Our bodies need vitamin B12.
“We know that B12 deficiency is very bad for the nervous system,” said Dr. Jonathan Woodcock, an associate professor of neurology and psychiatry at the University of Colorado School of Medicine in Aurora, Colorado. It can cause problems with cognition and memory, as well as peripheral neuropathy, where the nerves going to the arms and legs degenerate, among many other issues. He noted that a B12 deficiency is also associated with depression and anxiety.
Doctors recommend raising low levels of vitamin B12 with supplements, along with improvements in diet (like eating more food rich in B12, such as seafood, meat and eggs), or B12 shots.
“There’s two types of B12 deficiency,” points out Dr. Rif El-Mallakh, a professor of psychiatry and director of the Mood Disorders Research Program in the University of Louisville School of Medicine.
“There’s a deficiency that’s related to poor intake — so there isn’t enough B12 in your diet; and then there’s a deficiency that’s related to poor absorption — so you’re eating B12, but you’re not absorbing it.”
B12 shots are recommended, in particular, for those who don’t have a protein called intrinsic factor that helps the intestines to absorb the vitamin.
“If you don’t have that protein you get a deficiency that has to be replaced with a shot,” El-Mallakh said. For individuals with this condition, referred to as pernicious anemia — in which the body isn’t able to make enough healthy red blood cells — it’s usually recommended they get a B12 shot once a month.
[See: The Many Ways Exercise Fights Depression.]
Normal B12 values are between 200 and 900 picograms per milliliter, according to the National Institutes of Health, and less than that could possibly signal a B12 deficiency, though labs vary somewhat in what’s considered abnormal and how it’s measured. In addition, having lower levels of B12 (even if not determined to be a deficiency), can cause issues like fatigue.
“Our B12 levels tend to drop as we get older. So a significant proportion of elderly people will have low B12 levels,” Woodcock said.
But while doctors recommend raising low levels of B12, experts emphasize that research doesn’t demonstrate any reasons why people with normal levels of the vitamin should take a supplement or get B12 shots. Still, you don’t have to look far to see vague advertising claims touting how vitamin B12 shots and supplements can boost energy and help you out in the gym.
“Due to its role in energy metabolism, vitamin B12 is frequently promoted as an energy enhancer and an athletic performance and endurance booster,” the NIH notes. “These claims are based on the fact that correcting the megaloblastic anemia caused by vitamin B12 deficiency should improve the associated symptoms of fatigue and weakness. However, vitamin B12 supplementation appears to have no beneficial effect on performance in the absence of a nutritional deficit.”
Similarly, for a person who is depressed who has normal B12 levels — which can be checked with a blood test — it’s not recommended they take a B12 supplement or get a B12 shot.
What’s more, though an association between a B12 deficit and depression has been recognized, it’s not known if lower levels of B12 can cause depression, said Dr. Mark A. Frye, director of the Mayo Clinic Depression Center in Rochester, Minnesota, and chair of Mayo’s department of psychiatry and psychology. And, there’s no evidence that, at least in the short term, raising low B12 levels reduces depressive symptoms.
[See: Am I Just Sad — or Actually Depressed?]
“A couple long-term studies have found that regular dosing of vitamin B12 may reduce relapse rates of depression,” Frye said. “When we see an abnormality, we want to treat it, recognizing that there is a nutritional deficit that in some way is impacting brain neurotransmission. But we would never have that be a primary focus of treatment for depression, or an exclusive focus for treatment of depression.”
In short, if you’re depressed, experts don’t advise shelving traditional treatment, such as medication and therapy, in favor of focusing on B12 supplementation instead. Rather, it’s suggested that B12 deficits be addressed as part of a well-rounded approach to improving overall wellness. That can also dovetail into a discussion (for those whose B12 deficit is diet-related) about how dietary improvements can be helpful to bolster mental and physical health.
Research shows vegans and vegetarians who eat very little animal products (the main dietary source of B12) are also more likely to have low B12 levels and benefit from supplementation.
For anyone suffering from depression who suspects they may have low B12 levels, mental health experts recommend having B12 levels tested. There’s some indication that raising low B12 levels could make it more likely a person with depression will respond, for example, to antidepressant medication.
“Although there is a limited amount of evidence in the medical literature, there are strong reasons to believe that treating (and raising) a low B12 level will make antidepressant treatment more effective,” Woodcock said. He reiterated, however, that this doesn’t provide support for the idea that giving people who already have normal B12 levels additional B12 would have a similar benefit.
[See: 10 Reasons You May Be Feeling Fatigued.]
Though the B12 injections and supplements are generally considered safe, side effects and risks can range from pain and itching at the injection site to rare, serious concerns such as unusual weakness to irregular heartbeat. At very high levels, B12 supplementation could be toxic to the liver, Woodcock said. For people who don’t have a low B12 level, experts generally recommend against the supplements and shots. “I think it’s quite clear that they’re wasting their money,” Woodcock said. “They’re not going to gain anything, and they may harm themselves.”
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Should You Take Vitamin B12 to Boost Mood? originally appeared on usnews.com
