B vitamins are used in the body individually or in combination with enzymes to help release energy from carbohydrates, fat, and protein. Vitamin B coenzymes are crucial to the metabolic pathways that generate the energy needed by every cell in the body. Because they are co-dependent in their metabolic activities, a deficiency of one B vitamin can affect optimal functioning of organ systems throughout the body.

Vitamin B12, or cobalamin, works synergistically with the B vitamin folate, to regenerate (methylate) the amino acid methionine, which helps to maintain healthy physiologic amounts of homocysteine.* In addition, vitamin B12:

• Is necessary for the formation and regeneration of red blood cells.*
• Promotes growth and increases appetite in children.*
• Increases energy.*
• Maintains a healthy nervous system.*

B12 deficiency is often the result of underproduction of hydrochloric acid or intrinsic factor in the stomach, rather than a dietary lack. Pernicious anemia is a B12 deficiency caused by atrophic gastritis and lack of intrinsic factor. Most B12 is derived from meat products, making vegetarians more susceptible to a dietary deficiency.

Because B12 converts folate to its active form, a physical or dietary deficiency of B12 can lead to anemia caused by folate deficiency. Inactive folate, due to a B12 deficiency, will slow DNA synthesis resulting in large immature red blood cells that are incapable of carrying oxygen or dividing. Supplementing with folate when vitamin B12 is needed however can result in severe neurological symptoms.

Many elderly people report that B12 supplementation greatly improves their cognitive function. Published studies show that vitamin B12 in supplement form is absorbed better by elderly people than vitamin B12 that is bound to food.

The most common form of vitamin B12 is cyanocobalamin. While this form of vitamin B12 works well to prevent anemia, it is the methylcobalamin form that is required to maintain neurological health. The liver naturally converts a small amount of cyanocobalamin into methylcobalamin, but to regenerate neurons and the myelin sheath that protects axons and peripheral nerves, higher doses of methylcobalamin are necessary. There is no known toxicity at these doses. These methylcobalamin lozenges that are dissolved in the mouth are available in a vanilla flavor.