Vitamin B12 Fights Nerve Pain and Defends Your Heart and Brain

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Did you know that a deficiency in vitamin B12 could be an underlying cause of nerve pain and is associated with higher risks for heart disease and increased symptoms and severity of brain disorders? Foods rich in B12, like fish, meats and dairy, are a natural way to restore your health

A vitamin B12 deficiency or lower level of B12 has been associated with a variety of conditions including neuropathic pain, increased risks for heart disease such as obesity, high blood pressure and poor lipid profiles, and cognitive and brain disorders such as dementia, Alzheimer's, Parkinson's, schizophrenia, depression and tremors.

Three Benefits of Vitamin B12

1. Decreases Nerve Pain

In a review of 24 studies, researchers found evidence for the therapeutic effect of B12 in the treatment of post-herpetic neuralgia, a pain symptom of shingles (strong evidence) and the treatment of painful peripheral neuropathy, which is often associated with diabetes (strongest evidence).[i]

How does vitamin B12 impact nerve pain? B12 promotes myelination, which means it increases the protective fibers and sheaths around your neurons thus improving the efficiency of electrical transmission of neuron processes.[ii] It also increases nerve regeneration and decreases ectopic nerve firing, which is highly correlated with neuropathic pain.[iii],[iv]

Scientists performed a meta-analysis of 18 studies of serum vitamin B12 levels (1,239 cases and 1,562 controls) in patients with Type 2 diabetes. Reduced vitamin B12 levels were found in patients with diabetes and nerve pain compared with patients in the diabetes group without nerve pain, showing  B12 supplementation as a potential treatment for diabetic-related nerve pain.[v]

The prevalence of vitamin B12 deficiency was significantly high in diabetics, especially those treated with the drug metformin, in a study of 200 patients in Nigeria, and researchers recommended vitamin B12 supplementation to prevent the occurrence of complications such as impaired immunity, peripheral neuropathy and degeneration of the spinal cord.[vi]

In a similar study of diabetics in Oman, 248 subjects included 26 (10.5%) who were vitamin B12 deficient and 53 (21.4%) who were borderline deficient, with those taking the highest metformin dose found to be the most vitamin B12 deficient. Researchers recommend B12 level monitoring for patients with diabetes, particularly those on metformin treatment.[vii]

2. Lowers Risk for Heart Disease

Conditions that increase the risk for heart disease include obesity, imbalanced cholesterol, high blood sugar and high blood pressure (when multiple conditions are present, it is called metabolic syndrome).[viii] Research shows a strong relationship between low B12 levels and elevated heart risks.

In a study of 80 middle-aged women, obesity was found to negatively affect vitamin B12 levels, indirectly, by reducing their vitamin D levels, thus increasing the risk for heart disease.[ix] In a large nationally representative sample of U.S. adults (9,075), higher serum vitamin B12 levels were inversely associated with obesity.[x]

Indian patients (75) were studied and those with metabolic syndrome (obese, high lipid profile and high fasting sugar levels) had elevated blood levels of homocysteine, which can contribute to arterial damage and blood clots in your blood vessels[xi] and reduced levels of vitamin B12 compared to the control group.[xii]

An abnormal lipid profile, an independent risk factor for cardiovascular disease, was found in a study of 341 apparently healthy Saudi women, aged 19 to 30 years, who had low vitamin B12 levels.[xiii]

3. Improves Brain Health

Increasingly, science is showing the importance of vitamin B12 as an excellent food source or supplementation treatment to bolster brain health and decrease brain disorders and cognitive decline in subjects.

The results of a study of 89 children and adolescents with depression showed that vitamin B12 deficiency and elevated homocysteine levels are part of the pathology of depression.[xiv] In a study of 100 psychiatric patients, 25% were found to be vitamin B12 deficient when compared to the healthy control group; further studies are needed to establish the cause-effect relationship between vitamin B12 deficiency and psychiatric illness and the effectiveness of vitamin B12 treatment.[xv]

In another study of 202 vitamin B12-deficient patients with noted cognitive impairments, 171 (84%) patients reported marked symptomatic improvement after vitamin B12 replacement while Mini-Mental State Examination (MMSE) scores improved in 158 (78%) patients; in 44 patients who reported no symptomatic improvement, MMSE scores improved in 26.

