Tier A

Vitamin B12 · Cobalamin (Cyanocobalamin · Methylcobalamin · Hydroxocobalamin · Adenosylcobalamin)

Also known as: Cobalamin · Cyanocobalamin · Methylcobalamin · Hydroxocobalamin

1 PMID anchor · BLOOD · NEURO · METABOLISM · Last reviewed 2026-06-04

Mechanism of action

  • Cofactor for methionine synthase (homocysteine → methionine remethylation)
  • Cofactor for methylmalonyl-CoA mutase (odd-chain fatty acid metabolism)
  • Supports myelin synthesis via methylation pathways

Molecular + tissue targets

  • Erythropoiesis (red blood cell formation)
  • Homocysteine metabolism
  • Myelin / peripheral nerve maintenance

Dosage range

RDA 2.4 μg/day (adults); high-dose oral replacement 1000 μg/day can be effective in food-cobalamin malabsorption, but is not always sufficient at 4 months follow-up (Favrat 2011 PMID 21232119 BMC Family Practice pragmatic RCT n = 50, 1000 μg/day x 4 weeks · MMA partially normalised vs placebo but markers not sustained at 4 months); higher doses (5000 μg/day) may be required for sustained correction

Safety notes

Very wide safety margin in healthy adults — no Tolerable Upper Intake Level established by NIH ODS; rare allergic reactions to cyanocobalamin reported; methylcobalamin or hydroxocobalamin alternatives available for cyanide-sensitive individuals

Cross-market regulatory status

🇺🇸 FDA

GRAS · DSHEA dietary supplement · multiple structure/function claims permitted; DV 6 μg (current label)

🇪🇺 EFSA

Authorized claims Reg 432/2012 cover red blood cell formation, energy metabolism, fatigue, nervous system, homocysteine metabolism, psychological function, immune system, cell division; NRV 2.5 μg

🇧🇷 ANVISA

RDC 243/2018 dietary supplement · IN 28/2018 Anexo V alegações funcionais verbatim: "A vitamina B12 auxilia na formação de células vermelhas do sangue." + additional energy / nervous system claims available when nutrient threshold met

Authorized claims · verbatim (5)

Direct quotes from each jurisdiction's framework · never paraphrased · with framework reference and conditions of use.

🇪🇺 EFSA · 4 claims

Reg 432/2012

Vitamin B12 contributes to normal red blood cell formation.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin B12" as referred to in the Annex to Reg 1924/2006

Authorized 2012

Reg 432/2012

Vitamin B12 contributes to the reduction of tiredness and fatigue.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin B12"

Authorized 2012

Reg 432/2012

Vitamin B12 contributes to normal energy-yielding metabolism.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin B12"

Authorized 2012

Reg 432/2012

Vitamin B12 contributes to normal functioning of the nervous system.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin B12"

Authorized 2012

🇧🇷 ANVISA · 1 claim

IN 28/2018 Anexo V alegação funcional

A vitamina B12 auxilia na formação de células vermelhas do sangue.

Conditions: IN 28/2018 Anexo V: alegação restrita a suplementos cujo aporte diário do nutriente atenda à quantidade mínima do Anexo II (2,4 μg para adultos)

Authorized 2018

Common use cases

  • plant-based diet adequacy (B12 is exclusively animal-source in nature)
  • food-cobalamin malabsorption in adults > 50
  • pernicious anaemia replacement (with clinician oversight)
  • fatigue reduction with confirmed deficiency
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