Can I take Vitamin B12 (Vit B12) with calcium at the same time of day?

From the Guidelines

You can take Vitamin B12 and calcium supplements at the same time of day without significant concerns about negative interactions. These two nutrients have different absorption mechanisms in the body, and there is no evidence to suggest that taking them together would cause adverse effects 1. Vitamin B12 is a water-soluble vitamin important for nerve function and red blood cell formation, while calcium is a mineral essential for bone health and muscle function.

When considering supplementation, it's essential to note that high-dose supplements can have adverse effects, as seen in studies of beta-carotene and lung cancer 1. However, for Vitamin B12 and calcium, the concern is more about ensuring adequate intake rather than avoiding high doses. The American Cancer Society guide suggests that lower-dose nutrient supplementation may be indicated for biochemically demonstrated nutrient deficiency, such as low plasma vitamin D levels or B12 deficiency, where dietary approaches have been inadequate 1.

For optimal absorption of calcium, consider taking it with food and splitting larger doses (over 500mg) throughout the day. Vitamin B12 supplements are available in various forms, including cyanocobalamin and methylcobalamin, typically in doses ranging from 500-1000mcg for general supplementation. If you have specific health conditions or take medications, it's always best to check with your healthcare provider about your supplement regimen. Open dialogue between patients and healthcare providers is crucial to ensure there are no contraindications in relation to prescribed cancer therapy or for longer-term health effects 1.

Key points to consider:

• Vitamin B12 and calcium can be taken at the same time without significant concerns about negative interactions.
• Ensure adequate intake of these nutrients through diet or supplementation, especially if you have a demonstrated deficiency.
• Follow the recommended daily intake levels and consult with your healthcare provider if you have specific health conditions or take medications.
• High-dose supplements can have adverse effects, so it's essential to discuss your supplement regimen with your healthcare provider 1.

From the FDA Drug Label

Gastrointestinal absorption of Vitamin B12 depends on the presence of sufficient intrinsic factor and calcium ions. Vitamin B12 is bound to intrinsic factor during transit through the stomach; separation occurs in the terminal ileum in the presence of calcium, and Vitamin B12 enters the mucosal cell for absorption

You can take Vitamin B12 with calcium at the same time of day, as calcium ions are actually necessary for the gastrointestinal absorption of Vitamin B12. 2

From the Research

Vitamin B12 and Calcium Interaction

• There is no direct evidence that suggests taking Vitamin B12 (Vit B12) with calcium at the same time of day has any adverse effects 3.
• A study found that calcium supplements could be an effect modifier of the association between gastric acid inhibitors and vitamin B12 deficiency, suggesting that taking calcium with vitamin B12 may have a positive effect 3.
• However, the primary concern with taking vitamin B12 and calcium together is not their interaction, but rather the potential for calcium to interfere with the absorption of other nutrients.

Calcium Supplementation

• Calcium supplementation has been found to be beneficial for bone health in children, young adults, and menopausal women 4.
• The maximum dose of elemental calcium that should be taken at a time is 500 mg, and calcium carbonate should be taken with a meal to ensure optimal absorption 4.
• Calcium intake, up to a total intake of 2,000 mg/day, appears to be safe in most individuals, but high doses may increase the risk of advanced and fatal prostate cancer 4, 5.

Vitamin B12 and Folic Acid

• Folic acid supplements may be given with vitamin B12 to prevent neurological damage in individuals with undiagnosed vitamin B12 deficiency 6.
• However, there is no evidence to suggest that taking vitamin B12 with calcium has any specific benefits or drawbacks related to folic acid supplementation.

Calcium Absorption

• Vitamin D is often recommended to increase calcium absorption, but the effect of vitamin D on calcium absorption is relatively small, and the increase in absorbed calcium may not be significant enough to justify adding vitamin D to calcium supplements 7.
• Calcium absorption is more significantly related to serum 25-hydroxyvitamin D levels than to the dose of vitamin D, and there is no evidence of a threshold for reduced calcium absorption in the serum 25OHD range of 10-66 ng/ml (25-165 nmol/liter) 7.