Vitamin B12 deficiency was strongly linked to cognition and replacement therapy was suggested as an option to improve patient cognition and memory outcomes and symptoms like numbness and tingling.[xvi]

In 165 elderly (80 years or older) people from Brazil studied, over 35% experienced cognitive decline as measured by the Mini-Mental State Examination; those with higher B12 levels (greater than 19 but lower than 496 nanograms per milliliter) showed less cognitive decline.[xvii]

In a study of postmortem human frontal cortex of 43 control subjects, from 19 weeks of fetal development through 80 years of age, and 12 subjects with autism and nine with schizophrenia, vitamin B12 levels were significantly lower in older control subjects (greater than 60 years of age), reflecting a 10-fold age-dependent decline. Both autistic and schizophrenic subjects' B12 levels were more than three-fold lower than age-matched controls.[xviii]

Parkinson's disease (PD) patients with low vitamin B12 levels (less than 587 nanograms per milliliter) were over five times more likely to develop dementia, with 50% having dementia within five years of PD diagnosis compared with 11% in those with a higher vitamin B12 level; vitamin B12 is a likely treatment to lower future dementia risk for those with Parkinson's.[xix]

In research of 55 outpatients, a low vitamin B12 level was also associated with greater production of a proflammatory cytokine called IL-6 in peripheral blood mononuclear cells compared to the control group; scientists suggest that this neuroinflammatory effect could be implicated in the pathophysiology of Alzheimer's disease.[xx]

Both adults and infants deficient in vitamin B12 may present with chorea -- involuntary muscle movement, tremors, Parkinsonism and dystonia -- cramped toes or feet, or a combination, and these various movement symptoms responded well to vitamin B12 supplementation in a review of cases.[xxi]

B-vitamin treatment (folic acid, B6 and B12) reduces, by as much as seven-fold, cerebral atrophy in gray matter regions specifically vulnerable to Alzheimer's disease, including the medial temporal lobe. B vitamins lower homocysteine, which directly leads to a decrease in gray matter atrophy, and slows cognitive decline.[xxii]

In a case study of a patient presenting with progressive cognitive and functional deterioration, psychosis and seizures, which five years later was found to be secondary to pernicious anemia, vitamin B12 replacement caused a remarkable neuropsychiatric recovery.[xxiii]

Vitamin B12 is known to play critical roles during development and aging of the brain, and vitamin B12 deficiency has been linked to neurodevelopmental and degenerative disorders; Research shows the isoform-specific regulation of PTP-3/LAR PRTP expression is a key molecular mechanism that mediates vitamin-B12-dependent neuronal and glial development.[xxiv]

Food Sources for B12

Nutritional foods in your diet that are packed with B12 vitamin include mostly meats (liver, beef, chicken, turkey), fish (salmon, tuna, trout and shrimp) and dairy products (milk, eggs, yogurt and cheeses like Swiss and feta).

Fermented soy (tempeh) as well as fortified nutritional yeast can also be helpful for vegetarians with a B12 deficiency to increase their B12 intake. Some B12 may also be found in seaweed (one of the most common ones in the U.S. being the purple laver nori sheets used in sushi), shiitake mushrooms and spirulina but experts caution as to the consistency and availability of B12 in these products.

Those who are allergic to or wish to avoid dairy products from cows may find fortified B12 substitutes such as almond milk, coconut milk and cheeses like buffalo mozzarella or feta. Dietary B12 is recommended as the best way to increase your B12 level, but supplements such as chlorella tablets may be a good alternative if nutrition does not adequately address a B12 deficiency.[xxv] See Table 1 for a handy reference to dietary sources of vitamin B12.[xxvi]

Table 1 - Foods with High Vitamin B12 Content (Descending Order)

Foods High in Vitamin B12


Micrograms (mcg)
per serving (2.4 daily recommendation)

Clams, cooked, 3 ounces


Liver, beef, cooked, 3 ounces


Mussels, 3-ounce


Nori, dried purple laver seaweed, 10 sheets, 26 grams


Crab, steamed, 3-ounces


Lean beef, cooked, 3-ounces


Trout, rainbow, wild, cooked, 3 ounces


Salmon, sockeye, cooked, 3 ounces


Trout, rainbow, farmed, cooked, 3 ounces


Tuna fish, light, canned in water, 3 ounces

Cheese, feta, 1 cup


Nutritional yeast, 100% fortified with vitamin B12, 1 serving

Coconut milk, 100% fortified, 1 cup


Shrimp, steamed, large, 4 ounces

Haddock, cooked, 3 ounces


Beef, top sirloin, broiled, 3 ounces


Milk, low-fat, 1 cup


Yogurt, fruit, low-fat, 8 ounces


Skim milk: 1 cup

Cheese, Swiss, 1 ounce

Beef taco, 1 soft taco


Turkey, 3-ounces


Tempeh, fermented soy, 1 cup


Breakfast cereals, 25% fortified with vitamin B12, 1 serving

Egg, whole, cooked 1 large, yolk has most B12


Chicken, breast meat, roasted, 3 ounces


B12 -- Essential Vitamin for Nerve Pain, Brain and Heart Health

Vitamin B12 plays essential roles in decreasing nerve pain, lowering risks for heart disease and improving brain health and brain disease symptoms such as tremors, dementia and cognition.

