Who should consider taking a vitamin B12 supplement?

Most Americans get plenty of vitamin B12, which is found in fish, chicken, red meat, milk and eggs. But some people don't get enough in their diets or their bodies can't use what they do consume, and they should consider a B12 supplement. These groups include vegans (vegetarians who don't consume milk, eggs or any foods that come from animals). For vegans, one of the few B12-rich foods available is fortified breakfast cereals.

The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) says strict vegetarians and vegans may need to supplement their diet by choosing a fortified breakfast cereal or by taking a vitamin B12 supplement that contains no more than 100% of the Daily Value. Vegans and lacto-ovo vegetarians (who do consume milk and eggs) should take a B12 supplement during pregnancy and breast-feeding, according to the Academy.

Other groups who should consider B12 supplements include older adults, who often don't produce enough stomach acid to absorb adequate amounts of vitamin B12, people with gastritis or other digestive conditions and people with pernicious anemia, a condition in which the body doesn't produce enough of a substance needed to absorb vitamin B12. If you think you may have one of these conditions, check with your doctor, who can determine your B12 levels and tell you if you need a B12 supplement.
If you are over the age of 50, you may benefit with a supplement.

The body’s ability to absorb naturally occurring vitamin B12 from foods diminishes with age. This decline appears to be due to a reduction in the acidic juices in the stomach, which are needed to break the bonds that bind the B12 to the proteins in food. If the bonds aren’t broken, the vitamin can’t be released.

Up to 30 percent of individuals over the age of 50 experience this decline in acidic juices in their stomachs. With less acid juice present, the bacteria normally found in the intestines aren’t properly destroyed and so tend to overgrow. This abundance of bacteria feed on vitamin B12, diminishing the amount of the vitamin that may be available.

Luckily, the synthetic form of vitamin B12 that is used in fortified foods and supplements isn’t bound to a protein, so it doesn’t depend on your stomach secretions to be absorbed. Because the synthetic variety is a more reliable source, individuals over the age of 50 should meet their vitamin B12 needs primarily from fortified foods or a supplement.

You should always meet with a registered dietitian (RD) before taking a supplement to make sure that it is appropriate for you based on your diet and medical history. You can find an RD in your area at:

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.