Vitamin B12 Injections: Do You Really Need Them?

Answer

• The Western diet has many vitamin B₁₂ sources and its deficiency is due to gut absorption problems. Vitamin B₁₂ injections bypass the digestive tract and make sense in the developed world.
• Vitamin B₁₂ deficiency in India is mainly due to vegetarianism and unfortified foods. It might be better to first try vitamin B₁₂-rich foods and supplementation.
• Discuss this with your doctor; don’t take any decisions yourself.

The Science

Vitamin B₁₂ or Cobalamin

• Vitamin B₁₂ is a water-soluble vitamin (which means, your body will excrete it if taken in excess).
• It is needed for red blood cell formation, cell DNA creation, protein formation and breakdown, and healthy functioning of the immune and nervous systems.

Vitamin B₁₂ Deficiency

• Vitamin B₁₂ deficiency for prolonged periods can cause permanent nervous system damage.
• It can also cause heart disease, stroke, and brain damage.
• Many individuals with severe vitamin B₁₂ deficiency are advised vitamin B₁₂ injections.

However, consider this. Vitamin B₁₂ deficiency can arise from two main possibilities:

1. Your diet lacks adequate vitamin B₁₂; and
2. Your diet has sufficient vitamin B₁₂ but your body is not able to absorb it properly, due to multiple reasons:
   • Pernicious Anaemia: A condition in which a protein essential for vitamin B12 absorption cannot be produced in the stomach;
   • Stomach operations like gastrectomy;
   • Intestinal problems like inflammatory bowel disease (IBD); and
   • Certain medicines like metformin (diabetes medicine) and PPI (acidity medicine).

The Western Diet and Vitamin B₁₂

• In the developed world, the diet is based on animal foods such as meat and dairy, which are high in vitamin B₁₂.
• Some vegetarian foods are also fortified with vitamin B₁₂.
• It is uncommon to develop vitamin B₁₂ deficiency in the Western world due to insufficient dietary vitamin B₁₂.
• Typically, 6% of the people in the developed world have a vitamin B₁₂ deficiency, which is caused by an inability to absorb vitamin B₁₂ properly in the intestines.
• Giving additional vitamin B₁₂-rich foods or supplements won’t help in such situations. So western medical protocols involve vitamin B₁₂ injections.

India and Vitamin B12

• In countries such as India, nearly 47% of the people have vitamin B₁₂ deficiency.
• It is mainly because many people are vegetarians, and those foods are not fortified with vitamin B₁₂. So it is not the malabsorption of vitamin B₁₂ but its inadequate presence in the foods, which is the main cause of its deficiency in India and similar countries.
• So people in India are better off trying good vitamin B₁₂ supplements first, before resorting to injections.

Summary

Vitamin B₁₂ injections:

• Are needed life-long for vitamin B₁₂ absorption problems;
• Are required for urgent replenishment in severe or prolonged vitamin B₁₂ shortfall;
• Are not a substitute for eating healthy food; and
• Are not a long-term solution for people without malabsorption.

Don’t make this decision yourself; discuss this point with your doctor.

To Read More

• NHS, UK: Vitamin B₁₂ or folate deficiency anaemia
• Harvard Medical School: Ask the doctor: B12 shots vs. pills
• On this Website: Everything you want to know about B–vitamins
• Advanced in Nutrition Journal: Vitamin B-12

First published on: 9th June 2022
Image credit: timolina on Freepik
Last Edited on: 5th June 2023