Many people experience a deficiency in vitamin B12, caused by drugs, aging, diet or other precursors to diseases, which compromises their body. If you would like to read more about the scientific evidence of B12's benefits, see:


[i] Thomas Julian, Rubiya Syeed, Nicholas Glascow, Efthalia Angelopoulou, Panagiotis Zis. B12 as a Treatment for Peripheral Neuropathic Pain: A Systematic Review. Nutrients. 2020 Jul 25 ;12(8). Epub 2020 Jul 25. PMID: 32722436

[iii] Sun Q, Tu H, Xing GG, Han JS, Wan Y. Ectopic discharges from injured nerve fibers are highly correlated with tactile allodynia only in early, but not late, stage in rats with spinal nerve ligation. Exp Neurol. 2005 Jan;191(1):128-36. doi: 10.1016/j.expneurol.2004.09.008. PMID: 15589519.

[iv] Holmes SA, Barakat N, Bhasin M, Lopez NI, Lebel A, Zurakowski D, Thomas B, Bhasin S, Silva KE, Borra R, Burstein R, Simons LE, Borsook D. Biological and behavioral markers of pain following nerve injury in humans. Neurobiol Pain. 2019 Dec 4;7:100038. doi: 10.1016/j.ynpai.2019.100038. PMID: 31890990; PMCID: PMC6926375.

[v] Dan Wang, Jun-Xia Zhai, Dian-Wu Liu. Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis. Mol Cell Endocrinol2017 Jan 9. Epub 2017 Jan 9. PMID: 28081987

[vi] Sampson Omagbemi Owhin, Tomisin Mathew Adaja, Olumuyiwa John Fasipe, Peter Ehizokhale Akhideno, Olufunto Olufela Kalejaiye, Michael Olufemi Kehinde. Prevalence of vitamin B deficiency among metformin-treated type 2 diabetic patients in a tertiary institution, South-South Nigeria. SAGE Open Med. 2019 ;7:2050312119853433. Epub 2019 May 23. PMID: 31205703

[vii] Ahmed Al-Hamdi, Mohammed Al-Gahhafi, Shihab Al-Roshdi, Sanjay Jaju, Ali Al-Mamari, Abdulaziz M Al Mahrezi. Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman. Sultan Qaboos Univ Med J. 2020 Feb ;20(1):e90-e94. Epub 2020 Mar 9. PMID: 32190375

[viii] Health Topics. Metabolic Syndrome. Symptoms and Diagnosis of Metabolic Syndrome.

[ix] Nikola Curic, Branislava Ilincic, Natasa Milic, Velibor Cabarkapa, Stanislava Nikolic, Milica Medic-Stojanoska, Rinaldo Pellicano, Ludovico Abenavoli. The relationship between the vitamin serum 25(OH)D and the B12 concentrations in obese women. Minerva Med. 2017 Nov 7. Epub 2017 Nov 7. PMID: 29115801

[x] Yangbo Sun, Minxian Sun, Buyun Liu, Yang Du, Shuang Rong, Guifeng Xu, Linda G Snetselaar, Wei Bao. Inverse Association Between Serum Vitamin B12 Concentration and Obesity Among Adults in the United States. Front Endocrinol (Lausanne). 2019 ;10:414. Epub 2019 Jun 27. PMID: 31316466

[xi] Health. Homocysteine Levels.

