Lisa,
Eating more soy would be the easiest way: tofu, tempeh, soy meats. And other legumes. We list them at the top of this page under Protein.

Merete,

> does the overall ratio of amino acids matter?

No, it doesn’t.

Ann,

The supplemental amounts in the rows of this chart were devised to provide approximately the same amounts of absorbed B12.

> I also read that high B12 supplementation can cause acne because skin bacteria stop producing B12 and start producing more porphyrins. If that’s true, I wonder how it can be distinguished from cobalt sensitivity.

That appears to be true (according to this study) but it probably applies mostly to people receiving injections. Someone who receives a vitamin B12 injection of 1,000 µg will effectively “absorb” all 1,000 µg while someone taking a 1,000 µg oral supplement will only absorb about 1%. Only 1 out of 10 healthy subjects receiving an injection developed signs of acne.

I’ve been reading a lot about folate and folic acid the past few days and found out something that had slipped past my attention previously—that food folate can’t mask a B12 deficiency, only supplemental folic acid, 5-MTHF-glucosamine, and L-5-MTHF-Ca can mask B12 deficiency. It’s kind of the key point of the methylfolate trap, and I’m a little embarrassed to say that I never realized it. I’ve updated the section of the site about folic acid masking B12 deficiency.

Thanks. The kidney question is regarding someone else, good to know that the risk doesn’t seem so much.

I wonder if 3x 3mcg per day is similar to 1x 100mcg, in terms of what is absorbed. If a lower supplement amount can have the same impact and possibly less chance of skin imbalances, maybe that’s preferable.

I also read that high B12 supplementation can cause acne because skin bacteria stop producing B12 and start producing more porphyrins. If that’s true, I wonder how it can be distinguished from cobalt sensitivity.

Ann,

> Also it wasn’t being taken for a while as my child stopped liking it and we tried a few brands before finding another one, which is now 3mcg per tablet, 3 times a day (as the packet says 2-3 per day, but I’m separating the times).

That’s plenty of B12 for a child or an adult.

Folate can’t mask the neurological problems caused by B12 deficiency; it can only mask the red blood cell symptoms.

Your doctor’s advice sounds reasonable.

> Also, I read that sublingual B12 isn’t necessarily better than normal tablets, and intrinsic factor does most of the absorption. Do you know if that recommendation has changed?

No, you don’t need sublingual.

The amount of cyanide is physiologically insignificant and the precautions for people with kidney disease are just to be extra careful, not because of any cases of definite kidney damage. But there’s methylcobalamin instead of cyanocobalamin; I’d recommend talking to your doctor about it.

How about someone who has previously had congenital kidney issues but has had that corrected, or else, someone with risk factors but no diagnosis? Would they need to be wary about possibly not clearing the cyanide?

Also, I read that sublingual B12 isn’t necessarily better than normal tablets, and intrinsic factor does most of the absorption. Do you know if that recommendation has changed?