Question: My doctor was willing to order the natural form of vitamin B12 for me, but wanted to ask the pharmacist how to prescribe it. They came up with a sublingual form. The injectable form isn’t available. Is this the best treatment?

Dr. Brownstein's Answer:

I am amazed at how many patients suffer from vitamin B12 deficiency. In fact, B12 deficiency is occurring at epidemic rates, and it can cause or exacerbate myriad neurological problems including dizziness and inner ear problems.

The good news is that there is an injectable form available — that is, if the doctor is willing to prescribe it. The cost of a 30-dose vial of natural B12 shots is around $30.

In my experience, it’s not worth taking the oral, sublingual (under the tongue), or nasal versions of B12. The injectable forms of natural vitamin B12 clearly outperform the other versions. Unless you have a needle phobia, I recommend B12 injections to combat deficiency.

For neurological problems, I typically recommend injecting 1 mg of natural vitamin B12 per day for 30 days, then reducing the dose to 1 mg twice per week. If you do not see a response from one form of natural B12 (for example, hydroxocobalamin), consider using another natural form (such as methylcobalamin).

Vitamin B12 shots are very safe and have few side effects. The only problem I have seen with B12 shots is a failure for patients to respond to them.