For everyone, the challenge with B12 is the gulf between ingesting 2.4 mcg and actually getting 2.4 mcg into circulation, where it’s needed.   The next challenge occurs in ageing, which is when the body requires far more B12 than the RDA to obtain any benefit.   If a B12 deficiency exists (determined only by a lab test), one may need to ingest at least 200 times the RDA – about 500 mcg or more – that’s 0.5 mg, still a very small amount, but necessary for overall health.

In the Vegetarian and Vegan community, where the topic of B12 is ongoing, the subject of Marmite came up (the nutritional wiki).

Marmite is a “love it” or “hate it” substance; not much middle ground (which is their marketing slogan, btw).   For me, it’s foul tasting – too salty, too pasty, too nasty to smell – but then, it is a waste product.

The challenge with B12 is HOW it’s taken, not so much the amount.   When supplementing, it is best to take a tablet, under the tongue, BEFORE eating.   Or else, it is destroyed by the stomach acids and cast off with other waste.

The best sources of B12, in descending order, are:

steamed clams,


braised beef,

steamed mussels,

steamed crab, and

100% fortified breakfast cereals.

Less, but still significant amounts are found in a variety of fish, meat, poultry, eggs and dairy products.

However, be mindful, that cooking too effects B12; so that fried clams and broiled beef, for example, contain minimal B12 compared with the versions mentioned above.

Except among vegetarians and vegan, dietary deficiency of vitamin B12 is rare in American adults, because the RDA of 2.4 mcg/day is easy to obtain through foods of animal origin.   However, this fact obscures a much more important one: physiological B12 deficiency – inadequate B12 in the circulation – is easy to come by as we grow older, regardless of diet.

This is because B12 from food can become increasingly difficult for the body to absorb, because most of it is eliminated as waste.

With that said, the common symptoms of vitamin B12 deficiency are:


neuropathy (any disorder of the nervous system), and

neuropsychiatric disorders, including cognitive decline or dementia.

Additionally, look for inflammation of the tongue, or ‘scalaping’ (indentations around the edges; in link, third down on the left).

Both B12 and Folic Acid are necessary in the prevention of dementia and Alzheimer’s (ref: Fight Alzheimer’s and Heart Disease with B-Vitamins (December 2001); Folic Acid to the Rescue! (September 2002); and “Add Brain Assault to Homocysteine’s Rap Sheet (February 2006).   Likewise, both are necessary in the prevention of hip fractures.

And though other diseases are related to B12 deficiency – like celiac disease, Crohn’s disease, tropical sprue, pancreatic insufficiency, alcoholism, AIDS, and chronic use of antacids – the two stand-out conditions are: pernicious anemia and food-bound vitamin B12 malabsorption.

Now here is where it gets tricky:  A lack of B12 in the diet leads to atrophic gastritis, which is a chronic inflammation of the stomach lining that leads to the gradual loss (atrophy) of glands that produce digestive acid and enzymes.   If that is not enough, gastritis is associated with infection by Helicobacter pylori, the bacterium that also causes peptic ulcers and stomach cancer.

Now, in this disorder – atrophic gastritis – the non-food bound B12 is not impaired.   This means that once one has become deficient – because of a vegetarian or vegan diet, for example – one must rely on supplementation because the body is no longer able to absorb B12 naturally from food.

So, it becomes a matter of not just increasing the amount of B12 that one takes, but that one MUST take B12 in the form of a supplement.


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