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Vitamin B12 information
Deficiency may occur in patients with Crohn's disease.

Older men with low levels of vitamin B-12 are at increased risk for bone fractures, University of Gothenburg, news release, Dec. 12, 2013.

Acid-inhibiting drugs like Zantac and Prilosec have become hugely popular because they're so good at preventing the unpleasant symptoms of heartburn and acid indigestion. But the drugs also make it more likely that a person will be short on vitamin B-12. And that can contribute to health problems including depression, nerve damage and dementia. December 14, 2013

My question is on vitamin B12 and whether the different forms of taking it - orally, sublingually or by injection - result in different uptakes / absorption. In particular, does a vitamin B12 injection result in more immediate availability than an equivalent oral or sublingual dose? Incidentally, I notice that Harvard University are doing research on its effect on sleep / wake cycles although they are using the cyanocobalamin rather than the methylcobalamin form.
   Blood levels of vitamin B12 are influenced by the form of ingestion, whether orally or by injection. However, most of the time the dose of vitamin B12 that is given is so large, that practically speaking it is difficult to guess whether it makes much difference in overall health. Those who have a severe form of pernicious anemia or vitamin B12 deficiency are probably better off getting an injection.

Those who use proton pump inhibitors, such as Prilosec, for prolonged periods, particularly the elderly, may potentially have a deficiency.

The recommended daily intake for vitamin B-12 should be more than doubled from the current level.
In a study of 98 middle-aged and older women, researchers found that 6 micrograms of B-12 per day seemed to be enough to prevent signs of mild vitamin B12 deficiency. That compares with the current recommended dietary allowance (RDA) of 2.4 micrograms per day. Vitamin B-12 is essential for maintaining healthy nerve cells and red blood cells; a deficiency in the vitamin can cause symptoms ranging from the subtle -- including fatigue and mild dizziness -- to more severe complications like nerve damage, anemia and even dementia. Though the typical Western diet provides people with far more than the current RDA for B-12, certain individuals are at risk for a deficiency. Unlike most vitamins, B-12 occurs naturally only in animal products, including meat, poultry, fish and, in lesser amounts, eggs and dairy. So vegetarians and vegans -- who avoid all animal products, including dairy -- may have low stores of the vitamin. The same is true of adults older than 50, as many have a thinning in the stomach lining that prevents the proper release of digestive acids. Stomach acids are essential for "shaking loose" vitamin B-12 from its food source, allowing it to be absorbed. So older adults are advised to get their B-12 from pills and fortified foods like cereal. That RDA is what experts believe is the minimum B-12 needed to prevent anemia, nerve damage and mental dysfunction. But it's not clear that it's enough to prevent subtler effects. American Journal of Clinical Nutrition, January 2006.

Oral supplements of vitamin B12 appear to correct vitamin B12 deficiencies as well as B12 injections. However, the group of European researchers found that, in order to correct a deficiency, oral doses need to contain more than 200 times the recommended daily allowance (RDA) of vitamin B12. Study author Dr. Lisette C. P. G. M. de Groot of Wageningen University in the Netherlands explained that most people develop vitamin B12 deficiencies as a result of "malabsorption," in which their bodies become unable to extract vitamin B12 from food. The deficiency typically strikes older people, she added, and takes years to develop. In some instances, people who avoid animal products -- such as vegans and followers of a macrobiotic diet -- can also develop a deficiency in vitamin B12 as a result of not eating enough B12-rich foods. A vitamin B12 deficiency is typically treated by monthly, often painful, shots. To investigate whether an oral dose of vitamin B12 works, as well, they tested various daily doses of oral vitamin B12 supplements in 120 people aged 70 and older. They found that daily oral doses of 647 to 1032 micrograms of vitamin B12 appeared to correct the deficiency. The current RDA for vitamin B12 is 3 micrograms per day. Archives of Internal Medicine, May 23, 2005.

B6 toxicity and deficiency
Q. Do you have anything I can now read regarding the toxicity of Vitamin B6? I read an article by someone on the internet and it said an amount of 1000 times the RDA of Viamin B6 can be very toxic. My husband is taking 5000 times the RDA! So I called a nutrition physician to ask if this that I had read on the internet was true, and was assured the amount he was taking was perfectly safe. So we are very confused. I realize you cannot answer definitive questions re someone's health problem, but could you please tell us something we can read re the toxicity of Vitamin B6? Whatever my husband takes, the SAMe-, vitamin B6, etc. he will be probably be taking the rest of his life. He takes them for restless legs syndrome. He is not taking any prescription medication except a sleeping pill (Temazapam) which he uses nightly until it quits working, then off it a couple of nights, etc. Without the sleeping pill, he is lucky to get 2 hours a night; with it, maybe 4 hours. He is so very, very tired, you can see why we are trying to learn all we can. We are so appreciative of learning from your website about the possible side effects of SAM-e and also will be appreciative if you can help us learn about the toxicity of Vitamin B6.
   A. There have been reports of excess vitamin B6 causing neuropathy. 5000 times the RDA for vitamin B6 is quite a hefty dose.

