Vitamin B-12 Malabsorption Syndrome-An Often Misdiagnosed Medical Condition.

Food Groups That Are High In Vitamin B-12

Eating a variety of foods high in vitamin B-12 can in itself help prevent B-12 malabsorption syndrome. However if you have chronic alcoholism, or vitamin B-12 intrinsic factor-than eating all of the correct foods may not be enough to prevent it.
Eating a variety of foods high in vitamin B-12 can in itself help prevent B-12 malabsorption syndrome. However if you have chronic alcoholism, or vitamin B-12 intrinsic factor-than eating all of the correct foods may not be enough to prevent it. | Source

Your Fingernails Can Give You The Big Picture-As Far As Your Health Is Concerned

Your fingernails tell a great deal about your overall health and well being. For example if you have rigid and vertical lines as well as the absense, or lack of milky white half moons beneath your nail beds. This can indicate a B-12 deficiency
Your fingernails tell a great deal about your overall health and well being. For example if you have rigid and vertical lines as well as the absence, or lack of milky white half moons beneath your nail beds. This can indicate a B-12 deficiency | Source

Methylcobalamin-(Vitamin B-12)-In its More Active Form

Vitamin B-12 in the form of (Methylcobalamin), is usually used more efficiently by the bodies cells.The reason being is that instead of orally taking this form of B-12, you would place it under the tongue (sublingually) and let it dissolve slowly.
Vitamin B-12 in the form of (Methylcobalamin), is usually used more efficiently by the bodies cells.The reason being is that instead of orally taking this form of B-12, you would place it under the tongue (sublingually) and let it dissolve slowly. | Source

Before you reach for that anti-anxiety, or antidepressant medication your doctor may have recently prescribed. Why don't you first check with them to see if they had also recently ordered a CBC-(Complete Blood Count), which includes a comprehensive test that gives your total levels of serum B-12.


It would certainly be a smart move on your part, to have this completed first, before resorting to a prescription medication regimen that you may not even need for a variety of symptoms such as migraine headaches, chronic inflammatory conditions, and yes, as previously mentioned- those bouts of anxiety and depression.


Why should I be worrying about this in the first place, or even request a CBC from my physician, you may be asking yourself? Well one good reason that I can give you off the top of my head, is that many doctors today, are not readily, or even thoroughly trained in areas of nutrition and/or related vitamin deficiencies issues, often overlooked as a real vitamin deficiency disorder problem, just like that associated with vitamin B12 malabsorption syndrome.


And in addition to not being thoroughly trained in the area of nutrition for example, your healthcare practitioner also may be totally unaware, that vitamin deficiencies-mainly B-12 vitamin deficiencies can be more common then they had previously thought.


A vitamin B-12 deficiency could also be a direct cause of depression and mania, or even some form of a mood disorder as I previously touched upon. And it may be a common problem that you had been experiencing for many years now, but have not given it much thought as to what may be the real cause that is making you feel more than just chronically fatigued. In fact it may have never dawned on you, or your doctor for that matter, that you have a deficiency in Vitamin B-12.


The world and society that we live in today, more than ever before, is riddled with a conglomeration of unescapable stressors that cause our immune systems, to function at far less of an optimum level than we would like them to function at. That is why if we are not already taking a multivitamin supplement that contains at least 400mcg. of folic acid and an equal amount of vitamin B-12, than perhaps we should revisit the breakdown of the type and amount of vitamins we are really consuming on a daily basis.


Multivitamin and mineral supplements generally are not a substitute for those three well balanced meals that we should be eating regularly throughout any given day. Often it is important to eat a variety of foods that contain a high amount of vitamin B-12 as well as folic acid. Foods such as eggs, organ meats (ie.) liver, certain fish and cheeses for example, to name a few of many, are really essential in maintaining health and avoiding pernicious anemia, which can also be a direct result of a vitamin B-12 deficiency.


On the other hand you may be consuming just the right combinations of green leafy vegetables, eggs, whole milk and other dairy products and maybe even raw oysters-another delicacy that is very high in vitamin B12. And despite all of the correct things you are doing good and putting into your body, you still may find that when your Complete Blood Count is reviewed by your physician, that it is apparent to him/her that you still are plagued and have all the signs and symptoms of vitamin B-12 deficiency.


