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Vitamin B12

Vegans · Elderly · Cognition
Tier 2 — Promising

What it is

Essential for nerve function, energy metabolism, and red blood cell production. About 20% of adults over 60 and 50%+ of vegans are deficient. Absorption declines with age and is impaired by metformin and acid-blocking medications. Deficiency causes fatigue and — if untreated for years — irreversible nerve damage. Sublingual or methylcobalamin forms absorb better in people with absorption problems.

Efficacy
4/5
Safety
5/5
Research
4/5
Onset
3/5
Cost
4/5
Drug-int.
4/5

Dose

500–1,000 mcg/day sublingual methylcobalamin or cyanocobalamin; confirm deficiency with serum B12 + MMA test

Time of day & tips

Sublingual: dissolve under the tongue for best absorption. Take in the morning as B12 can be energising. Space 2 hours from antacids and PPIs, which reduce absorption.

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