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Vitamin B-12 Absorbancy and Osteoporosis\

Vitamin B-12 deficiency is a key risk factor for osteoporosis. The question is: If you're B-12 deficient, how can you change that?

An HSI member named Mike writes: "In your current article about B-12, there is no mention of the problem some people and older people have of stomach acid deficiency, which in turn leads to the inability to make 'essential factor' which is necessary for the absorption of B-12 in the gut."

When I shared Mike's e-mail with HSI Panelist Allan Spreen, M.D., he agreed, adding that the problem is more common than the medical profession lets on.

Dr. Spreen: "In my opinion this is why oral intake of B-12 pills is minimally effective for therapeutic purposes (though probably okay to avoid an overt deficiency state). For that reason most people use B-12 SL (Sub-Lingual, or under-the-tongue), which is an effort to bypass the stomach and utilize the capillary bed underneath the tongue for direct absorption of the nutrient.

"However, in a medical practice situation the gold standard is a B-12 injection, for the same reason. Anytime someone came into my office complaining of fatigue (any cause other than excessive partying the night before), they left with a B-12 shot…cheap, simple, and noticeably effective in a third of patients (by itself). Often, I also found that it seemed to 'prime the pump', causing the SL-form to become effective when it wasn't effective previously.

As for stomach acid deficiency, Dr. Spreen says that after B-12 SL, the next supplement he adds to a patient's regimen (immediately following a strong multi-vitamin/mineral product) is usually a digestive enzyme/hydrochloric acid combination.

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