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IMPORTANT: Please note that the following is not in any way shape or form intended to act as medical advice but purely as a recounting of my health experiences and the steps I took to overcome some serious issues I experienced with a vitamin B12 deficiency. If you happen to be experiencing a similar health complaint you must seek the counsel of a qualified health professional and not rely on this blog article and its contents for guidance.

In the beginning

It’s amazing how little you can know about your own body until things start to go wrong (often without you being aware until problems begin emerging).

Up until the early years of the last decade I had always been in reasonably good health (aside from the occasional seasonal cold). I trained weights in the gym once a week and was active in other sports wherever time allowed. My time was mostly devoted to contracting in and around London/South of England which saw considerable amounts of travel and stays at various hotels.

It’s fair to say that my diet wasn’t as balanced as it could have been, even if it was high in certain nutrients: some fruits, raw spinach, lots of varied types of nuts, protein powders, a multi-vitamin/mineral product and selected sports related supplements.

Added to this was my problem with getting sufficient sleep and being able to relax. I always felt cheated on both counts and found it very difficult to wind down and switch off.

Over time I started to notice that I was struggling to get out of bed and find the energy to get through the day. I also struggled more than usual to get to sleep and stay asleep (often waking needing to use the toilet multiple times during the early morning hours).

This became more problematic over the next couple of years and, after noticing other issues beginning to emerge (which included chest pains and problems with balance) I decided to visit my doctor and determine whether I had any issues with B12 levels.

As I have been following a plant-based diet for close to the past decade I am well aware of the risks of not getting sufficient nutrients (particularly in the form of Iodine, Vitamin D, Iron and, of course, vitamin B12). I tried to cover these as best I could through supplementation but something wasn’t right for all my efforts.

My first B12 blood serum test

I visited the doctor and undertook the blood test that would determine the exact concentration of B12 in my blood. The test results were supposed to be available within a fortnight after being sent off to the laboratory but, for some reason, I didn’t receive these until 6 weeks later.

When I was informed by my doctor of the results they didn’t make for good news. In the UK the clinical range for B12 levels in the blood is between 200 and 900 nanograms per millilitre (ng/mL).

My levels were reported at 137 nanograms per millilitre.

I was shocked. It was now official beyond all doubts. I was woefully deficient in B12.

Bare in mind that the original test was performed 6 weeks earlier so the chances that those B12 levels had dipped even lower were quite likely (and that was not a comforting thought given that I needed to reverse this situation).

This result perplexed me though as I had daily consumed a spirulina/chlorella supplement that was high in B12 for the past few years. Surely my blood levels should be well within the accepted clinical range given that I had consumed this supplement for so long?

Pseudovitamin B12….buyer beware

As it turned out (and it always pays to research any matter related to nutrition - particularly where supplements are concerned as there’s a lot of false marketing in that industry) it is 100% IMPOSSIBLE to obtain active B12 from spirulina.

Spirulina contains B12 analogues which are biologically inactive in humans. This pseudo-vitamin form of B12 was demonstrated, in an in-vitro study published in the European Journal of Biochemistry, to have a binding affinity to intrinsic factor (a protein required for the absorption of B12 in mammals) that was 500 times LOWER than that of true vitamin B12.

In short - your body simply cannot absorb B12 analogues.

This would explain why after years of using that Chlorella/Spirulina supplement my B12 levels were woefully deficient. All the B12 I thought I was getting was unable to be used. I was literally pissing away my money on that supplement.

The take away lesson at this point? Never EVER trust the supplement industry and its marketing - ALWAYS do your own research - no matter how reputable a company may appear.

Consequences of a B12 deficiency

So, given the results and being aware of the situation, the next step was to see how I could potentially reverse this as a prolonged B12 deficiency can lead to a range of unpleasant, and in some cases quite severe, health issues including:

• Constant exhaustion/tiredness
• Mood changes/irritability
• Heart palpitations
• Shortness of breath
• Tingling/pin and needles sensation in the hands and feet
• Restlessness/inability to concentrate
• Mental confusion/forgetfulness
• Pale/jaundiced skin
• Muscle weakness
• Constipation
• Diarrhoea
• Difficulty with coordinating movements
• Optic neuropathy
• Peripheral neuropathy

It doesn’t make for pleasant reading does it?

If a B12 deficiency is left untreated there is the very real risk of irreversible nerve damage so this is definitely no minor health issue that can be swept under the rug and dismissed.

As I was already experiencing the first seven of those symptoms I was quite eager to see what I could do to reverse course as quickly as possible.

Exploring my options

After sharing the test results with me my doctor informed me that I would need to take injections of B12 in order to reverse the situation.

I really didn’t like the sound of that as it meant I would be tied to taking injections for the rest of my life. I wanted to find out if I could reverse these low blood levels of B12 with high-strength supplementation but first of all I needed to determine if I was metabolically able to absorb B12 food from food/supplement sources.

I ran this past my doctor and he agreed to perform a test to see if my metabolism was able to absorb B12. I figured that if the results came back negative then I would have no other choice but to go ahead with the injections. On the other hand, if I could avoid having to rely on injections then my plan was to take high dosages of B12 for a month, return back to the doctor’s surgery and have another B12 blood test performed to see if this was positively affecting those blood levels of that particular vitamin.

Either way I would at least explore my options.