B vitamins alone including vitamin B9, better known as Folic Acid, as mentioned, are no doubt important to our overall health and well being. And in addition do help our bodies immune system combat the stressors once again, that life can weigh us down with.


However some people and even physicians, as I had spoke about earlier in the article, totally forget about vitamin B-12. Vitamin B-12 is one of the biggies of the B-vitamin family. A real powerhouse vitamin if you will. And a lack of it in your body that goes undetected over a long period of time can cause more harm than good. And if you think that the anxiety and depression you were previously suffering with was a big problem. Well let me inform you that those former issues will be nothing compared to what can result from a continued deficiency of vitamin B12.


Chronic inflammation, irreversible nerve pain, irritable bowel sydrome, constant migraines and autoimmune system problems (ie.) RA, or Rheumatoid Arthritis, are a few more problems that can be the direct cause of vitamin B-12 malabsorption syndrome. Should I go on, or have I convinced you that vitamin B-12 deficiency is nothing to take lightly and can make your life much less desirable than you would like it to be.


Vitamin B-12 deficiency is also known to cause its victims hands and feet to fall asleep and on a continual basis. In addition it is not uncommon to hear individuals who talk about chronic back pain, also talk about sciatica, or a pins and needles type feeling in their feet. Does this sound like you too? If so you may truly have a chronic back pain problem and also suffer from Sciatica which in turn, is also causing those pins and needles feeling.


But just to reiterate and place some additional light on the subject. Vitamin B-12 can be the real cause of that chronic back, or any other pain you have been suffering with over the years. So as you can see from my examples in the article so far, vitamn B-12 malabsorption syndrome, often referred to as vitamin B-12 deficiency, can be a real ugly foe to deal with. And if you thought that vitamin B-12 deficiency is not a real disease-think again! In fact it is classified as a real disease process under the ICD-9 handbook of identifiable diseases.


So far I have given you a good deal of information about Vitamin B-12 deficiency that you may have previously been unaware of. So If you thirst for more knowledge on the topic than I invite you to read on further, as you will learn there is much more to digest in terms of vitamin B-12 deficiency and how it can be prevented and treated.


The good news is that if you think you may indeed suffer from a B-12 maladbsorption issue- than there is definitely help on the horizon and a solution to your problem in the long run. So no one with vitamin B-12 deficiency has to suffer needlessly, just because his/her doctor has overlooked this as a possible cause of their prior symptoms.


A lot of different disease processes and illnesses including as previously mentioned, depression, can make you feel chronically fatigued. Having a long, stressful day at work can also rob you of the energy that you may have once possessed earlier in the day, when you had first risen from an otherwise restful sleep.


However when it comes to your health, you have to treat it like your wealth. Without your heath, you literally have nothing, no matter how well off you are, or in other words-no matter how much of one particular material possession that you may own. So when it comes to your health, you also have to be somewhat frugal, as you would when it comes to watching your pennies, or overall wealth. You also have to be your own MD at times, or personal investigator.


Doctors often do not always have the correct answer you are looking for, or have the answer you were wanting to hear. So because of this very reason, you have to do your own research and help your doctor by giving him/her suggestions in relevance to what may be ailing you. Whether it is a vitamin B-12 deficiency, or some other ailment causing you to feel much less than chipper.


In other words you literally have to give your doctor help with solving your mystery illness, or sickness. Spell it out to them in plain english-don't even think about giving them a hint or two. This may just be ignored, or go right over the top of their head. Simply stated, you cannot be too reserved when letting your personal physician know that you think you may possibl have a B-12 deficiency, that is causing your fatigue and you are going to be embarrassed because they may in be silently thinking that you are a little looney.


Nonsense! don't be thinking this at all, or else you will be the one who will suffer the consequences in the end. If there is something on your mind when it comes to your health, you have to speak up right away-do not be shy! It is not uncommon for your doctor to also tell you that your B-12 values upon completing a CBC, are within normal range and I've heard this from the horses mouth.


I would also like to point something else out in reference to the previous point I had just made about blood counts and normal ranges. At times blood counts performed in laboratories can come back with errors. And in addition to those errors, what is a normal blood count, when it comes to B-12 vitamin deficiencies, may be perfectly normal or vice versa in another country.


