What if all you need is a little B12?

It is so irritating to know that a simple solution to seemingly complex symptoms can be right under our noses and very accessible yet rarely used.  Such is the case with B12.

If there is one thing I do in my practice that feels miraculous… It’s optimizing vitamin B12 status.  

I have seen B12 increase energy, get rid of anxiety, stop plantar fasciitis in its tracks, reduce nerve pain, bring a better mood and enhance brain power and much much more…

So how is it that most of us consume B12, yet, our bodies are still running on low?  Read on and I will explain, but first you might want to understand some of the symptoms that could be caused by inadequate B12.

  1. Weakness and Fatigue

  2. Decreased Mobility

  3. Pins and Needles Sensation

  4. Mouth Inflammation or Ulcers

  5. Dizziness

  6. Anxiety or Depression

  7. Stress and Overwhelm

  8. Memory Loss

Many of my patients come to me deficient on a subtle level.  They believe their symptoms are just part of aging or being out of shape or damn hormones.  Sometimes their doctors even tell them their B12 status is fine when it is NOT…  This is because the current conventional ranges are based on population average.  And let me tell you…..You do not want to be average when it comes to this population.  Compared to other countries our ranges are extremely low and I regularly see people within conventional range get relief from optimizing B12 into functional ranges.

Here’s the weird part…. many of these patients come to me on a B vitamin supplement.  They feel confused as to why their B vitamin levels are low. “But, Andrea, I take B vitamins everydat?”

So what is going on?

7 Reasons Your B Vitamin Levels are Low (despite supplementation)

1. Lack Of Absorption in Your Gut

Our modern lifestyles have created an epidemic of gut issues.  Even if you feel like you have an iron stomach… the likelihood that your gut is functioning optimally on a western diet and lifestyle is very low.  B vitamins require an effective and efficient digestion in order to be absorbed.  This means any form of inflammation or digestive enzyme deficiency will make it very hard to get B12 across the gut lining.  Also… antacids completely impair B vitamin absorption.  If you are on antacids get OFF of them immediately.  Despite the lack of information from your doctor regarding GERD… a holistic nutritionist or functional medicine practitioner can help you with this with their eyes closed. 

2. GI Infection

You may be somewhat familiar with the concept that our gut is lined with trillions of tiny microbes that help us to balance our immune systems, activate vitamins, process toxins and much more. If you have an imbalance in your gut flora (again which can be asymptomatic from a GI perspective)  You may also experience the inability to activate and absorb your B vitamins from food. 

3. Stress

Doesn’t it feel like stress causes everthing? Well B12 is no exception. Stress affects B vitamin absorption in 2 ways…. 1. When you are under chronic stress the body uses up more B vitamins than when you are under a resting state. 2. This stressed state causes decreases in healthy microbes and effects digestive absorption.  SO… in my opinion stress is the worst offender of B vitamin deficiency.  Find yourself a good yoga class (toot, toot), go out in nature, say “No” more, learn emotional freedom technique or any other thing that makes you RELAX.  Even still you may need to supplement B12 to get your levels back to optimal.

4. Lack of Consumption

If your diet is high in refined carbohydrate and sugar you can bet you are B vitamin deficient.  This type of diet causes stress on the GI system directly and also is a direct cause of microbial imbalance.  I apologize to PETA in advance, but it is very difficult to get adequate B vitamins though a vegan diet.  It can be done, but is difficult, takes planning and some supplementation.  I can not tell you how often I see well meaning people on a vegan diet with very low B vitamin status.  These patients are the best because the restoration of optimal B12 makes them feel amazing.  Also, if you do not eat enough food for whatever reason…. this could also cause a deficit.  Foods high in B12: 






5. Genetics

Some of my patients come to me with a slight genetic difference in their MTHFR gene (found in about 30% of the population) This difference prevents them from adequately activating their B vitamins.  This genetic test which is often covered by insurance (MTHFR) is part of our blood regular blood panel.  It is very important to understand how you are utilizing and transforming your B vitamins on a cellular level as those with a certain type of MTHFR genetic status need specific types of B vitamins to help their body.

6. Alcohol

Alcohol impairs B12 absorption in the intestines.  If you are a heavy drinker… go get an injection to prevent damage…..and… try to cut back obviously.

7. Medications

Specifically medications for GERD such as antacids and acid blocking drugs AND metformin have been shown to deplete and impair absorption. 


  1. I recommend working with a qualified holistic nutritionist or functional medicine practitioner to find out if you have symptoms of GI imbalance and to make sure you are getting enough foods rich in B vitamins…. If you do one thing for your health… it is getting your digestion right and eating a nutrient rich diet.  In my humble opinion and after working with hundreds of patients… always start with food and the gut.  80-90% of ailments clear with just this effort.

  2. Get your B Vitamin status checked and make sure you are within functional ranges… not conventional ranges.  This means your B12 level should be close to 800.  There are other markers that can be checked to make sure your cells are getting all the B12 they need.  Some things we look at here are the size of your red blood cell, MMA, serum B12 and homocysteine levels.  Sometimes one marker can be bordering on low, but the others are clearly showing signs.  It is best to get a full assessment on B12 status and the labs required to do so are generally covered.

  3. Replace with a high quality sublingual (under the tongue) B12 or get B12 injections and see how you feel. If you feel better… awesome!  Just remember… you will want to investigate why you are deficient and find the root cause of deficiency.

  4. Know your genetic MTHFR status.  This also important in regards to risk factors for other diseases such as cancer and autoimmunity.  

  5. Work at eliminating or reducing medications that drain or prevent B12 absorption.  Contact a Functional or Holistic Practitioner to help you.  

  6. Most importantly control your stress by being honest with yourself and others.  Say No when appropriate, take a yoga class, take time for yourself, spend time in nature and use meditation or a stress relieving modality like emotional freedom technique daily.

Thank you for reading this to the end.  My passion is helping others understand what it takes to keep them happy and vibrantly healthy.  B12 can be a powerful tool in my box.

Take Care!

Andrea Telfer-Karbo, FNP

Andrea Telfer