The one good thing about B12 is that as a water-soluble vitamin it is non-toxic in high amounts (unless you have very specific health issues with your kidneys) as the body only absorbs 1.5 micrograms of vitamin B12 at any one time (the remainder is simply flushed out of the system).

I undertook the test and was subsequently greeted with very welcome results: my body was able to absorb B12 from food/supplement based sources. This was fantastic news as it meant I could now proceed with my plan to start supplementing with high dosages of B12.

The high dosing regimen

Worryingly I had started to experience an aching pain in my right eye a couple of days before I received my test results. This began growing in intensity over the next two days and, after receiving my results, I was eager to stop off at the local Holland & Barretts store to purchase some 1000 microgram tablets of B12 in cyanocobalamin form and begin supplementing.

Interestingly (and I swear that this is the God’s honest truth) within 60 seconds of ingesting the 1000 microgram tablet the pain in my right eye disappeared. It stopped just like that. I couldn’t believe what I was experiencing. I was absolutely gobsmacked as I did not expect such a rapid response (and I do not believe for one minute that this was a placebo response).

Right there I knew I was onto something with the supplementation.

Over the next month I regularly supplemented up to 4000 micrograms a day of B12, divided over 4 separate intervals throughout the day so as to ensure better absorption. The pain in my right eye never did return and the tingling in my hands and on parts of my face that I had been experiencing also disappeared. This meant that the B12 levels in my blood were definitely increasing as the neurological symptoms of my B12 deficiency were beginning to diminish.

This was very, very reassuring and after a month of heavy supplementation I returned to the doctor’s surgery to arrange for another B12 blood test to check what my current blood levels of that vitamin were now recorded at.

The phlebotomist unfortunately was very clumsy with the needle and I experienced a very intense vasovagal reaction as she hit a nerve when drawing blood. It felt like fire was running down the entire length of the inside of my arm and I struggled to not fall onto the floor with the shock of the sensation. For someone who was apparently experienced and, in my doctor’s words, “the best phlebotomist they had ever worked with”, I was distinctly unimpressed with the pain she left me in.

I was also unimpressed with her lack of empathy as she didn’t seem in the least concerned about my wellbeing after running to get a nearby doctor to help with what was happening. She simply carried on drawing the blood and getting that bottled up to send to the lab.

So much for the caring profession.

Moment of truth

My results came back the next week (far quicker than the results from my first blood test) and I discovered that these were now recording a blood serum reading of 914 nanograms per millilitre of B12.

Remember that my first blood test result, a little over 2 months earlier, had recording a reading of 137 nanograms per millilitre (ng/mL)?

This meant that in a little over a month of heavy B12 supplementation I had managed to increase my blood serum levels of B12 by 777 points!!!! I expected some progress for sure but that result just blew my mind! I had now swung right over the other end of the clinical range (and a little excess on that scale is negligible - it really won’t have any detrimental effects on one’s health and wellbeing as any excess B12 is generally removed from the body quite quickly).

More than anything though this meant I wouldn’t need to take injections. I could raise my B12 blood serum levels to a healthy range purely through supplementation. This was great news and very, very well received.

Aftermath

So even though I managed to reverse a B12 deficiency I will always be prone to sliding back into that state if I am not careful. Lack of regular B12 supplementation combined with any prolonged form of stress can see those blood serum levels drop significantly.

My last B12 blood serum test was performed in October 2019 and recorded a level of 419 picomoles/Litre. If I have my maths correct, and have gauged the correct molar mass weight of vitamin B12 (and do correct me if I am wrong!), then I believe my B12 blood serum level is equivalent to 568 nanograms per millilitre.

The calculation I used to arrive at this figure is as follows:

Molar mass of Cyanocobalamin  = 1355.388

Picomoles = 419

Picomoles x molar mass = (419 * 1355.388) = 567,907.572 nanograms per litre

Nanograms per millilitre = (567,907.572/1000) = 568

I cobbled this together from various DuckDuckGo searches for converting between picomoles to nanograms and then dividing the result to get to litres. If my logic/calculation is completely inaccurate here do let me know!

So, if the above is correct then my B12 blood serum levels are looking pretty good 5 years later.

Conclusion

It is possible to reverse a B12 deficiency providing you are able to metabolically absorb B12 from food/supplement sources (and you have no underlying medical problems which may inhibit B12 absorption).

You simply need to take high doses of B12 in supplement form at regular intervals throughout the day. I took 1000mcg tablets of Cyanocobalamin 4 times a day for a month and managed to reverse clinically deficient levels of B12 to the point where they now exceeded the opposite end of the clinical range.

I’m not suggesting you should do this - I’m just offering my experiences and their outcome to prove that reversal of deficiency is fully possible with the right approach.

IF you decide to go down this road DO consult with a qualified medical practitioner who has both knowledge and expertise in this area and get your blood tested before and, at a minimum, 1 month after supplementing to see whether your regimen is working.

I would then advise getting your B12 levels checked at least once a year afterwards just to gauge that all is well.

As for supplementing with B12 after successfully reversing a deficiency I think that twice a week is sufficient but, once again, subsequent B12 blood tests will provide guidance on what is working dosage wise.

Some general information

Most B12 supplements come in the form of Cyanocobalamin although B12 is available in the following forms:

• Adenosylcobalamin
• Cyanocobalamin
• Hydroxycobalamin
• Methylcobalamin

This excellent article gives an overview on the different types of B12 with detailed information about each type.

Resources you might be interested in

https://www.b12-vitamin.com/

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