What I am referring to here, is that In Japan and China for example, a vitamin B-12 blood count that is 500 or below, is considered on the borderline and treatment with vitamin B-12 1000(mcg), Micrograms should be started, and given once a week, for three weeks simultaneously, then once a month therafter.


In the U.S. most physicians will not suggest vitamin B-12 shots be given to an individual patient unless their B-12 values fall to 200, or below. I know an individual whose doctor said that their B-12 level of 336 was still within the normal range. However their physician is basically following the guidelines that the U.S. has implemented for B-12 values and not what China, or Japan goes by.


So which country and its physicians has the right answers and standards that should be followed, and who is wrong when it comes to referencing vitamin B-12 deficiencies and preventing disease? Maybe neither are wrong and it all lies within the individual makeup of the person who is the targeted candidate with the B-12 deficiency.


But besides suggesting other probable, or possible causes for not feeling well and being abnormally lethargic. Possibly a person who has an undetected vitamin B-12 deficiency, is without a doubt experiencing other problems throughout their body; Including that constant dragging, tired feeling and depression I also spoke about earlier on in this article. These in turn could be beginning signs and symptoms of a blood cancer, or lupus. Something certainly to think about carefully isn't it?


Two significant factors that can help you identify a possible vitamin B-12 deficiency is by taking a close look at your fingernails. This may sound a bit ridiculous but actually it is a known fact that your fingernails tell a lot about your overall health. Someone who has a vitamin B-12 deficiency will have fine ridges running vertically through the fingernail. And if you gently run your fingernail across the fingernail with those fine lines, you will feel these ridges as well, if you cannot visually see them.


One other important sign that you may have a B-12 deficiency is also found by looking beneath your nail beds. Normally a healthy individual and one who does not have a B-12 deficiency problem, will have prominent half moons showing beneath their nail beds. A lack, or disapearance of these milky white half moons under the nail beds, can be the direct result once again, of a vitamin B-12 absorption problem.


But a complete blood count (CBC) will without doubt, confirm for sure if you have a vitamin B-12 malabsorption syndrome problem or not. This along with the lack, or disappearance of the half moons from beneath your nail beds are real strong indicators that you certainly could have some sort of a B-12 deficiency problem.


There is also another big problem that is sometimes overlooked in individuals who suffer from B12 deficiencies. This is called vitamin B-12 intrinsic factor. If you carefully study the diagram I have included at the end of the article, in a bit more detail, you will see that even though this process may appear complicated by viewing it within the diagram.


It nevertheless points out that if something within this cycle is just a little out of balance, than a good deal of things, such as vitamin B-12 deficiency can take place. And despite all of the correct things you do, in the way of taking the right vitamins and foods you consume. The result is you will not be able to absorp the vitamin B-12 from those foods, because you may still lack that very important intrinsic factor.


Basically the intrinsic factor is a group of complex proteins called glycoproteins that are secreted by specialized cells in your stomach given the fancy name of Parietal cells. In turn this process is necessary for the absorption of vitamin B-12. Hence if the intrinsic factor is absent, or if there is some other disease going on within the stomach wall such as cancer or a gastric ulcer, than that essential vitamin B-12 you need to prevent the deficiency will not occur.


Some common things you can also do to help remedy or reverse a vitamin B-12 malabsorption, or vitamin B-12 deficiency if you already have the problem, is to take the most active form of vitamin B-12. And this is called-(Methylcobalamin)-another long and fancy word. Just try to simply remember vitamin B12 and you will be okay.


Recently I was in a health food store with a friend and I asked him to repeat Methylcobalamin back to me three times and do so quickly. I asked this just out of curiosity to see how he could locate the product on the shelf, by asking a clerk. He told me that he would rather say the word aluminum three times quickly instead. Because after locating the store clerk and asking where the Methylcobalamin was, he managed to do nothing more than confuse the poor store clerk, who had no idea what he was mumbling about.


The best Methylcobalamin, or vitamin B-12 to take is the liquid form. The reason for this is because it is usually placed beneath the tongue (sublingually) and is more readily absorbed by the bodies cells in this form. However there is also a tablet form of active Methylcobalamin, which is also placed beneath the tongue. And it dissolves rather almost as quickly because of body temperature.


