It may be difficult to believe that a vitamin deficiency exists nowadays with the abundance of food all around us. Yet deficiencies of this vitamin are quite prevalent, in part due to the recent epidemic of digestive problems causing a widespread use of acid-blocking medications. And a growing vegetarian population also ups the incidence of this deficiency.
What vitamin is it? It’s vitamin B12, also known as cobalamin. B12 plays a role in a myriad of important body functions, including your bone health.
B12: A Vitamin with Many Roles
Interestingly, the color of B12 when it’s isolated is bright red. This is due to the presence of cobalt in the B12 molecule. Even more amazing is the fact that B12 supports the production of red blood cells – pernicious anemia is the primary way severe B12 deficiency manifests.
B12 is also involved in DNA synthesis and nerve health, and aids cells in protein, fat, and carbohydrate metabolism.
B12 Absorption – an Exacting Process
The absorption of this vitamin is quite complex, involving a delicate interplay between digestive enzymes, hydrochloric acid, and the presence of a particular protein. It’s a process that is subject to disruption and blockage, such as interruptions caused by cobamides. Cobamides are substances that act as a foil to B12 absorption, and they are produced by unhealthy bacterial overgrowth and imbalance in the intestines.
In addition, healthy gut flora actually manufacture B12, so it’s worth pointing out that antibiotics can contribute to B12 deficiency in two ways: by causing an overgrowth of unhealthy bacteria and by killing off B12-producing bacteria. A diet high in refined carbohydrates can also contribute to unhealthy bacterial overgrowth and hence lower B12 levels.
Because absorption of B12 is so particular and subject to blockages, supplements are recommended in addition to eating B12-rich foods. (More on this below.)
How do you know you’re getting enough B12?
Vitamin B12 deficiency is fairly common, and the risk for deficiency has been show to increase with age. According to a 1992 study,1 15% of adults over the age of 65 are vitamin B12 deficient.
Acid-blockers such as those prescribed for reflux and heartburn can also disrupt absorption of B12,2 because you need sufficient stomach acid for proper B12 uptake into your system. As the use of these medications become more widespread, it’s no wonder that B12 deficiency is also on the rise. The minimum requirement is 2.4 micrograms, but in view of the complex absorption process, it’s best to err on the high side. And because it’s a water-soluble vitamin, the body will eliminate what it doesn’t need.
A lack of B12 can cause a host of unpleasant signs and symptoms. Here are some of them:
- Tingling and burning sensations in the feet
- Tired muscles
- Obsessive-compulsive behavior
- Memory loss
- Low energy levels
- Sleep problems
- Mood swings
- Poor immune function
As you can see, B12 covers a lot of ground!
B12 and Your Bones
Unfortunately, we can add “decreased bone density” to the list of symptoms of B12 deficiency.
In 2005, a group of researchers undertook the study of how B12 affects bone turnover. What they found is a link between low B12 concentrations, high homocysteine levels, low broadband ultrasound attenuation (BUA), and increased fracture risk.3 I’ll explain.
Homocysteine is an inflammatory marker, meaning high levels of this amino acid indicate inflammation in the body. BUA is an ultrasound method used to determine fracture risk, and when it issues a low reading, this means the bone is experiencing a high turnover rate and is more likely to fracture. This study showed that low B12 levels were associated with all of these factors. In short, the study showed that a B12 deficiency increased fracture risk.
B12 and Hip Density
Another study showed that the hips are particularly vulnerable to the effects of a B12 deficiency. Researchers found that elevated homocysteine levels are also a marker for low B12 concentration. Further, a lack of vitamin B12 was implicated in an increased risk of hip fracture.4
Still another study clearly showed the correlation between low B12 levels and decreased hip density. “…low serum vitamin B-12 levels are associated with increased rates of hip, but not calcaneal bone loss in older women”5 the study concludes.
There is more than enough evidence to show how important B12 is in maintaining bone health and building bone strength.
Foods That Contain B12
There are many, foods that can help you get more of this important vitamin. B12 is derived exclusively from animal foods.
Here is a list of foods highest in B12, starting with foods that have the greatest amount:
- Calves’ liver
- Grass-fed beef
If you’re familiar with the Osteoporosis Reversal Program, you probably noticed that these foods are acidifying (with the exception of yogurt). Although acidifying foods are not off-limits, upping your intake to get enough B12 may result in an imbalance of the 80% alkaline/20% acidic ratio. The solution? Make sure you take a daily supplement.
What to Look for in a B12 Supplement
As we’ve discussed, B12 uptake is tricky, so if you suspect you have a deficiency, you can request a blood test from your doctor, and then decide on the best dosage. You can get B12 in capsules and also as sublingual.
Also note that most B12 supplements contain a form of B12 called cyanocobalamin. The name is a combination of cyanide – cyan – and B12 – cobalamin. This means the B12 molecule has a cyanide molecule attached. Given the toxic nature of cyanide, it makes sense to look for an alternative, a safe form of B12 called methylcobalamin. (The methyl refers to hydrogen and carbon atoms.) Fortunately, it's easy to find methylcobalamin in just about any health food store or online.
