Vitamin B12

With Dr Ilham AZGHARI

By Jasmin

Disclaimer: Dr Ilham Azghari is in no way sponsored nor sponsoring any products, has no financial interest, nor does she promotes any specific diet. Dr. Ilham Azghari shares her professional honest scientific opinion based on her studies, experience and ethics as a medical professional.

I am Dr Ilham Azghari, specialist in hepato-gastroenterology and medical nutrition, I practice my profession in my specialized clinic in Rabat (Hay Riad), I was trained at the Faculties of Medicine of Rabat and Amiens with an additional diploma in medical nutrition given my passion and interest in the subject and the close link with gastroenterology.

Dr Ilham Azghari,Hépato-gastroentérologue, Cabinet de gastroentérologie, nutrition médicale et proctologie Angle Av Annakhil et rue Arrayhane, rés. Les Palmiers2, N 4, Hay Riad, Rabat. Tel: 0537564064 Email:

  1. What is Vitamin B12, what is it for and why is it so important ?
  2. Absorption and storage
  3. Recommended daily allowance of vitamin B12
  4. Vitamin B12 on a vegan diet
  5. Methylcobalamin or cobalamin? What is the difference ?
  6. Deficiency, symptoms and treatment
  7. Where does it come from? Natural source of vitamin B12, Do animal produce vitamin B12?
  8. References
  9. B12 supplements recommandations
how to choose vitamin B12 ? And where to find them ?

Welcome back Dr Ilham and congratulation on the release of your first book ! I can’t wait to read it. What is it about and Is it available in stores yet ?

Dr Ilham Azghari: Thank you, it relates the journey we go through as medical interns. The book is entitled “L’Internat”and soon will be available all around Morocco and internationally as well.

Wonderful. Let’s dive straight into the interview, which is about vitamin B12. What is Vitamin B12 and what is it for ?

Dr Ilham Azghari: Vitamin B12, also known as cobalamin, is one of eight B vitamins. It’s an essential vitamin for the body because vitamin B12 is involved in the synthesis of essential elements such as DNA, and therefore, intervenes in main functions of the body such as the production of blood cells, epithelial cells and the development of the nervous system as well.

Why is it so important?

Dr Ilham Azghari: Aside the key roles it plays in the body, vitamin B12 is essential, which means it cannot be substituted by other molecules to ensure its metabolic functions.   

What is the recommanded daily allowance of vitamin B12 ?

Dr Ilham Azghari: The recommended daily allowance range from 2 to 6 micrograms per day depending on health authorities.

Methylcobalamin or cobalamin? What is the difference ?

Dr Ilham Azghari: There are different molecular forms of vitamin B12 cobalamin and methylcobalamin is two of them. It is a form adapted to certain metabolic events and functions.

Where and how our body absorbs vitamin b12 ?

Dr Ilham Azghari: Vitamin B12 is absorbed at a part of the gut called the distal ileum which is the final section of the small intestine. However, it is only absorbed once bound to another molecule called intrinsic factor which is a protein synthesized by our body at the stomach. Therefore, the proper functioning of these 2 sites is essential for the absorption of vitamin B12.

Does our body store vitamin B12? If so, where is it stored and how? How long does it take for vitamin B12 stores to deplete ?

Dr Ilham Azghari: Indeed, our body does store Vitamin B12 in organs such as the liver, pancreas and brain. The storage is build gradually off our intake of vitamin b12, as our daily needs are very little. It allows our body to meet our needs of vitamin B12 for years in case of insufficient intakes.

Is it possible to meet your vitamin B12 allowance if you are on a vegetarian and vegan diet? How?

Dr Ilham Azghari: The only way to ensure the recommended intake of vitamin B12 under a strict vegan diet is to consume foods enriched with vitamin B12 or to resort to systematic supplementation. Regarding vegetarian diets that include foods of animal origin other than meat, this can be ensured by dairy products and eggs.

Is vitamin B12 deficiency possible? What are the symptoms and the health issues it may cause? And how to treat it ? 

Dr Ilham Azghari: Vitamin B12 deficiency is possible and even common. The symptoms are very variable since this vitamin has several functions. It can be anemia or insufficient production of blood lines, neurological symptoms, it can also affect the skin and mucous membranes. You must first pinpoint the cause of the deficiency, because an intake deficit is not always the reason, but can also be a lack of absorption, then supplement based on the cause obviously.

Have you encountered vitamin B12 deficient patients in your Rabat based medical office practice ? What is the most common cause ?

Dr Ilham Azghari: Yes, they’re most frequently caused by an autoimmune disease called Biermer’s disease (formerly known as pernicious anaemia). This disease is responsible for the malabsorption of vitamin B12.

Where is vitamin B12 found naturally?

Dr Ilham Azghari: Vitamin B12 natural sources are foods of animal origin (meat and fish, offal, eggs, milk, etc.)

Do animals synthesize vitamin B12? where does their vitamin B12 ratio come from then?

Dr Ilham Azghari: As I answered in some of the questions it’s the bacteria that make the vitamin, but for now and as far as i know these bacteria are only present in animal bodies; and they complete this action through living in their organism, so I can’t unfortunately testify of something else. 

According to my research, vitamin B12 is only synthesised by microorganisms: certain bacteria (and archaeons). These bacteria were naturally found in soil . When farm animals graze on grass, they swallow the soil particles (stuck to the roots) containing these bacteria that produce vitamin B12, which is then absorbed by their body and then stored in the muscles. The same for us humans, we drank from streams and rivers and ate unwashed vegetables plants, and thus we naturally consumed our daily dose of vitamin B12.

But for sanitary reasons and the use of chemicals to treat the soil, the natural sources of vitamin B12 have disappeared.

Currently, farm animals are systematically supplemented with vitamin B12, the same one sold in food tablets at the health stores and pharmacies, which is produced industrially by fermentation generally using genetically modified bacteria. So as a vegan; my source of vitamin B12 is the same as cows, chickens and my fellows omnivores.

Ultimately, the only source of vitamin B12 these days is the one made in labs or factories. Whether you go straight to the supplements as a vitamin B12 source, or eat an animal flesh to get it is a personal choice to make.

But know that arguments such as ” if the vegan diet is the most natural for human beings, why is the source of vitamin B12 are animals? ” or ” if we need artificial supplementation, the vegan diet is not enough nor suitable for humans” are no longer valid now that you know that animals are not the natural source of vitamin B12.

Dr Ilham as usual it has been a pleasure. Thank you for your time and see you soon for our next interview.


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