Page 120
The Willner Window Product Reference Catalog, Autumn, 2013
since 1911
• Willner Chemists •
the nutritional supplement professionals
Natural Health International
Vitamin B12--Sublingual, Nasal
Spray or Oral?
Should You Swallow?
“So, you are saying that the Sublingual B12
does not work as a sublingual because the
molocules are too large to be absorbed
through the barrier. Does the nasal spray ver-
sion work ?”
This comment was posted on my blog,
www.dongoldberg.com, in response to a post
titled “Vitamin B12: Sublingual Form?” origi-
nally dated October 11, 2010.
The current question about nasal spray
vitamin B12 is a valid one.
First, let’s look at why this discussion per-
sists. Vitamin B12 is an essential vitamin,
“playing a role in DNA synthesis, red blood
cell formation, homocysteine metabolism,
and synthesis of S-adenosylmethionine. It is
involved in the functioning of the nervous
system and immune system.” The problem is
that due to its unique absorption mechanism,
correcting deficiencies is not always easy.
Before I explain why this is so, let’s look at
a slightly more technical explanation by Dr.
Alan Gaby (Nutritional Medicine. Alan R.
Gaby, M.D., 01/2011.) :
“Vitamin B12 in food is usually bound to
protein. It is released from the protein by the
combined action of gastric hydrochloric acid
and pepsin, and then binds to intrinsic factor,
which is secreted by the stomach. The vita-
min B12-intrinsic factor complex is absorbed
into the bloodstream in the ileum. Crystalline
vitamin B12 used in nutritional supplements
does not require the action of hydrochloric
acid and pepsin in order to be available for
binding to intrinsic factor. Some 50–75% of
vitamin B12 bound to intrinsic factor is
absorbed, but intrinsic factor becomes satu-
rated at vitamin B12 doses greater than
about 2 μg. Larger doses of vitamin B12 can
be absorbed by passive diffusion, a process
that is independent of intrinsic factor. While
fractional vitamin B12 absorption by this
mechanism is only about 1–2%, oral adminis-
tration of high doses of vitamin B12 (such as
1,000 μg/day) can compensate for the loss of
intrinsic factor (as in pernicious anemia).
Pernicious anemia is a condition in which
vitamin B12 malabsorption occurs secondary
to autoimmune destruction of the gastric
parietal cells (the cells that produce intrinsic
factor.) . . . Hypochlorhydric individuals have
an impaired capacity to absorb protein-
bound vitamin B12 from food, but they
absorb crystalline vitamin B12 normally.
People with hypochlorhydria are therefore at
risk of developing vitamin B12 deficiency
unless they take a vitamin B12 supplement.”
Note that Dr. Gaby points out that large
doses of vitamin B12, taken orally, can be
absorbed by “passive diffusion.” In other
words, enough B12 can be absorbed (about
1 to 2 percent) even in the absence of intrin-
sic factor, from oral dosage.
Let’s look at that from a practical stand-
point. Supplements are available that provide
1,000 mcg and 5,000 mcg per dose. The
form of vitamin B12 used in these supple-
ments is methyl cobalamin, which is one of
the coenzyme forms of vitamin B12. If 2% of
the methyl cobalamin is absorbed, by passive
diffusion, that will deliver 20 micrograms of
B12 from the 1,000 mcg product, and 100
mcg of B12 from the 5,000 mcg products. At
the time I am writing this, the 1,000 mcg
product (Jarrow Formulas, Willner Code
34453, 100 Lozenges at $8.37) would cost
you a little over eight cents per dose. The
5,000 mcg product (Jarrow Formulas, Willner
Code 34918, 60 Lozenges at $20.97) would
cost about thirty-five cents a dose.
That’s pretty inexpensive, isn’t it? And
that’s why, when we say you get the same
benefit from a “large” oral dose of vitamin
B12, it is important to recognize that a
“large” oral dose of vitamin B12 is very small
when it comes to cost. Compare this to the
cost of an intramuscular injection or of a pre-
scription nasal spray.
OK, so what about “nasal sprays” as an
alternative to oral forms or injections?
First, to the best of my knowledge, nasal
gels and nasal sprays are not classified as
“nutritional supplements” or “foods.” The
FDA prohibited vitamin B12 nasal gels from
being sold as over the counter nutritional
supplements many years ago, and I assume
the same regulatory status applies to B12
nasal sprays. They are available on prescrip-
tion, however.
Do they work–whether on prescription or
otherwise? The answer seems to be, “kind
of!” I looked at the “package insert” for one
prescription B12 nasal spray product, and I
found the evidence a little vague. I am
appending the pertinent section at the end of
this article. You can decide for yourself.
At best, the same practical question begs to
be answered, i.e. why spend all that money
for an expensive, prescription B12 nasal
spray when you can get the same result from
an inexpensive vitamin B12 1,000 mcg or
5,000 mcg supplement?
And finally, here is what Dr. Alan Gaby has
to say about B12 nasal sprays:
“Hydroxocobalamin administered by the
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Cedarwood (Himalayan)
1 fl oz, # 63003
Cinnamon Leaf
1 fl oz, #62679
Clove
1 fl oz, #63004
Eucalyptus
1 fl oz, #62680 - 4 fl oz, #62681
Grapefruit (Pink)
1 fl oz, #62710
Lavender (French)
1 fl oz, #63005 4 fl oz, #62787
Lavender (Bulgarian)
1 fl oz, #62815
Lemon
1 fl oz, #63006
Orange (Sweet)
1 fl oz, #62820
Oregano
1 fl oz, #62821
Patchouli
1 fl oz, #62822
Peppermint
1 fl oz, #62884 - 4 fl oz, #63007
Rosemary
1 fl oz, #63008
Tea Tree (Australian)
1 fl oz, #63009 - 4 fl oz, #63010
Ylang Ylang
1 fl oz, #63011
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