You can also take a B-complex supplement to ensure that you're getting adequate levels of all B vitamins, especially since they're Foundation Supplements. And last but not least, many multivitamin supplements also contain good levels of B-complex vitamins, including B12.
1 Pennypacker LC, Allen RH, Kelly JP, Matthews LM, Grigsby J, Kaye K, et al. “High prevalence of cobalamin deficiency in elderly outpatients.” J Am Geriatr Soc. 1992;40:1197–204.
2 Bradford GS, Taylor CT. “Omeprazole and vitamin B12 deficiency.” Ann Pharmacother. 1999;33:641–3.
3 Dhonukshe-Rutten, RA, et al. “Homocysteine and vitamin B12 satus relate to bone turnover markers, broadband ultrasound attenuation, and fracures in healthy elderly people.” J Bone Miner Res. 2005 Jun;20(6):921-9. Epub 2005 Feb 7. Web. https://www.ncbi.nlm.nih.gov/pubmed/15883631
4 McClean, Robert R. “Plasma B Vitamins, Homocysteine, and Their Relation with Bone Loss and Hip Fracture in Elderly Men and Women.” J Clin Endocrinol Metab. 2008 June; 93(6): 2206–2212. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2435634/
5 Stone, KL, et al. “Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: a prospective study.” J Clin Endocrinol Metab 2004 Mar; 89(3) :1217-21. Web. https://www.unboundmedicine.com/evidence/ub/citation/15001613/Low_serum_vitamin_B_12_levels_are_associated_with_increased_hip_bone_loss_in_older_women:_a_prospective_study_
Comments on this article are closed.
I break out in a rash on my back from any B vitamin (B6, B12, Biotin, Multivitamins, etc) supplement. Doctors are no help. Do you have a thought about why this would happen. I take natural/organic supplements when possible.
Thank you for all the information you research and pass on to us Ladies so we can make better choices in our lives.
I HAD MY VITAMIN B12 LEVEL CHECKED, IT WAS 1999, IS THAT TOO HIGH? MY DOCTOR SAID, IT WAS O’KAY, CAN ANYBODY HELP ME WITH THIS? I WOULD APPRECIATE IT, THANKS.
In Feb. I sent a letter of request and it was received but no reply was ever received. I am in need of help. If possible, please review my letter of Feb. 25 and send reply. I also need the Save our Bones Program. Am ordering True Osteo today. Is there a way I can contact Vivian? Am not receiving her e-mails recently. Thanks
Vivian, why if we need only 2.4 micro grams of B12, do manufacturers only put on their shelves doses of thousands of times higher than that? And could taking high doses of B12 be harmful? Right now I’m eating cereal that has “100%” of the minimum daily requirement, though it doesn’t say how much that is. (I’m completely vegan as of a month ago, and majorly osteoporotic!)
Hello and how are you?
This is not a reply of the previous question. What I wish to mention is that, I have a bursitis in the left shoulder since last december 2013 wich is rather painful and limiting my mouvements a great deal. A sister of mine suggested that I get an injection of B12. Having had this before, she said that the pain went away in about 24hrs. The doctor I saw never did mention any of it. I am financially limited in the present moment and cannot afford physio therapy or any treatment that cost $80.00 an hour.. I would be very curious to hear how you feel about this B12 injection? Or can I just go for the list of good food recommanded on your site. Thank you so much, Looking forward to hear from you.
I have followed your emails and advice with great interest and benefit since 2006. Thank you very much Vivian from saving me from fosamax. Your latest, on Feb 8 re Vitamin B 12 is very interesting, especially the Obsessive Compulsive behaviour reference.
I have suffered from gluten and lactose intolerance for 60 years. These allergies forced me to retire more than 20 years ago from my practice as a personal injury lawyer. While I was practicing, my clients were often examined by psychiatrists and other specialists for the insurance companies handling the defence. They would often try to minimize the injury by accusing the clients of being obsessive compulsive personalities, thus blaming the client rather than the tortfeasor. I discussed this with my own psychiatrists, who helped me point out in cross examination of the defence experts, that most successful professionals and businessmen need to be both obsessive and compulsive in order to overcome obstacles and difficulties in caring for their clients or customers. We should feel a strong need to stick to our clients’ problems until we have solved them.
Imagine my chagrin when two senior gastroenterologists diagnosed me with Obsessive Compulsive disorder. I realized that the reason they were blaming the patient was that they were ignorant, and did not want to admit it. Imagine my rueful amusement when I found out later that the distinction between celiac and gluten intolerance had been clearly explained in the professional literature years before these two denied it.
They were right that they had a case before them of an Obsessive Compulsive Disorder, not mine, but theirs; not my excessive Obsession or Compulsion, but their lack of desire and determination to help patients by continuing their own education in their specialty.
Recently I developed very painful Polymyalga, and received much unhelpful advice and drug advice for six months. I read a reference on the internet about Vitamin B 12, tried it, and received great relief. My doctors had tested the vitamin 12 levels in my blood, and concluded that it was within normal limits. The standard limits are wrong, of course.
