The Potential Health Benefits of Vitamin B12
Vitamin B12 is one of the more popular vitamin supplements, and for good reason. The vitamin appears to have potential benefits for preventing dementia, improving mood, increasing energy and helping reduce pain. And while it is also often touted for weight loss, little, if any research supports its ability to help reduce weight. In order to better understand vitamin B12, it’s worth exploring its effects on the body.
The biochemistry of vitamin B12 is somewhat complex. As a vitamin, B12 plays a role in two types of reactions: processing of fats and providing “methyl groups.” Methyl groups are critical for protecting your nerves and for the production of DNA. In fact, a deficiency of vitamin B12 is well known to cause painful nerve damage that, in severe cases, may not be reversible (Green 2017). B12 deficiency can also disrupt the formation of red blood cells causing anemia (Stabler 2013). Some of the potential researched benefits of Vitamin B12 include:
- Helping to prevent Alzheimer’s dementia
- Improving mood
- Increasing energy
- Decreasing pain
Prevention of Dementia
Vitamin B12 has a relationship with the health of the nervous system. Unfortunately, vitamin B12 deficiency is quite common, especially as we get older. Vitamin B12 is the largest vitamin and, as such, is difficult to absorb from food. Estimates suggest that 20% of older individuals have a deficiency of vitamins (Andres 2004).
And vitamin B12 deficiencies are not benign. They can lead to mood symptoms, psychosis and dementia (Lachner 2012). In fact, numerous case reports of reversible dementia due to vitamin B12 deficiencies have been reported (Ishida 2021, Semergen 2020, Soysal 2018). Cases of reversible cognitive problems have also occurred in young adults with vitamin B12 deficiency (Huddar 2021). Unfortunately, vitamin B12 deficiency is often missed due to confusion around the interpretation of laboratory test results (Wolffenbuttel 2019).
As individuals get older, maintaining adequate vitamin B12 is a crucial part of maintaining cognitive function. While there is controversy on vitamin B12 supplementation for preventing dementia outright (Ford 2019), preventing and treating B12 deficiency is still of critical importance (Spence 2016)
Improving Mood
Research has slowly been building that vitamin B12 may play a role in mood. And it makes sense since vitamin B12 is needed for the production of the “feel-good” neurotransmitters dopamine and serotonin. Studies have found that depressed patients are more often deficient in the vitamin (Coppen 2005).
While studies are somewhat mixed, there is evidence of benefits from taking vitamin B12 for mood. In one study, three months of supplementation with vitamin B12 reduced depression scores by at least 20% (Syed 2013). A recent review of vitamin B12 for depression concluded that while it doesn’t appear to help in the short term, using vitamin B12 long-term may help in the management of depression (Almeida 2015).
Increasing Energy
People usually associate B vitamins with energy, which makes sense, since B vitamins are needed for energy production. Vitamin B12 is necessary for the manufacture of DNA, critical for the formation of red blood cells. Red blood cells carry oxygen to your tissues for producing energy. In more severe cases of vitamin B12 deficiency, a person may not make enough red blood cells—a condition referred to as anemia. Without enough red blood cells, there may not be enough oxygen delivered to your cells. This can decrease energy production and cause fatigue.
Clinically, over the course of my medical career, I’ve probably prescribed more than a thousand vitamin B12 injections. In my opinion, around half of people experience an energy boost that lasts a couple of days from a B12 shot, even in the absence of vitamin B12 deficiency. Several studies have also found improvements in energy levels with injections of the vitamin (Ellis 1973, Ali 2013, Regland 2015, Patel 2019). It’s worth noting that oral B12 doesn’t appear to have as strong of an effect (Scholten 2018) and may only work for cases of fatigue directly related to anemia from vitamin B12 deficiency.
Decreasing Pain
Since its discovery, vitamin B12 has been explored as a treatment for different types of pain. While not all studies showed benefits, some conditions did appear to respond—in some cases profoundly.
“Tabes dorsalis” is a condition from another time. Chronic syphilis infections, in advanced cases, can cause severe nerve damage resulting in shooting pain called tabes dorsalis. The condition is often poorly responsive to treatment, even to pain medications like morphine. Yet case reports of profound benefits from vitamin B12 injections have been reported (Redmond 1957). Early research also suggests the benefits of vitamin B12 injections with Morton’s neuroma, a painful nerve swelling in the foot (Steinburg 2007).
More recent clinical trials have found reductions in pain with vitamin B12 for neuropathy, compressive nerve damage and low back pain (Talaei 2009, Yaqub 1992, Goldberg 2017, Mauro 2000). While most studies used injectable vitamin B12, studies on the nerve damage associated with diabetes and compressive nerve damage still found benefits with oral supplementation (Didangelos 2021, Goldberg 2017).
Oral Versus Sublingual
While many sources recommend sublingual vitamin B12, the data appears to suggest that oral capsules are just as effective (Yazaki 2006). In addition, sublingual tablets often include fillers that can have negative effects on the digestive tract. Generally, my preference has been to use oral B12, sublingual liquid formulations or injections when prescribing vitamin B12 for patients.
Conclusion
Vitamin B12 is an important nutrient for nerve health and function. It’s also commonly deficient, especially in older individuals. The vitamin appears to have the potential for the prevention of dementia, improving mood, increasing energy and decreasing pain. Hopefully, more research can flesh out the full benefits and the potential uses of the vitamin.
Author - Dr. Scott Buesing, ND
After receiving a Bachelor’s degree in Electrical Engineering from Iowa State University, Dr. Buesing went on to acquire a Doctorate in Naturopathic Medicine in 2004 from Bastyr University. While in school, Dr. Buesing received an NIH research training grant to study the in-vitro effects of alternative cancer treatment from the 1930s. Upon graduation, he collaborated on several research studies at Bastyr University including the workout benefits of creatine for vegetarians and the weight loss effects of diets high in beans/legumes.
Along with private practice, he gained experience working in two separate multidisciplinary programs, including a partial hospitalization program for patients suffering from mental health conditions in Seattle and a multidisciplinary pain clinic focusing on integrative care. Dr. Buesing utilized treatments including dietary and lifestyle changes, oral and intravenous nutrient therapies, botanical medicine, biofeedback, mind-body techniques, and meditation. While in practice, he taught patient-oriented classes on meditation, nutrition, fibromyalgia, irritable bowel syndrome, and dietary approaches to wellness.
Further articles and writing from Dr. Buesing are available at: https://www.buesingnaturopathic.com/blog/