Vitamin B-12 is measured in micrograms (mcg). It's available as an oral tablet. It comes in strengths of 25 to 250 mcg. It's also available as a nasal gel or sublingual pills. Sublingual means under the tongue. It can also be given by injection. Your body can't absorb all the vitamin B-12 from dietary supplements. Absorption is limited by how much intrinsic factor your stomach makes. Intrinsic factor is needed for your body to absorb B-12. For example, only about 10 mcg of a 500mcg oral supplement is actually absorbed in healthy people.
The RDA is the recommended dietary allowance.
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Group
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RDA
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Infants (0–6 months)
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0.4 mcg
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Infants (6 months to 1 year)
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0.5 mcg
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Children (1–3 years)
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0.9 mcg
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Children (4–8 years)
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1.2 mcg
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Children (9-13 years)
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1.8 mcg
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Children and adults (14 years and older)
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2.4 mcg
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Pregnant women
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2.6 mcg
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Breastfeeding women
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2.8 mcg
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Food source
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Vitamin B-12 content
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Liver, beef, cooked, 3 ounces
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70.7 mcg
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Clams cooked (without shells), 3 ounces
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17 mcg
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Salmon, cooked, 3 ounces
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2.6 mcg
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Tuna, light, canned in water, 3 ounces
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2.5 mcg
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Beef, ground, 3 ounces
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2.4 mcg
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Milk, 2% milkfat, 1 cup
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1.3 mcg
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Cheddar cheese, 1 ½ ounces
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0.5 mcg
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Vitamin B-12 isn't found in vegetables or fruits. It is found in animal products. These include fish, meat, poultry, eggs, milk, and milk products. It is added to breakfast cereals. They are called fortified breakfast cereals. Some nutritional yeast products also contain vitamin B-12. Fortified foods vary in how much B-12 they have. The product labels tell you how much the product contains.
Bacteria in the large intestine may be able to create some vitamin B-12. But the amount can vary. And it's not known whether it's excreted with stool or absorbed back into the body. Normally, the small intestine is where B-12 is absorbed in the gut. If it can't absorb B-12, it is not used by the body and is lost through stool.
Vitamin B-12 is stable at room temperature. It doesn't need to be refrigerated. Cooking doesn't destroy it. Vitamin B-12 doesn't break down for several hours. This is so even at the boiling point of water.
A diet low in animal proteins, milk, or dairy foods may increase the need for vitamin B-12. People who eat vegan diets need to take B-12 supplements. Breastfed babies of vegans also need supplements.
You may need supplements if you have a condition that causes you not to absorb enough B-12. These can include:
- Gluten-induced enteropathy
- Celiac disease
- Sprue
- Having a fish tapeworm
- Weight loss surgery or surgery to remove all or part of the stomach (gastrectomy)
- Heavy alcohol use
- Liver disease
- Hypothyroidism
- Thalassemia
Vitamin B-12 absorption in the intestinal tract may decrease with age. So, people over age 60 may need vitamin B-12 supplements.
Women who are pregnant or breastfeeding may need to take B-12 supplements. Always talk with your doctor before doing so.
Vitamin B-12 deficiencies tend to be caused by not getting enough B-12 in your diet. They can also be due to a reduced secretion or lack of intrinsic factor. This is a stomach secretion that helps the body absorb vitamin B-12.
Pernicious anemia is a rare blood disorder. This is where the body can't correctly use vitamin B-12. Vitamin B-12 is needed for the development of red blood cells. It's thought to be an autoimmune disorder. It may be hereditary because it tends to run in families.
Symptoms of pernicious anemia can include:
- Weakness, severe tiredness (fatigue), or a sudden spinning feeling (vertigo)
- Feeling lightheaded
- Shortness of breath
- Chest pain
- Ringing in your ears (tinnitus)
- Fast heart rate (tachycardia)
- Yellowish color to the skin (jaundice)
- Sore tongue or a smooth, "beefy" red tongue
- Loss of appetite with weight loss
- Diarrhea
- Numbness, tingling, abnormal feelings, or sensitivity in your hands or feet
- Muscle weakness
- Unstable walking
- Irritability, memory loss, dementia, and psychosis