The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

Recommended dietary amounts (RDAs) are 2.4 micrograms daily for ages 14 years and older, 2.6 micrograms daily for pregnant females, and 2.8 micrograms daily for breastfeeding females. Those over 50 years of age should meet the RDA by eating foods reinforced with B12 or by taking a vitamin B12 supplement. Supplementation of 25-100 micrograms daily has been used to maintain vitamin B12 levels in older people. A doctor and a pharmacist should be consulted for use in other indications.

For canker sores, sublingual (under the tongue) vitamin B12 has been given daily for six months.

For claudication, a total daily dose of 1.5 milligrams of vitamin B12 was taken by mouth in divided doses of 0.5 miligrams three times daily for six months.

For vitamin B12 deficiency, 125-2,000 micrograms of cyanocobalamin has been taken by mouth daily for up to 2.5 years or longer. Five hundred micrograms of sublingual (under the tongue) vitamin B12 has been used daily for up to four weeks. The following doses have been given intravenously (through the veins): 1,000 micrograms of intramuscular cobalamin once daily for 10 days (after 10 days, the dose was changed to once weekly for four weeks, followed by once monthly for life); 1,000 micrograms of intramuscular cyanocobalamin given on days 1, 3, 7, 10, 14, 21, 30, 60, and 90 of treatment. For vitamin B12 deficiency caused by long-term PPI therapy, cyanocobalamin nasal spray has been used for eight weeks. The exact dosage is unclear. One study tested intranasal vitamin B12 replacement therapy (500 micrograms weekly).

For prevention of anemia, the following doses have been taken by mouth: 2-10 micrograms of vitamin B12 daily combined with iron and/or folic acid for up to 16 weeks; 100 micrograms of vitamin B12 every other week plus daily folic acid and/or iron for up to 12 weeks.

For mental performance, the following doses have been taken by mouth: 0.05-1 milligram vitamin B12 taken daily for four weeks to 5.4 years; 10 micrograms or 50 micrograms of cyanocobalamin daily for one month; and one milligram of cyanocobalamin weekly for four weeks. One 1,000 microgram vitamin B12 injection has been used daily for five days, followed by one 1,000 microgram injection monthly for five months. Additionally, 1000 microgram injections have been used weekly for four weeks or monthly for six months.

For cyanide poisoning, an intravenous (IV) infusion of five grams of hydroxocobalamin (up to 20 grams) has been used.

For depression, one milligram of cyanocobalamin, through intramuscular injections, was used weekly for four weeks.

For hereditary sideroblastic anemia, 100 micrograms of intramuscular vitamin B12 has been used monthly, with or without daily folic acid, for up to four months.

Children (under 18 years old)

Recommended dietary amounts (RDAs) are lacking for all age groups; therefore, adequate intake (AI) levels have been used instead. The RDAs and AI levels of vitamin B12 are as follows: for infants 0-6 months old, 0.4 micrograms (AI); for infants 7-12 months old, 0.5 micrograms (AI); for children 1-3 years old, 0.9 micrograms; for children 4-8 years old, 1.2 micrograms; and for children 9-13 years old, 1.8 micrograms.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration