22/02/2026
Get that B-12 before it’s too late
William Wallace, Ph.D.
Product Development, Scientific Affairs, and Regulatory Compliance Dietary Supplements, Ingredients and Health Education Ph.D.
A recent study published in Annals of Neurology (PMID: 39927551) reveals that low levels of active Vitamin B12 (holotranscobalamin) are linked to reduced white matter integrity and poorer cognitive performance, while total B12 levels may not accurately reflect brain health.
Vitamin B12 is crucial for maintaining nerve function, brain health, and DNA synthesis. It exists in two forms:
- Active B12 (Holotranscobalamin): The bioavailable form directly utilized by cells.
- Inactive B12 (Haptocorrin-bound): Circulates in the bloodstream but is not available for cellular functions.
Traditional blood tests measure total B12, which includes both active and inactive forms, potentially masking deficiencies that could impact cognitive function.
Findings:
- Participants with low active B12 showed significant white matter breakdown and impaired cognitive function compared to those with adequate levels.
- The study demonstrates the importance of measuring active B12 for accurate brain health assessment.
This study highlights the need for a paradigm shift in Vitamin B12 testing and supplementation, emphasizing active B12 as a critical biomarker for brain health and cognitive function.
In the United States, Vitamin B12 deficiency is defined as a blood level below 148 pmol/L. The American Society for Nutrition criticized this approach, highlighting that over 5% of patients with symptoms of B12 deficiency and who respond to B12 supplementation have blood levels above this threshold. Studies suggest that B-vitamin supplementation benefits individuals with clinical signs of deficiency, regardless of their measured blood levels.