Vitamin B12 is naturally present in foods of animal origin, including fish, meat, poultry, eggs, and dairy products [ 5]. In addition, fortified breakfast cereals and fortified nutritional yeasts are readily available sources of vitamin B12 that have high bioavailability [ 12, 13]. Some observational evidence also shows an association between supplements containing vitamin B12 and a higher risk of certain types of cancer. For example, an assessment of 77,118 participants age 50 to 76 years in the Vitamins and Lifestyle cohort study found that use of at least 55 mcg/day supplemental vitamin B12 for an average of 10 years was associated with a 40% higher risk of lung cancer in men [ 60]. However, the study found no association between supplemental vitamin B12 use and cancer risk in women. Mineva EM, Sternberg MR, Zhang M, Aoki Y, Storandt R, Bailey RL, et al. Age-specific reference ranges are needed to interpret serum methylmalonic acid concentrations in the US population. Am J Clin Nutr 2019;110:158-68. [ PubMed abstract]

Third party testing does not test to see if a product is effective or safe for everyone, and it does not ensure the supplement will not interact with other supplements or medications. Good sources of folate include green vegetables, such as broccoli, brussels sprouts and peas. Complications of vitamin B12 or folate deficiency anaemia One serving of Vitacost Liquid Vitamin B12 is 16 drops, which contains 1,000 mcg of vitamin B12 as cyanocobalamin. One drop would provide you with 65 mcg, so you can adjust as needed or share with family members. The low price point makes this an affordable option that will add mere cents to your daily expenses. Office of Dietary Supplements, National Institutes of Health. Dietary Supplement Label Database. 2021.The amount of vitamin B12 included in a supplement varies between brands. This is another reason why it’s important to look closely at the manufacturer’s instructions for the product. While methylcobalamin may be more readily absorbed than synthetic types, research has not shown a significant difference among the various vitamin B12 types. Vitamin A is a fat-soluble vitamin that’s essential for eye health. You need it to produce tears and lubricate your eyes. But a vitamin A deficiency can lead to eye issues, including dry eyes. Still, multiple studies have also found oral vitamin B12 supplements to be safe and effective ( 33, 34, 35, 36).

Vitamin B12 is also available as a prescription nasal gel spray. This formulation appears to be effective in raising vitamin B12 blood levels in adults and children [ 27, 28]. A small clinical study with 10 participants (mean age 81 years) found that the bioavailability of a 1,000 mcg cobalamin dose was 2% with intranasal administration, which is similar to the bioavailability of an oral dose [ 29]. Vitamin B12 Intakes and Status You might notice that we have several Nature Made products on our list. That’s because Nature Made is a trusted company that produces quality supplements at affordable price points. We like that their slow-release vitamin B12 supplements are cost effective and require only one tablet daily. In general, evidence from RCTs does not show that vitamin B12 supplementation alone or with folic acid, vitamin B6, or both for 1 to 2 years improves cognitive function in older adults with or without dementia, mild cognitive impairment, or Alzheimer’s disease, even though supplementation lowers homocysteine levels [ 91-94]. For example, an RCT administered 400 mcg/day folic acid and 500 mcg/day vitamin B12 (B-vitamin group) or a placebo for 2 years to 2,919 adults age 65 and older with homocysteine levels of 12 to 50 mcmol/L [ 93]. Although homocysteine concentrations declined significantly more (by 5.0 mcmol/L) in the supplementation group than in the placebo group (1.3 mcmol/L), cognitive test scores did not differ between groups. A Cochrane Review of vitamin and mineral supplements to maintain cognitive function in cognitively healthy people included 14 studies that compared folic acid, vitamin B12, vitamin B6, or a combination of these supplements to placebo in 27,882 participants, most of whom were age 60 years or older [ 95]. The supplements had little to no effect on global cognitive function when administered for up to 5 years and appeared to have no impact when administered for 5 to 10 years. In particular, its Garden of Life Vitamin Code Raw B12 is a great option for people who prefer natural ingredients. It contains vitamin B12 derived from cultures of Saccharomyces cerevisiae, a yeast that is naturally occurring in some foods and is also known as brewer’s or baker’s yeast.

Watanabe F, Yabuta Y, Bito T, Teng F. Vitamin B₁₂-containing plant food sources for vegetarians. Nutrients 2014;6:1861-73. [ PubMed abstract]