Recently I developed atrial fibrillation, and was plied with ‘essential’ ‘well tolerated’ ‘good reputation’ drugs containing a base of lactose, and had to fight to get four prescriptions changed. Plavix, I now find, has a bad record.
When you see your doctor, pray that he has a good case of Obsessive Compulsion when he prescribes for you.
PS. Vivian, you should put a link to my comment in your original article, because a diagnosis of Obsessive Compulsive Disorder is good evidence that your doctor has the disorder.
Humphrey, you make some excellent points! I am glad you found relief by taking B12, and I appreciate the irony you pointed out about being diagnosed with OCD. Very clever, and only too true!
I am mixing an alkaline drink daily. I want to ask if you think it is healthy. I mix 1/3 cup of Bragg’s raw unfiltered apple cider vinegar with 1/2 tsp. of baking soda (and stevia to sweeten) and a liter of water. I drink that daily. It helps my digestion and elimination. Is it too much sodium and will it help with making my system more alkaline for better bone health?
By following your advice (I got your first book), my bone density has improved. My doctor wanted me to take Boniva or one of those drugs, but I found you! I am almost 58 years old and very active.
Hi Vivian, thank you for all your articles. I had osteoporosis long time ago. After taking Fosamax for 5 years I had to stop. Now I have osteopenia at a higher level. I had the first shot of Prolia. But I have a problem with my jaw and teeth so I decided to stop the shot. What you recommend me to do for my bone, I am now taking multivitamin Centrum for women, fish oil, calcium, B complex, probiotic, turmeric, and eating a healthy diet. I just add to my diet a combo of fruits, vegetables, seeds, nuts smoothies every day. What else do I need to do? Thank you.
Nikita, you’ve already done something very important toward the health of your bones: you’ve taken your health into your own hands! You’re making your own decisions and for that I commend you.
There’s all kinds of free information here at the Save Our Bones site, and you can check in any time for the latest information. You can also subscribe to receive free e-mail updates!
If you are concerned about the lasting effects of the osteoporosis drugs in your system, you might be interested in Rapid Cleanse. It’s a 7-day cleanse designed to flush toxins and osteoporosis medications from your body. You can check it out here:
I wish you well on your health journey!
As I said in a previous comment, I took fosavance prescription and had bone loss. After I stopped taking it and took natural supplements, I now have a 9% increase in my right femoral neck, associated with the hip area, I also have a 1% increase in my lower spine. How I continue to progress., I expect to.
I have just learned recently of spcific B vitamins are important for bone health. I was deficient in B-12, once that I was aware of. I took cyanocobalamin, under the tongue. My B12 returned to normal quickly and has not decreased since. I take a B-complex vitamin, 100Mg, 3-4 times daily. So if I end up only taking it twice daily on some days, I do not worry about being low in B’s. Thanks for the info. Sincerely,Faye
Faye, I am so glad to hear that you discovered the deficiency and did something about it! 🙂
I posted a comment on here quite a while back but never saw your answer. The clerk at the Vitamin Store told me to take cilica and MSM, since my body wasn’t absorbing calcium supplements. I hope this is okay. On my last dexascan my numbers had improved.
I had gastric bypass surgery 10years ago. Now I have osteoporosis . I was told by my doctor that I have high risk for hip fracture. She wants me to take Fosomax. I haven’t but I am scared. I am 70 years old.
Looks like the yogurt and the Sardines are the safest foods in the list.
Another good thing about sardines and yogurt is that they are readily available and not too expensive. 🙂 But they would probably not taste too good together!
There is a collagen product being offered at http://www.HealthyBonesPlus.com. Do you
have information on this product? I am following your program and supplementing with algaecal.
What about B12 shots?
Do B-12 shots have all of the right ingredients??? My daughter is always tired and listless.. She is on Levequin thyroid. I take the natural (Armour)
Thank you, Sue
Vivian,can you please tell me if this is true. Someone told me that the Algeacal Plus Calcium has lead in it.Can you help me?
I thought you had told not to take CYANOCOBOLOMIN that we should be taking mythelcobolomin when we take vit. B supplements …..
I don’t take any Vitamine supplyments, I take the milk powder as doctor
recomended, it includes all vitamines c, e, b6, b12 etc… 6 scoops with
a cup of water. Recently, I add one tablet vitamine c 500 mg, my blood
test all is going well, the doctor said keep going this way. But I know I
still have osteoporosis. I am going to cook brown rice water as a tea to drink to get more vitamine B complex. Thanks your information
I like all your arcicles Vivian, but just wonder why you are recommending syntethic vitamins to your readers. Are they not just as bad to your bones as not taking any?
Actually, Agnes, methylcobalamin is the natural form of B12 – cyanocobalamin is synthetic. 🙂
I heard that fish oil vitamins are not good for you. Is this true
I love your articles. I wish the absolute best for you and your whole team. ?✌✌✌✌?❤