I personally do not recommend any one brand over the other, but I have heard good things about the methylcobalamin made by the company Wonder. Just think of Wonder bread and when you are in the health food store next time, and you will have a much easier time of picking it out on the shelf. Just do not try to say the word Methylcobalamin!


I find that Methylcobalamin 3000 to 5000 mcg. taken three times per week sublingually, is a good starting amount, especially for someone who has less than normal values of vitamin B-12 as part of overall their serum blood levels. However always consult your physician at all times before taking vitamin B-12, whether it be in the tablet form, or a liquid form in the bottle. Your physican is always the best judge, for the most part, when it comes to suggesting what vitamin and mineral supplements to take.


There is always the slightest chance that a prescription medication that your doctor has previously prescribed, could interfere, or cause a reaction with (OTC) vitamins like Vitamin B-12. So a good rule of thumb to remember, is always ask first before you start taking B-12, or any other herb or supplements on your own for that matter.


One other noteworthy piece of information to mention while on the subject of vitamin B-12 deficiency and the concommitant use of prescription drugs. And that is-prescription medications can also be a direct cause for a deficiency of this vitamin. To add, smoking and drinking are a few other causes of a deficiency of vitamin B-12 which in turn, can lead to a vitamin B-12 deficiency within the cells of the body.


So if you are at times a little too fond of the bubbly-whether it be beer, wine or liquor. And in addition may also be a habitual smoker. Than giving up these two habits alone, will not only help to improve your overall health, but also possibly prevent a vitamin B-12 deficiency problem as well. Remember being frugal with your health, just like that of your wealth, can help you achieve a better standard of living, and a much better quality of life! The best of health to you.



The Process Of Vitamin B12 Absorption And The Related Intrinsic Factor

It may certainly appear to many that this illustration of what the vitamin B-12 absorption process looks like, may seem like something right out of an anatomy and physiology class. But in reality it gives a real working picture of what can go wrong.
It may certainly appear to many that this illustration of what the vitamin B-12 absorption process looks like, may seem like something right out of an anatomy and physiology class. But in reality it gives a real working picture of what can go wrong. | Source

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Comments 18 comments

vikkijov profile image

vikkijov 4 years ago from Mystic, CT

Very informative and interesting! Thank you


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Hello Vikki:

Thank you for stopping in and providing feedback on my article. And I am glad you found the information within, interesting and useful in some way. Take care.

Jl


Francesca27 profile image

Francesca27 4 years ago from Hub Page

I think that this is one of the best hubs I ever read! Great job!


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Hi Francesca:

I wouldn't say it is one of the very best hubs that you will ever read. However I do appreciate the very kind comment, as well as the insightful remarks. I always try to extend myself and do my best when it comes to writing useful as well as interesting information. Particularly when it comes to medical and health related content. When I recently went back into proofread this article, I was surprised how many basic grammatical errors I had made. It's always nice to have an editor, or second pair of fresh eyes, to go back in to proof read info.like this for you. Anyway even thogh I have made corrections, I know someone else may out a few more errors between the lines. Again I appreciate you stopping in and providing you feedback. Take care.

Jl


Francesca27 profile image

Francesca27 4 years ago from Hub Page

Jlbowden: Remember, none of us are perfect. I try to go over my hubs and find many words or sentences that need revision. It's true, your hub was one of the best I've seen and I'm glad that I found you and you hubs. I'll take a look at some of your other hubs soon. Keep up the great work!


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Francesa:

I really appreciate the encouragement and do try to always remember that none of us are perfect, including myself. I will certainly keep that in mind while I create similar hubs to inform and educate my readers in the future.

If I had a choice to write on a full-time basis-believe me I would love to do that more than anything else in the world. But unfortunatetly for now, my regular job does not allow for that to happen at this moment in time.

I am currently working on a similar article like this one and will make sure all sleep is rubbed clear from my eyes, before the finishing touches are put on it. Thanks again for all the added inspiration and I will stop by to read some of your work as well.

Jlbowden


Moon Daisy profile image

Moon Daisy 4 years ago from London

Great hub, and great information, thanks! Doctors have suspected b12 deficiency as the cause of some strange symptoms I've been having, but the blood test came out fine. Not sure how accurate the test is (or what their normal ranges are), but hopefully it's correct.

