Vitamin B12

Also known as: cobalamin, methylcobalamin, cyanocobalamin, b12

Grade A — Strong Evidencevitaminfoundationalneurological
5002000 mcgMorning with or without food

Vitamin B12 (cobalamin) is essential for nerve myelination, DNA synthesis, red blood cell formation, and methylation reactions. Deficiency is common in vegans, vegetarians, the elderly (due to declining intrinsic factor), and metformin users, and can cause irreversible neurological damage if prolonged. Methylcobalamin is the preferred form for neurological support, while sublingual or intramuscular routes bypass potential absorption issues in the gut.

TL;DR: Critical for nerve function, DNA synthesis, and red blood cell formation. Vegans, elderly, and metformin users are at high risk of deficiency. Methylcobalamin preferred for neurological benefit.

Last reviewed: 2026-03-12

Quick Facts

Evidence

Grade A

Studies

2

Interactions

2

Forms

1

Evidence Rating: Grade A — Strong Evidence

Multiple high-quality RCTs, systematic reviews, or meta-analyses with consistent findings.

Interaction Warnings

MetforminModerate

Metformin reduces B12 absorption by up to 30%. Supplement B12 if on long-term metformin.

Proton pump inhibitors (PPIs)Moderate

Acid suppression reduces B12 absorption from food; may need higher supplemental dose.

Important Notes

  • Vegans and vegetarians are at high deficiency risk
  • Methylcobalamin is better retained than cyanocobalamin for neurological use
  • Sublingual or intramuscular preferred for pernicious anemia

Clinical Evidence (2 studies)

Vitamin B12 deficiency and cognitive impairment in the elderly

Langan RC and Goodbred AJ (2017) — Am Fam Physician

B12 deficiency independently associated with cognitive decline and neurological damage; methylcobalamin preferred for neurological benefit

View on PubMed

Homocysteine-lowering interventions for preventing cardiovascular events

Martí-Carvajal AJ et al. (2017) — Cochrane Database Syst Rev

B12 + folate lower homocysteine, associated with reduced stroke risk

View on PubMed

Alternatives to Consider

These supplements target similar goals and may be worth considering alongside or instead of Vitamin B12.

Related Supplements

🧪 Get Your Personalized Stack

See how Vitamin B12 fits with your goals and current supplements — AI-powered, evidence-graded recommendations.

⚕️ Important Disclaimer

This information is for educational purposes only. It is not medical advice. Always consult a healthcare provider before starting any supplement regimen, especially if you take medications or have health conditions.

DoseGrade does not sell supplements and has no affiliate relationships with supplement manufacturers.