Vitamin B12 is essential for the body. It is required for:

• Red blood cell formation;
• Neurological function; and
• DNA synthesis.

Vitamin B12 functions and as a cofactor is needed for DNA, RNA, hormones, proteins, and lipids.

Vitamin B12 is bound to protein in food. Pepsin and acid pH in the stomach will degrade these food proteins and release vitamin B12. When the synthetic form of vitamin B12 in Nutritional supplements is added to foods and dietary nutritional supplements, it is already in free form and, thus, does not require activation by HCL or any other enzymes.

Vitamin B12 is naturally found in animal products such as fish, meat, poultry, eggs, milk, and milk products. Vitamin B12 is generally not present in plant foods. Fortified foods vary in formulation, so it is important to read product labels to determine which added nutrients they contain. Older people (due to GI disorders), vegetarians and vegans should have their serum checked as they have a tendency of low B12.

Four different types of B-12

There are four types of nutritional supplements of B-12 that are prescribed by Integrative Medicine Doctor or Complementary and Alternative Medicine practitioners. These are:

• Methylcobalamin

This is the most active form in the human body and is the best form of B-12.  This B-12 form can also cross the blood-brain barrier thus provide overall protection to the nervous system.

• Cyanocobalamin

This synthetic version of vitamin B-12 and is the cheapest form of nutritional supplement B-12. Many Complementary and Alternative Medicine practitioners prefer cyanocobalamin when compared with methylcobalamin. This is because this form of B12 still requires a conversion cyano into methylcobalamin and into ethylcobalamin, all of which requires energy. Some people are concerned by the addition of the ‘cyano molecule’ but there is no scientific evidence to verify this. Furthermore, the cyano form is only an issue if there is a genetic issue of cobalamin metabolism.

• Hydroxocobalamin

Hydroxocobalamin is commonly used via injection as a treatment for B-12 deficiency as well as a treatment for cyanide poisoning.

• Adenosylcobalamin

This form of vitamin B12 stored in the mitochondria and is good for patients who are tired and fatigued. When taken in as a nutritional supplement, the body does not have to convert or activate this form of B12 to get it into the mitochondria.

Take-home message

Depending on your condition, your integrative medicine doctor or Complementary and Alternative Medicine practitioner will prescribe the appropriate Vitamin B12 nutritional supplement for you. Generally, for straightforward cases, either Methylcobalamin or Cyanocobalaminis recommended. Some integrative medicine doctor or Complementary and Alternative Medicine practitioners prefer the sublingual form of Vitamin B12 nutritional supplements, e.g. under the tongue, spray or lozenge. This is absorbed through the mucous membranes under the tongue, by passive diffusion thus avoiding anyone with digestive issues. It is also important to note that some manufacturers try to improve the taste of B-12 supplements by adding sugar substitutes and these can cause gas, bloating, and diarrhoea.