicious anemia: if you have chronically low B12 levels without a clear explanation, pernicious anemia should be investigated as the cause, which is an autoimmune condition that affects the absorption of B12. If you have this, weekly to monthly B12 shots are something that should be in your routine.
Benefits of B12 Injections
Vitamin B12 injections offer many health benefits, making them a preferred choice for individuals with deficiencies.
- One of the biggest advantages is the noticeable improvement in energy levels and reduced fatigue, which is advantageous for those leading high-stress lifestyles or recovering from illnesses.
- Improved cognitive function and mood stabilization are prominent benefits, aided by B12’s role in brain health and neurotransmitter balance.
- Recipients often experience better sleep, contributing to a higher quality of life.
- Vitamin B12 injections help prevent anemia.
- It mitigates neurological issues, making it a necessary supplement for those at risk, such as vegetarians, vegans, and older adults.
- Vitamin B12 injections improve your overall well-being.
Different Forms of Vitamin B12
Different forms of vitamin B12 Injections are appropriate depending on your unique biochemistry and needs.
- Cyanocobalamin is the synthetic form used in conventional settings to treat B12 deficiencies and pernicious anemia. However, it may not be the best choice for individuals with methylation issues or those that may be sensitive to its cyanide content. Due to this, it is less recommended for long-term use, but it remains helpful in emergencies.
- Methylcobalamin is the most active form of B12 meaning it doesn’t require any additional steps for your body to use it. This is particularly beneficial for individuals with methylation issues. This is the form we use most readily for injections at Infuse.
- Hydroxocobalamin, is a semi-active form of B12, and can be a good choice for those that feel too stimulated from methyl-B12. We use this form both as an injection and in IVs at Infuse.
- Adenosylcobalamin is another and active form natural form of B12, but not found in injectable form.
How to Use Vitamin B12 Injections
Typically, the effects of a B12 injection can be felt within days and may last for several months depending on your need. For overt B12 deficiency (<200 pg/mL), a once-weekly injection x 4-6 weeks is recommended. This can be followed by monthly injections as maintenance, as needed.
As a water-soluble vitamin, it is hard to over-do B12 as your body will urinate out what it doesn’t need. Those with with sub-optimal B12 levels (<600 pg/mL) may benefit from the one-off injection. However, it is important to understand why your B12 levels are not adequate, and if it is due to a factor you can’t change (dietary preference, IBD, pernicious anemia), then more regular injections up to once weekly may be needed ongoing.
Our expert team in Santa Monica and the Greater Los Angeles area has been blending conventional and alternative medicine to address the root causes of various health conditions—come in and chat with us so we can develop a plan personalized to you.