How much vitamin B6 is toxic?
Ned Tijdschr Geneeskd. 2005. Katan MB. Wageningen Centre for Food Sciences en Wageningen Universiteit, afd. Humane Voeding, Bomenweg Wageningen.
Vitamin B6 (pyridoxine) causes neuropathy at intakes of 1000 mg per day or more, which is about 800 times the daily intake from foods. There have also been occasional reports of toxicity at intakes of 100-300 mg per day. The US authorities set the no-observed-adverse-effect-level at 200 mg per day and the safe upper limit at 100 mg per day. A report of neurotoxicity in 2 patients who had taken 24 mg and 40 mg of vitamin B6 per day respectively, may be coincidence rather than a true toxic effect of such relatively low doses. However, physicians need to remain alert to high intakes of vitamin B6 as a cause of unexplained neuropathy.

Rosacea fulminans triggered by high-dose vitamins B6 and B12.
J Eur Acad Dermatol Venereol. 2001.
Rosacea fulminans is a rare variant of rosacea conglobata that occurs almost exclusively in women well past adolescence. The aetiology is unknown, although immunological, hormonal, and vascular factors have been suggested. We report the case of a 17-year-old girl with rosacea fulminans that was temporally associated with daily ingestion of high-dose vitamin B supplements.

Pak J Pharm Sci. 2013. Vitamin B6: deficiency diseases and methods of analysis. Vitamin B6 (pyridoxine) is closely associated with the functions of the nervous, immune and endocrine systems. It also participates in the metabolic processes of proteins, lipids and carbohydrates. Pyridoxine deficiency may result in neurological disorders including convulsions and epileptic encephalopathy and may lead to infant abnormalities. The Intravenous administration of pyridoxine to patients results in a dramatic cessation of seizures.

Q. I've just purchased some Sam-e for depression as I experience too many side-effects with anti-depressants. I have read that it is wise to take additional vitamin B s, particularly B6, B12 and folic acid, when taking Sam-e in order to prevent toxic build-up of homocysteine. Apparently these vitamins assist in the breakdown of homocysteine which is formed when Sam-e breaks down.
     A. We're not totally sure whether extra vitamin B is needed if someone is taking SAM-e. Perhaps it depends on one's diet and biochemistry. It would not hurt to take 1 to 3 times the RDA of vitamin B.

Source Naturals Coenzyme Vitamin B Complex, 60 Tablets - Source Naturals
Sublingual (melts under the tongue), Orange flavored

In order for the various vitamin B compounds to be utilized by the body, they must first be converted into their active coenzyme forms. This sublingual Coenzyme vitamin B Complex goes directly into your bloodstream in its active form, ready to go to work immediately.

Supplement Facts:
Vitamin C (as niacinamide ascorbate)
B 1 Thiamin (from 20 mg cocarboxylase [Coenzymated])
B 2 Riboflavin (from 15 mg flavin mononucleotide [Coenzymated])
Niacin (from inositol 34 mg, niacinamide ascorbate 30 mg, nicotinamide adenine dinucleotide 10 mg [Coenzymated])
B-6 (from 15 mg pyridoxal -5-phosphate)
Folate (as folic acid)
Vitamin B-12 (from 1 mg dibencozide [Coenzymated])
Biotin
Pantothenic Acid (as calcium D-Pantothenate)
Coenzyme Q10 (ubiquinone)
Inositol (as inositol hexanicotinate)

Right now im looking for a 100% Vegetarian Coenzymated Sublingual B Complex Lozenge or Tab that dissolves in the mouth OTHER than the Source Naturals brand. The reason why i dont want to use the Source Naturals brand is because it contains Sorbitol. Can you please let me know if any other company provides a coenzymated sublingual vegetarian B complex Lozenge or Tab thats either sugar free or uses Xylitol or Stevia instead of Sorbitol?
   A. We have not looked to see what other company sells this. The amount of sorbitol is so small as to be insignificant in terms of health effect.

I purchased a product Vitamin-B-Coenzyme-Complex. I am having very good results. I have a doubt regarding the dosage. the product contains NADH-5mg / tablet. the dosage for NADH in the book mind boosters is to take 2.5-5mg of NADH only a few times a week. whereas the the bottle indicates to take 2-3 tablets daily (which is 10 / 15 per day).
   A. We believe 1 tablet of vitamin B coenzyme a few times a week is sufficient. However each person is different.

I purchased a product Vitamin-B Coenzyme Complex and having very good results. The product contains NADH 5mg / tablet. The dosage for NADH in the Mind-Boosters book is to take 2.5-5mg only a few times a week whereas the the bottle indicates to take 2-3 tablets daily (which is NADH-10 to 15 mg per day). Please let me know about the safe dosage of the product Vitamin-B Coenzyme Complex for daily use .
   We believe 1 or two tablets of vitamin B coenzyme a few times a week is sufficient. However each person is different. Some need more, others less.

Is it advised to take a B50 vitamin supplement at night with tryptophan for sleep?
   High dosages of B vitamins can cause alertness and should only be taken in the morning.

Is it necessary to take a vitamin B complex while supplementing with tyrosine and phenylalanine amino acids?
    We don't see any reason to take B vitamins along with these amino acids. If you do, we suggest lowering the dosage of the amino acids.

I am interested to know which vitamin ingredients are domestic or imported. I have chewable calcium with d2 from my market, and wonder if the d2 and the calcium are made in the USA, or imported. I do not think they have to say where the ingredients are manufactured. If it is all put together in the US, it appears US made, but the ingredients could be from some other country. Are there websites that show where vitamins are manufactured?
    Vitamin companies purchase their raw materials from various sources and even the same product, when a new batch is made, could have ingredients purchased from different sources, companies, and countries, and hence it could vary over time. Therefore it is nearly impossible to keep up where all the ingredients are being made for any particular bottle and there is no such website that would keep us with this.