After reading your hub though, I looked at how much b12 was in my regular multivitamin, and it says 2 micrograms!! (which it says is 100% of the rda). That's not much is it? At least compared to the recommendations in your article. Is this the amount you should have if your b12 is fine? I know that recommendations are different in each country (I liked the Japan/China example), but it's confusing isn't it?

How much b12 should a normal person be having each day, I wonder?


Glenn Stok profile image

Glenn Stok 4 years ago from Long Island, NY

I take B12 tablets randomly, not every day. But sometimes I feel tired all day, so I'm going to try taking B12 each day now. May be that will help. Your Hub convinced me. Next time I have a checkup I'll ask my doctor to include a complete blood count and check the vitamins.


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Glenn:

Maybe your job is making you stressed out a bit (: . Or simply you may just be working too hard some days. At times job related stress for example, can be the contributing factor, without having a real B12 deficiency at all. But it is becoming more common for people, especially women, to have a deficiency of this important vitamin. And it is also good to be aware of how you feel overall. You alone are the best judge of how your body is feeling. And if something just doesn't feel right for a few days to a week. Then it may be time to visit the doc. Also many other things can make one feel tired all of the time, beside stress and low hemoglobin or B-12 values example. But like you mentioned getting a CBC, that includes a Key vitamin breakdown within your blood, isn't such a bad idea. Some people who as they age, tend to need to receive shots intramuscularly, as I mentioned in the article. Thank you for providing your feedback in reference to this article, and hope you did find it beneficial in some way.

Jim


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Hello Moon Daisy:

Previously I must have overlooked your comment and I apologize for that. Thank you for stopping in and providing your comments as well, in reference to my B-12 article. I am glad you found it useful and interesting in some way or another. Check with your doctor about raising your individual levels of vitamin B-12. What is okay for one person, may not be good for another. And like I mentioned you can eat all of the right combinations of food high in vitamin B-12, but once again because of certain problems...intrinsic value for example. Can in turn cause you not to properly absorb this important vitamin. I personally know people who take up to 10,000 mcg. three times a week and they say they still feel tired at times. Again this could be from a variety of problems and other disease states, as I mentioned to Glenn in my previous comment to him. Depending on your age-If you're in the mid-sixties or so, you may need to beging receiving a monthly shot of B-12 intramuscularly which will be better absorbed by your body. Again I know a great deal about medical and health issues, but do not have an MD after my name. And I also cannot stress enough how important it is, as mentioned in the article- to always check with your doctor to make sure it's okay to take a certain vitamin, even if you think they have the right answer or not. Take care and be well!

Jim


RTalloni profile image

RTalloni 4 years ago from the short journey

Thanks much for this information on B 12 deficiency. It is helpful on several levels!


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Hello RTalloni:

I am glad you enjoyed the read and useful content that I provided about B12 deficiency. Appreciate the comments and hope you also found the info. interesting to boot! I have also been working on a similar, but more intense version of vitamin D3 deficiency. I should be finished with it today. So I will eventually submit, so others can also benefit from the info. contained within that vitamin D deficiency article. And of course what to look for in prevention of a lack of vitamin D. Take care.

Jl


GmaGoldie profile image

GmaGoldie 4 years ago from Madison, Wisconsin

I was fortunate, I had a brilliant physician who diagnosed my B12 deficiency early. Very informative - you provided very valuable research - thank you!

I never had the test to determine IF what I ate caused it or my genetics but even IF it was my nutrition, I figured the cause was not needed to know, the must know was to cure and live with it as best as I could.


Jlbowden profile image

Jlbowden 4 years ago from Long Island, New York Author

Hello Gina:

I am glad you had found my B12 article useful and appreciate the feedback. It helps to have the right physician and you were quite lucky that it was diagnosed correctly the first time. Because as you know by reading the article it could have led to other disorders and/or disease states. Research and in turn educating oneself about common medical problems like B12 deficiency in turn is the key. And it certainly can also prevent a lot of unnecessary problems in the future. Thanks again for chiming in and be well!

Jlbowden


MsDora profile image

MsDora 3 years ago from The Caribbean

This article is very insightful. To think that we have been trusting doctors with our health and they can't advise us on what to eat. Thanks for showing us the importance of the CBC and Vitamin B12. Voted Up!


