Treating B12 deficiency early on is extremely important. This is because neurological symptoms like dementia and other nerve injuries are typically irreversible once the deficiency has been left untreated for enough time:
It seems that there may be a time-limited window of opportunity for effective intervention in patients with cognitive dysfunction and low serum cobalamin.Prevalence of vitamin B12 deficiency among demented patients and cognitive recovery with cobalamin replacement
For that reason, the British Society for Haematology recommends:
In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment.Guidelines for the diagnosis and treatment of cobalamin and folate disorders
So, don’t wait. Treat your B12 deficiency as early as possible.
Now, how to treat B12 deficiency is a different question. We’ll answer that now.
B12 Deficiency Treatment Guidelines
To determine what your vitamin B12 deficiency treatment protocol should look like, we’ll ask you these two primary questions:
1. Why are you deficient?
Vegan or vegetarian?
If so, and if your body is able to absorb B12 through the gut, then any B12 supplement (tablets, spray, etc) will work. Although we would like to suggest another route:
Bivalveganism. To be more exact – oyster veganism:
Oysters may be animals, but even the strictest ethicist should feel comfortable eating them by the boatload … Biologically, oysters are not in the plant kingdom, but when it comes to ethical eating, they are almost indistinguishable from plants.Consider the oyster
Bivalveganism could solve many of the problems that vegans face. Clams, mussels, and oysters are loaded with nutrition that’s often lacking in vegans, especially B12. Ethically speaking, they are similar to plants, because they don’t have a central nervous system, and are therefore not consider sentient. They make for B12-rich foods, and a few pieces a day could be a great vitamin B12 treatment for deficient vegans or vegetarians.
In food-bound cobalamin malabsorption, the body is unable to release the B12 from food, though it can fully absorb the free crystalline form found in oral supplements or fortified foods. This condition could be the result of achlorhydria, H.pylori gastritis, certain medicines, or the surgical removal of any part of the stomach. If you have this condition, B12-rich foods won’t work. But any good oral supplement will.
If you have pernicious anemia and lack the ability to create intrinsic factor, you’ll need B12 injections for life. No other supplement should be used in this case. In pernicious anemia, your body is simply unable to absorb B12 through the stomach. B12 injections are literally life-savers. If you can’t get your doctor to prescribe B12 shots (or enough of them), you can get them here prescription-free, and inject at home.
Another cause, or unknown?
Still haven’t identified the cause of your B12 deficiency? Then just use injections. In B12 deficiency, the myelin coating of the nerves strips off, and nerve protection rapidly declines. Regardless of what’s causing your deficiency, B12 shots are always the gold standard to replenish your stores as quickly as possible, and in B12 deficiency you don’t want to take any risk. B12 shots are very safe, and you can’t overdose.
In fact, you can treat with B12 shots by default if you want to play it safe, while you’re waiting for diagnosis. For any cause of B12 deficiency, including parasites or bacteria competing for the vitamin, or the depletion of B12 by toxins or drugs, injections are always the optimal treatment. It’s the best way to increase B12 levels and make sure the vitamin is absorbed, and is simply the best cure for vitamin B12 deficiency.
2. How bad are the symptoms?
How to treat vitamin B12 deficiency also depends on how bad symptoms are. For example, neurological symptoms indicate an advanced deficiency. In this case, daily injections should be started immediately. Daily B12 shots are the best treatment for neurological symptoms caused by B12 deficiency, where replenishing the stores as quickly as possible is crucial (to avoid permanent damage). Methylcobalamin B12 shots in particular are great, as methyl B12 shows unique nerve-repairing properties.
Yes, oral tablets will raise your serum B12 levels, but they may not affect cellular levels or repair nerve damage. Blood levels mean very little, because they will rise regardless of remedial effectiveness. If you show nerve damage, injections are your best hope. Don’t accept anything else, because the alternatives aren’t worth the risk.
You can rely purely on oral supplements only if your B12 deficiency symptoms aren’t severe, or if they’re the result of low intake or of food-cobalamin malabsorption. In all other cases, injections should fuel your B12 deficiency management protocol, at least in the beginning, when you want to improve B12 deficiency status as quickly as possible.
B12 Deficiency Treatment Dosage
What should be the dosage and frequency of your vitamin B12 deficiency treatment?
Vitamin B12 is water-soluble, and so any excess is quickly washed out in the urine. For that reason, there are no toxicity levels for vitamin B12. So, how much and how often should you supplement? The secret is in smaller, but more frequent amounts.
When you suffer from B12 deficiency, you’ll want to supplement daily. If the choice is between supplementing a weekly mega-dose of 25,000μg versus daily doses of 1,000μg (7,000μg over a week), choose the latter. 25,000μg is a lot, and only a tiny fraction of it is absorbed. The rest is urinated out in a matter of hours. 1,000μg is still a lot, but at least when you inject day after day, you will have high amounts of B12 circulating in your blood around the clock, saturating your tissues and cells.
So, supplement daily, at least until your symptoms disappear or stop improving. If you have pernicious anemia, you will likely have to inject for the rest of your life.
Again, the key is little and often. If not daily, then at the very least your doctor should be in line with the NICE guidelines for B12 treatment, which state that you should be on every-other-day doses until your symptoms stop improving.
When you begin your low-B12 treatment, you may also want to supplement with folate, which works together with B12. Avoid folic acid, which is a synthetic form of folate, and use a form better absorbed, like l-methylfolate. If you’re low in ferritin, you’ll also require iron supplementation.
Summary: How to Cure B12 Deficiency?
To sum up, this is how your vitamin B12 replacement protocol should look like:
- Supplement daily.
- Choose methylcobalamin, or at the very least adenosylcobalamin.
- If you show neurological symptoms, or if you have pernicious anemia, don’t accept any “vitamin B12 deficiency medication” from your doctor other than injections. Only in softer cases (where you can still absorb B12 through the stomach) should you rely on oral supplements like sublingual tablets or spray.
Good luck, and all the best.