[xii] Moninder Narang, Mukul Singh, Shruti Dange. Serum Homocysteine, Vitamin B12 and Folic Acid Levels in Patients with Metabolic Syndrome. J Assoc Physicians India. 2016 Jul ;64(7):22-26. PMID: 27759338

[xiii] Sara Al-Musharaf, Ghadeer S Aljuraiban, Syed Danish Hussain, Abdullah M Alnaami, Ponnusamy Saravanan, Nasser Al-Daghri. Low Serum Vitamin B12 Levels Are Associated with Adverse Lipid Profiles in Apparently Healthy Young Saudi Women. Nutrients. 2020 Aug 10 ;12(8). Epub 2020 Aug 10. PMID: 32785129

[xiv] Erman Esnafoglu, Deniz Deniz Ozturan. The relationship of severity of depression with homocysteine, folate, vitamin B12, and vitamin D levels in children and adolescents. Child Adolesc Ment Health. 2020 Apr 18. Epub 2020 Apr 18. PMID: 32304285

[xv] Rashmi Sagar, Nitin Aggarwal, Nimmi Jose. A Cross-Sectional Study of Serum Folate and Vitamin B12 Levels in Psychiatric Inpatients. Prim Care Companion CNS Disord. 2019 Oct 10 ;21(5). Epub 2019 Oct 10. PMID: 31617966

[xvi] Shazia Jatoi, Abdul Hafeez, Syeda Urooj Riaz, Aijaz Ali, Muhammad Ishaq Ghauri, Maham Zehra. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus. 2020 Feb 13 ;12(2):e6976. Epub 2020 Feb 13. PMID: 32206454

[xvii] M I da Rosa, W O Beck, T Colonetti, J Budni, A C B Falchetti, L Colonetti, A S Coral, F O Meller. Association of vitamin D and vitamin Bwith cognitive impairment in elderly aged 80 years or older: a cross-sectional study. J Hum Nutr Diet. 2019 Feb 28. Epub 2019 Feb 28. PMID: 30821057

[xviii] Yiting Zhang, Nathaniel W Hodgson, Malav S Trivedi, Hamid M Abdolmaleky, Margot Fournier, Michel Cuenod, Kim Quang Do, Richard C Deth. Decreased Brain Levels of Vitamin B12 in Aging, Autism and Schizophrenia. PLoS One. 2016 ;11(1):e0146797. Epub 2016 Jan 22. PMID: 26799654

[xix] Stuart J McCarter, Cole Stang, Pierpaolo Turcano, Michelle M Mielke, Farwa Ali, James H Bower, Rodolfo Savica. Higher vitamin B12 level at Parkinson's disease diagnosis is associated with lower risk of future dementia. Parkinsonism Relat Disord. 2020 Mar 16 ;73:19-22. Epub 2020 Mar 16. PMID: 32203914

[xx] Antonis Politis, Paolo Olgiati, Petros Malitas, Diego Albani, Alessandra Signorini, Letizia Polito, Stefania De Mauro, Aikaterini Zisaki, Christina Piperi, Evangelia Stamouli, Antonis Mailis, Sara Batelli, Gianluigi Forloni, Diana De Ronchi, Anastasios Kalofoutis, Ioannis Liappas, Alessandro Serretti. Vitamin B12 levels in Alzheimer's disease: association with clinical features and cytokine production. J Alzheimers Dis. 2010;19(2):481-8. PMID: 20110595

[xxi] Aaron de Souza, M W Moloi. Involuntary movements due to vitamin B12 deficiency. Neurol Res. 2014 May 22:1743132814Y0000000396. Epub 2014 May 22. PMID: 24852503

[xxii] Douaud G, Refsum H, de Jager CA, Jacoby R, Nichols TE, Smith SM, Smith AD. Preventing Alzheimer's disease-related gray matter atrophy by B-vitamin treatment. Proc Natl Acad Sci U S A. 2013 Jun 4;110(23):9523-8. doi: 10.1073/pnas.1301816110. Epub 2013 May 20. PMID: 23690582; PMCID: PMC3677457.

[xxiii] Bruno Silva, Ana Velosa, J Bernardo Barahona-Corrêa. Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B deficiency. BMJ Case Rep. 2019 May 14 ;12(5). Epub 2019 May 14. PMID: 31092496

[xxiv] Albert Zhang, Brian D Ackley, Dong Yan. Vitamin B12 Regulates Glial Migration and Synapse Formation through Isoform-Specific Control of PTP-3/LAR PRTP Expression. Cell Rep. 2020 Mar 24 ;30(12):3981-3988.e3. PMID: 32209461

[xxv] Randall Edward Merchant, Todd W Phillips, Jay Udani. Nutritional Supplementation with Chlorella pyrenoidosa Lowers Serum Methylmalonic Acid in Vegans and Vegetarians with a Suspected Vitamin B12 Deficiency. J Med Food. 2015 Oct 20. Epub 2015 Oct 20. PMID: 26485478

[xxvi] Office of Dietary Supplements. National Institute of Health. Factsheets. Vitamin B12.

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