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Vitamin B12

Methylcobalamin / cyanocobalamin / B12 shots · Foundation

StrongFor the population and outcome described, multiple large human trials broadly agree.

Essential, cheap, and dramatic to fix when deficient — placebo-tier energy shots when you are not.

What the evidence says

Deficiency correction is textbook medicine with unambiguous benefit — and deficiency is genuinely common in vegans, long-term metformin users, and older adults (absorption, not intake, is usually the problem). In replete people, extra B12 — including the injection ritual — has repeatedly failed to beat placebo for energy.

What studies used

Supplement studies commonly use 500–1,000 mcg/day oral; deficiency treatment is a clinical decision. Published studies had not established a timing dependence.

Reported from published studies and product labelling — a record of what was used in research, not a recommendation. What is right for you is a conversation with a clinician.

Watch out for

  • Long-term metformin use is associated with B12 deficiency; markedly reduced food intake from any cause may warrant individualized assessment
  • High-dose oral treats most people effectively — passive diffusion absorbs a small fraction even without intrinsic factor — though injections remain the choice for severe neurologic disease or significant malabsorption

Evidence base

S21,984 research papers
established literature

Large human evidence base: several phase 3 or 4 trial reports, plus multiple meta-analyses or systematic reviews.

This letter measures how much human research exists, not whether it works for you — the tier above (Strong) is the read on quality.

Research (12)

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