Tuesday, October 3, 2023

Vitamin B12 Injections: Do You Really Need Them?

Vitamin B12 injections are advisable for people who have vitamin B12 malabsorption problems in the intestines.


  • 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.


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

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


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