Vitamin B12: Something to measure or not to measure -- and WHY

Elizabeth asked... Is it necessary or desirable to have my vitamin B12 levels checked?

Yes, and YES!

Vitamin B12 is important for good health. If you’re low on vitamin B12, you could develop...
  • weak muscles
  • numbness
  • trouble walking
  • nausea
  • weight loss
  • irritability
  • fatigue
  • increased heart rate
And who needs that?

Ask your doc to add the vitamin B12 blood test to your lab script next time you're due for blood work. Different labs use different measurements. Generally, results above 200 or 250 pg/mL (148 or 185 pmol/L) or so means that you’re


We don’t need a lot of vitamin B12 to stay healthy, but we do need a steady supply. Most adults need 2.4 mcg (micrograms) a day. To get an idea of what that means… 3 ounces of pan-fried beef liver has more than 70 mcg. BLAH! Beef, salmon, and tuna have about 2.5 mcg in each 3 oz. serving. But these aren’t such great options either. See below.

Things to consider:
  • Metformin and PPIs (Pepcid, Zantac, Prilosec, etc.) can lower B12 levels.
  • As we age, it’s more likely that we can be low in vitamin B12 levels. 20% of 60+ year-old US adults are low in vitamin B12.
Intrinsic factor is the compound in the gut that allows the body to absorb vitamin B12. The body makes less intrinsic factor as we age so it's good to have more vitamin B12 around to improve your chances of B12 levels staying adequate.

Your body wants its vitamins from whole food. 
Vitamins that come in pill form are not ideal but are sometimes needed.

There aren’t many clean or safe food sources of vitamin B12. Here’s why…
Vitamin B12 is made by bacteria, not by plants or animals. These bacteria are in manure and unsanitized water – 2 things that you'd agree that we don’t want to eat and drink. But these bacteria ARE in and on the animal products that we buy at the supermarkets – so we DO EAT IT after all!

Generally, animal products spend their lives in unsanitary conditions. Not only do they live in manure, but many eat manure. (For example, cows are sometimes fed poultry waste.) Don’t believe me? This report that says that most meats are contaminated with fecal bacteria which can cause an array of ailments from diarrhea to death.

Relying on seafood to get your vitamin B12 isn’t wise either. Toxins like pesticides and plastics in our waters build up in seafood. And we eat that! Likewise, these toxins get stored in our bodies. They interfere with normal nerve function and can cause dementia, Alzheimer's, and Parkinson's, etc.

It’s probably ok to eat animal products occasionally, but it’s much safer for you to EAT CLEAN FOOD.

You'll have to be a little creative here. In their whole forms, fruits and vegetables, beans and lentils, and whole grains like oatmeal and brown rice won’t give you a lot of vitamin B12. So choose plant-based milks and cereals that have been fortified with B12 and tofu and tempeh to boost your B12 levels.

Try nutritional yeast. It's known as the 'Parmesan cheese of the plant-based food world.' It’s deactivated and dried into tiny granules or flakes. It has a nutty-cheesy flavor that’s perfect in sauces, salads, pasta, and more. Depending on the variety and the brand, nutritional yeast contains 8 to 24 mcg of vitamin B12 in every ¼ cup. Email me back by replying to this message, and I'll send you some of my favorite recipes that use nutritional yeast.

Animal foods threaten my health. I avoid them. 
I take a 500mcg vitamin B12 supplement 3 or 4 days a week. I use a few tablespoons of nutritional yeast in bean dishes, in 'cheez' sauces, and in hummus every week. I drink oatmilk that does not contain oil (read your labels!) 
My B12 blood levels are consistently in the low range of acceptable. That means... 


In the end, Elizabeth... You should take a vitamin B12 supplement if your levels are low. Invest in a bottle of vitamin quality vitamin B12. Not the supermarket brand. Look for NSF certification to be sure your supplement has what it says it has. Your doctor can tell you how much to take depending on your lab result.

I'd LOVE LOVE LOVE to hear from YOU! 

Leave me a comment below, or ask your question by clicking this link.

Watanabe F, Bito T. Vitamin B12 sources and microbial interaction. Exp Biol Med (Maywood). 2018 Jan;243(2):148-158. doi: 10.1177/1535370217746612. Epub 2017 Dec 7. PMID: 29216732; PMCID: PMC5788147.

Smith M, Love DC, Rochman CM, Neff RA. Microplastics in Seafood and the Implications for Human Health. Curr Environ Health Rep. 2018 Sep;5(3):375-386. doi: 10.1007/s40572-018-0206-z. PMID: 30116998; PMCID: PMC6132564.

US Department of Health & Human Services. National Institutes of Health. Vitamin B12 Fact Sheet.

US Department of Health & Human Services. FDA. Retail Meat Report. National Antimicrobial Resistance Monitoring System. 2009.


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