How much vitamin B12 is too much?

Vitamin B12 is a water soluble nutrient that performs many critical functions in your body.

Some people think that taking high doses of B12, instead of the recommended intake, is best for your health.

This practice has led many to wonder how much of this vitamin is too much.

This article examines the health benefits as well as the potential risks of taking megadoses of B12.

Benefits of vitamin B12 supplementation

Too much vitamin B12

There is no doubt that vitamin B12 is essential for health.

This nutrient is responsible for numerous functions in your body, including the formation of red blood cells, the production of energy, the formation of DNA and the maintenance of nerves (1).

Although vitamin B12 is found in many foods, such as meat, poultry, seafood, eggs, dairy products and fortified cereals, many people do not consume enough of this important vitamin.

Health conditions such as inflammatory bowel disease (IBD), certain medications, genetic mutations, age and dietary restrictions may contribute to an increased need for B12.

Vitamin B12 deficiency can lead to serious complications such as nerve damage, anemia and fatigue, so people at risk should add a high quality vitamin B12 supplement to their diet (2).

While people who consume adequate amounts of foods rich in B12 and are able to properly absorb and use this nutrient do not necessarily have to supplement, taking additional B12 has been linked to some health benefits.

For example, studies show that supplementation with B12 can benefit people without deficiency in the following ways:

  • Improved mood: One study found that supplementing healthy men with a B-complex vitamin that contained a high dose of B12 improved stress ratings and improved performance on cognitive tests (3).

  • Reduction of anxiety and depression symptoms: Treatment with a supplement containing a high dose of B12 for 60 days significantly improved depression and anxiety symptoms in adults compared to a placebo (4).

Although B12 supplements are commonly taken to increase energy levels, there is currently no evidence to suggest that more B12 increases energy in people with adequate levels of this vitamin.

However, vitamin B12 supplements will probably increase energy levels in those who are deficient, since this nutrient plays an important role in the conversion of food into energy.

Summary B12 is an important nutrient that is essential for the formation of red blood cells, the synthesis of DNA and many other vital processes. Supplements can help improve mood and reduce symptoms of depression in those who are not deficient in this vitamin.

Is it useful or harmful to take high doses of B12?

Since vitamin B12 is a water soluble vitamin, it is generally considered safe, even in high doses.

A tolerable upper intake level (UL) for B12 has not been established, due to its low level of toxicity. UL refers to the maximum daily dose of a vitamin that probably does not cause adverse side effects in the general population.

This threshold has not been established for B12 because your body excretes everything it does not use through urine.

However, supplementation with excessively high levels of B12 has been linked to some negative side effects.

Several studies have shown that megadoses of the vitamin can cause breakouts of acne and rosacea, a skin condition that causes redness and bumps on the face filled with pus.

However, it should be noted that most of these studies focused on high dose injections instead of oral supplements (5, 6, 7).

There is also some evidence to suggest that high doses of B12 can lead to negative health outcomes in people with diabetes or kidney disease.

One study found that people with diabetic nephropathy (loss of kidney function due to diabetes) experienced a more rapid decline in kidney function when they were supplemented with high doses of B vitamins, including 1 mg per day of vitamin B12.

In addition, participants who received high doses of B vitamins had an increased risk of heart attack, stroke and death, compared to those who received a placebo (8).

Another study in pregnant women showed that extremely high levels of vitamin B12 due to vitamin supplements increased the risk of autistic spectrum disorder in their offspring (9).

Although there is evidence that supplementation with B12 can cause negative health outcomes, studies have shown that daily oral supplements of up to 2 mg (2,000 mcg) are safe and effective in treating B12 deficiency (10).

For reference, the recommended daily intake (RDI) of vitamin B12 is 2.4 mcg for both men and women, although pregnant and lactating women have a greater need (11).

Summary Although there is some evidence that very high doses of B12 can cause adverse health effects in certain populations, megadoses of this vitamin are commonly used to treat B12 deficiency safely and effectively.

How much B12 should you take?

For healthy people who are not at risk for B12 deficiency, eating a healthy and complete diet should provide all the B12 that your body needs.

Food sources of this vitamin include eggs, red meats, poultry, seafood, milk, yogurt, fortified cereals, nutritional yeast and non-dairy fortified milks.

However, people who take medications that affect the absorption of B12, pregnant or lactating women, vegans and anyone with a condition that adversely affects absorption or increases the need for B12, should consider taking a supplement.

In addition, evidence from population studies suggests that vitamin B12 deficiency in older adults is common, so it is recommended that adults older than 50 years take supplements (12).

While megadoses of up to 2,000 mcg are considered safe to treat B12 deficiency, it is always best to avoid excessive amounts of any vitamin, especially when it is not necessary.

Although high daily doses of vitamin B12 are unlikely to cause harm in most people, extremely high doses should be avoided unless prescribed by a healthcare professional.

If you think you may have vitamin B12 deficiency, talk to your doctor, who can recommend appropriate treatment based on your level of deficiency.

While UL has not been established for B12, your body's ability to absorb the vitamin depends on what it really needs.

For example, it is estimated that only 10 mcg of a B12 supplement of 500 mcg is absorbed in people without deficiency (13).

For this reason, it is not necessary to take high doses of B12 for people without a greater need.

Summary Although supplemental B12 is required for people with a greater need for this vitamin, it is unnecessary for people without a deficiency to take high doses.

The bottom line

B12 is an important nutrient that is popularly used as a nutritional supplement, even by those without a B12 deficiency.

Although doses of up to 2,000 mcg of vitamin B12 are considered safe, it is best to talk to a doctor to find out if a supplement needs to be taken.

Most people can meet their B12 needs through a healthy diet. Some, like older adults or those with certain dietary restrictions, should complement.

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