Herbal Medicines and Elevated Vitamin B12 Levels
There is no clear evidence that herbal medicines cause elevated vitamin B12 levels. Based on current medical guidelines, herbal supplements have not been documented to increase vitamin B12 levels in the body 1.
Current Evidence on Herbal Supplements and Vitamin B12
- Medical guidelines consistently state there is no clear evidence of benefit from herbal supplementation for people without underlying deficiencies 1
- Routine supplementation with herbs and micronutrients (including cinnamon, curcumin, aloe vera, and chromium) has insufficient evidence to support their use for improving glycemia or other health outcomes 1
- American ginseng has been studied for glycemic effects but not for vitamin B12 elevation 1
Known Causes of Elevated Vitamin B12
- Persistently elevated vitamin B12 levels (>1,000 pg/mL on two measurements) have been associated with solid tumors, hematologic malignancy, and increased risk of cardiovascular death 2
- Normal vitamin B12 levels typically range from 180-914 pg/mL, with levels below 180 pg/mL considered deficient 2, 3
Common Sources of Vitamin B12
- The usual dietary sources of vitamin B12 are animal-derived foods: meat, milk, eggs, fish, and shellfish 4
- Some plant foods contain vitamin B12, particularly dried purple laver (nori), though most plant foods do not contain reliable amounts 4, 5
- Fortified breakfast cereals and vitamin B12-enriched vegetables can be valuable sources, especially for vegetarians and vegans 4, 6
Medications That Affect Vitamin B12 Levels
- Metformin is associated with vitamin B12 deficiency, not elevation 1
- Proton pump inhibitors (PPIs) may reduce vitamin B12 absorption, potentially leading to deficiency rather than elevation 1, 3
Clinical Implications
- While herbal medicines have not been documented to cause elevated B12 levels, unexplained elevated vitamin B12 (>1,000 pg/mL) should prompt evaluation for underlying conditions 2
- For patients with vitamin B12 deficiency, oral supplementation (1-2 mg daily) is generally as effective as intramuscular administration for correcting deficiency 3
- Bioavailability of vitamin B12 varies significantly between food sources, with approximately 50% absorption assumed for dietary vitamin B12 in healthy adults 4
Recommendations for Specific Populations
- Vegetarians and vegans should consume foods fortified with vitamin B12 or take supplements to prevent deficiency 6, 5
- Adults over 50 years should also consider vitamin B12 supplementation due to decreased absorption with age 3
- Patients who have had bariatric surgery should receive 1 mg of oral vitamin B12 daily indefinitely 3
In conclusion, while many herbal supplements have been studied for various health effects, there is no evidence in current medical literature suggesting that herbal medicines cause elevated vitamin B12 levels. Unexplained elevated B12 levels should prompt investigation for other medical conditions rather than being attributed to herbal supplement use.