Jlbowden profile image

Jlbowden 3 years ago from Long Island, New York Author

MsDora:

Thank you very much for stopping by and providing your feedback on my B12 Article - It's unfortunate for many patients who visit Doctors, about this common problem isn't it? Basically, I don't know why more Doctors haven't been trained properly in medical school, on the Vitamin B12 malabsorption syndrome.

While as you already know, a great deal of these issues can be related to what we eat, and how much of the proper foods, with B12, we are getting in our diets. On the other hand, all a lot of them can say, if your B12 levels come back, below the standard levels.

Is to pick up some Vitamin B12 liquid drops, or the sublingual type pill form, and place it under your tongue once a day, for a month or so. And hopefully your B12 levels will reach a norm once again.

However this is not exactly the case, if you have intrinsic factor for example and cannot absorb this vitamin, even through eating the proper foods, such as liver, which a lot of folks, including myself cannot stomach, let alone chew a mouthful or two. LoL.

It's really not as complicated as some really think it is, and that includes the Doctors themselves. Anyway, thanks and glad once again - hope you benefited from this information. And glad you stopped by to check out this article.

Jl


Glenn Stok profile image

Glenn Stok 9 months ago from Long Island, NY

I actually read, and commented in, this hub of yours about three years ago. But it is most worthwhile reading all over again. Funny thing is, I've been feeling tired lately. So I started taking B12 daily, and I noticed an improvement.

As for doctors doing a complete blood count, not many of them pay attention to that. Once when I had my annual physical, I asked for a copy of my blood report. I noticed that my vitamin D was low.

I asked my doctor about that since he never mentioned it. He acted like it was nothing to be concerned about. I asked if it might be due to not getting enough sunlight. He just replied with "possibly."

Then I asked if I should take more vitamin D as a supplement. His answer - "it can't hurt."

My conclusion was that he just didn't care to consider this an important part of the overall analysis of one's health. It's hard to find a doctor who includes this in his or her approach to health issues. As you had talked about in your hub, many health issues can be a result of an imbalance of blood chemistry. And I realize that taking a medication can end up causing other problems. Many doctors focus on expensive medications that are also toxic, rather than considering getting the vitamins in the blood back into balance.


Jlbowden profile image

Jlbowden 9 months ago from Long Island, New York Author

Hi Glenn - first off thanks for keeping me engaged by keeping, or getting me to stay somewhat active in the HubPages community. Greatly appreciate that!

Anyway I think of it as a way to keep me interactive so I will not Lapse on my activity again. And by others like yourself reading over my articles like this one again. It's a great way for me to respond back in reference to your comments.

Anyway it's a great way to keep active and I know the best way to stay active is really through participating in the forums like you and many others here to. But enough on that topic now and thank you for reviewing this article about B-12 malabsorption. I don't claim to know as much as a physician, or do I have an MD, or DO after my name.

But I can tell you that my extensive training in pharmaceuticals and medical devices has given me the knowledge along the way. To be fortunate enough to know what many physician's know.

And you should already know through experience that Doctors are not going to give up secrets learned in medical school to their patients. Otherwise they wouldn't have many patients!

In my opinion your physician is not thorough enough when examine you, or she or he just has too much of a patient load during any given week. And is behind on his next patient waiting in the exam room waiting to be seen. The later to me is no ones fault but the Doctor, or possibly their office manager.

A simple blood test will tell you if you are lacking in B12, or Vitamin D3. As we age our bodies do not readily absorb these essential vitamins as they once did when we were in our thirties or even forties for example.

Again the Docs today are all on a time clock and also have not been adequately trained on nutrition and related topics. So in turn they will push you along and just yes you to death. So literally you are better off educating yourself on these topics.

This is why I like to educate and share my knowledge of medicine. Mainly because I enjoy helping others and seeing people who are suffering with an illness - makes me feel a lot better when benefit from articles like this that I share with them.

3000 mg of vitamin D OTC taken every day with a meal along with 1000 Micrograms of Sublingual B12 - (under the tongue) would not be overkill for you. And lack of sunlight is not the only reason for a depletion of D3, but it is one of them! Again enjoyed giving you this additional feedback and thank you for reading over this article again.

Best of health to you!

Jim

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