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Vitamin B12 Supplements: Are They Safe and Beneficial for RA?

Posted on June 08, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sarah Winfrey

Some people with rheumatoid arthritis (RA) seek to supplement their RA treatment regimens with alternative or natural therapies. A common practice is adding dietary supplements like vitamins, herbs, and minerals to their diets to help manage RA symptoms.

One supplement that myRAteam members ask about regularly is vitamin B12. Although this vitamin may have some benefits for people with RA, talk to your doctor to get medical advice before you add any new products or therapies to your RA management regimen. Your rheumatologist or health care provider can help you find the best form of the vitamin, as well as monitor your symptoms and response to it.

How myRAteam Members Use Vitamin B12

Several myRAteam members have shared that they use vitamin B12 to combat fatigue or tiredness. Some find that it helps a little, like a member who shared, “I can barely get myself out of the car after the drive home from work. I do take a vitamin B complex with vitamin C and a sublingual B12. It does help a bit.”

Others find that vitamin B helps them combat fatigue quite a bit. One member explained, “I take a vitamin B1, B6, B12 complex. It allows me to work and is my key guard against being tired. A vitamin B supplement is essential.”

Others find that, while vitamin B12 supplementation helps, it does not do as much as they would hope. “I have received two B12 shots, and yes, they helped both times,” one member shared. “I actually had some energy to do a few things around the house and spend some fun time with grandkids. Just didn’t last long enough.”

Vitamin B12 may be even more essential for people who don’t get enough of it through their diet, like vegetarians. As one member explained, “I get B12 shots. One of my doctors, who is a vegetarian, told me that the only way vegetarians can get B12 is to take it as a supplement or through injections.”

In other cases, your vitamin B12 levels may be low for other reasons. Regardless of the reason, supplementing your diet with more vitamin B12 may help. “I take B12 daily because mine is low,” wrote one member. “I do feel a difference if I stop taking it. But I also take iron and vitamin D too. Without the B12 and iron, I’m really tired.“

Vitamin B12, while only rarely used alone, may be part of a supplement regimen that can help you feel better.

Could Vitamin B12 Help RA Symptoms?

Vitamin B12 is essential for the healthy functioning of the central nervous system and the formation of red blood cells. Most adults get adequate vitamin B12 through their diet, but some people are deficient, which results in symptoms like anemia, weight loss, and fatigue. Adequate vitamin B12 levels are especially important for older adults.

Some people have found that supplementing their diets with vitamin B12, either through a vitamin B complex or a multivitamin, has helped them to feel better while living with RA. There are several symptoms associated with RA that might be improved by taking this vitamin.

Fatigue

Although many people with RA experience fatigue caused by the condition, others may have additional fatigue because of a vitamin B12 deficiency. In these cases, taking vitamin B12 orally, sublingually (under the tongue), or by infusion may help improve fatigue.

It is not known if people with RA have an increased risk or a higher risk of vitamin B12 deficiency. If your health care provider suspects that you don’t have enough vitamin B12, they may do some tests to check your blood levels. They may also have you try a supplement to see how it works for you.

Nerve Pain

One study found that as many as 85 percent of people with RA experience peripheral neuropathy — a group of disorders caused by damage to the peripheral nervous system. There is some evidence that one version of vitamin B12, called methyl B12 or methylcobalamin, can help reduce pain caused by RA. Researchers believe that this pain reduction occurs because that form of vitamin B12 strengthens nerve fibers, which are then not as susceptible to irritation by inflamed joints.

Not all forms of vitamin B12 are suggested to help with nerve pain. If you want to try a vitamin for nerve pain, you will need to find a supplement that lists methyl B12 or methylcobalamin specifically in the ingredients. Cobalamin and cyanocobalamin are more common forms of vitamin B12 but are not recommended to help nerve pain.

What Else Should People With RA Know About Vitamin B12?

People often have many questions about taking vitamins for different health conditions and symptoms. Here is what you need to know about vitamin B12 and RA.

How Much Vitamin B12 Should Someone With RA Take?

There is no known upper limit for how much vitamin B12 a person can take. It is a water-soluble vitamin, meaning that the body will excrete what it does not need through urine. The average adult can take the daily recommended amount with little risk of toxicity or adverse side effects. If you have RA, talk with your rheumatologist or another health care professional before taking any vitamin B12 supplements.

The National Institutes of Health recommends an allowance of 2.4 micrograms per day of vitamin B12 for adults. People with deficiencies or conditions that affect their body’s ability to absorb the vitamin will be advised to take different amounts. Women who are pregnant should take up to 2.6 micrograms per day, and those who are lactating or breastfeeding need 2.8 micrograms each day.

People taking methyl B12 for nerve pain should take between 1.5 and 6 milligrams daily. If they are using capsules, they need to take them twice a day to see the desired effects. The form of the vitamin taken (capsule, sublingually, or intravenously) does not matter to reap these benefits, although you and your doctor may need to experiment to find the amount that is right for you.

Supplements are not regulated by the U.S. Food and Drug Administration (FDA), so only buy and take supplements from a trusted source. You should consult a doctor about vitamin B12 supplementation especially if you have other chronic conditions, like Crohn’s disease, ulcerative colitis, kidney disease, or heart disease. In certain cases, supplementation may not be advised.

Does Vitamin B12 Interact With RA Medications?

Vitamin B12 is not known to interact with any medications taken specifically for RA. It can interact with metformin (Glucophage), most commonly taken for diabetes, or proton pump inhibitors that are taken for gastric issues.

Note that taking other forms of vitamin B, specifically folate or folic acid, may interact with methotrexate (Trexall). However, vitamin B12 has not been implicated in any of these studies or clinical trials.

Does Vitamin B12 Have Any Side Effects?

There are very few side effects from taking vitamin B12, especially when it is taken in normal doses. Some people who take it in high doses (which can be necessary to correct a serious deficiency in vitamin B12 levels) may experience gastrointestinal symptoms like nausea, vomiting, and diarrhea. There’s also a chance of experiencing headaches, increased tiredness, and tingling in your hands and feet.

Find Your Team

Are you or a loved one living with rheumatoid arthritis? Consider joining myRAteam today. Here, over 191,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Do you take vitamin B12 supplements to help with RA symptoms? Are you thinking about taking them and wondering if they are right for you? Share your story or thoughts in the comments below or by posting on myRAteam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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