Sublingual Vitamin B12
By Curtis Alexander, Pharm.D.
Summary: Sublingual Vitamin B12 tablets don’t raise blood levels faster or higher or offer better absorption than regular B12 tablets. A 2003 study clearly proved this.
Q: I may have to end up supplementing with Vitamin B12. Do you think it would be worthwhile to go with sublingual vitamin B12 over oral? I had read that vitamin B12 sublingually improves absorption.
A: The short answer is, no. It won’t really give you any advantages. However, it won’t cause any harm either. But, before you make your decision it’s important for you to understand WHY. So, here comes the long answer (not too long, I promise).
In the pharmaceutical world certain medications are formulated be to be given sublingually (under the tongue). The advantage of using the sublingual route is that it bypasses the stomach. In doing so you can avoid a lot of the problems that occur with medications in the stomach and it’s high acid environment.
Also, in certain populations – geriatrics for example – it’s advantageous to use the sublingual route because some drugs may require a high acid environment to be broken down and transported across tissues. Geriatrics have notoriously low stomach acid (higher pH) environments.
So, it certain instances, giving something sublingually can avoid a lot of problems and roadblocks.
Vitamin B12 Sublingual Absorption
In medical circles it’s known that people who have gastrointestinal issues often have problems absorbing B12. For example, Crohn’s Disease. Also, patients with pernicious anemia lack a certain compound to absorb vitamin B12. I think this opened up a lot of confusion – and a chance for some supplement companies to capitliazine on that confusion by insinuating that sublingually administered B12 is the only way to go. But, in the end, giving B12 as a sublingual vitamin doesn’t really accomplish anything significant.
Here’s why: when you eat food that contains vitamin B12 it is digested in your stomach by gastric enzymes. This requires an acidic (low) pH. However, when you take B12 in a supplement form these steps are actually bypassed.
This is one of the reasons why a 2003 study in the British Journal of Pharmacology showed there was essentially no difference in the blood levels of patients who took regular oral B12 (swallowed with water) versus patients who took sublingual vitamin B12.
Now, you can’t make this statement to mean the same for everybody across the board because every person is different. But, from the evidence I’ve seen to date I don’t see any advantages over sublingual vitamin B12. In addition, most sublingual preparations tend to be more expensive.