What is the best form of Vitamin B12?
Q: Dr. Kmiec, I’m confused about all the different types of Vitamin B12. Some have cyanocobalamin on the bottle, and others have methylcobalamin. Are the same? Also, what do you think of pills vs lozenges?
A: This is actually a great question that I get so often that I wrote an article about it that I think will help answer your question, Cyanocobalamin vs. Methylcobalamin: Which is Best?
Regarding pills vs lozenges (or sublingual)…I prefer and recommend sublingual Vitamin B12.
Absorbing Vitamin B12 requires two factors to be functioning properly:
Sufficient gastric acid (hydrochloric acid) present in the stomach
The presence of Intrinsic factor
Because a large portion of people suffer from gastrointestinal disturbances such as: constipation, diarrhea, and heart burn, it is more than likely that a subclinical Vitamin B12 deficiency is far more prevalent then what was previously thought because you may not be able to absorb the nutrient. Making matters worse, widespread use of anti-acids makes the absorption of Vitamin B12 nearly impossible.
Also, some people lack intrinsic factor (IE. People with Diabetes Type 2), which results in a condition known as pernicious anemia because without this enzyme, you cannot absorb the vitamin. . For unknown reasons, this condition doesn’t usually become apparent until mid-adulthood. You can by-pass this issue by taking Vitamin B12 in the form of a sublingual tab that simple dissolves under your tongue.
I typically recommend 1000 – 5000 mcg/day.