B12 shots are often unnecessary, but Canadians still spend millions on them


Vitamin B12 shots are touted by certain celebrities as energy boosters and offered by some spas — but are they really necessary?

For much of the population, no.

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According to the latest government data, 96 per cent of Canadians have sufficient vitamin B12 levels based on Health Canada’s recommendations. Stats show that adults aged 40 to 79 only have slightly lower B12 levels.

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But according to other research, vitamin B12 deficiency affects about a fifth of older adults and often goes unrecognized.

“Approximately 20 per cent of Canadian seniors are B12 deficient,” said Dr. William Silverstein, the co-author of a new Ontario study on seniors and B12 injections.

Older adults are more prone to B12 deficiency because as we age, our ability to absorb the vitamin can decrease.

Still, many older adults are being treated for a B12 deficiency they likely do not have.

Overprescribing B12 shots

Silverstein’s recent study found that nearly two-thirds of Ontario seniors who received vitamin B12 shots had no evidence of a B12 deficiency. The study, published in medical journal JAMA, looked at more than 140,000 people aged 65 and older who were prescribed injections between 2011 and 2015.

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Researchers found that 64 per cent of seniors who got the vitamin shot actually tested normal for B12 levels or were not tested for the vitamin deficiency at all.

The overprescribing of B12 shots is costing Ontario’s health-care system, Silverstein says.

“We calculated that this practice could be costing nearly $46 million to the system, and so this low-value care may be taking away from other health-care priorities in the province,” he told Global News.

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Silverstein said he and his team were unable to determine the cause of the overprescribing but suspect patient demands could be a contributing factor.

“There have also been studies that have shown that only 25 per cent of Canadian physicians are aware of the evidence base surrounding B12 supplementation and so, perhaps, that is contributing as well, but generally, we are unable to say definitively,” he said.

According to Erin MacGregor, a registered dietitian at How to Eat, B12 shots are not only costly, they’re time-consuming. What’s more, MacGregor says that if someone is really low on B12, over-the-counter oral supplements are often sufficient and more affordable.

Previous research found that converting patients to B12 pills from injections could result in millions of dollars in savings.

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Silverstein echoes this stance and says the only time people need injections is if they have malabsorption and B12 pills don’t work for them.

Vitamin B12 deficiencies

Our bodies need B12 to make red blood cells, nerves and DNA and to carry out other functions, Harvard Health says. B12 can’t be made by the body and must be gotten from food or supplements, the university adds.

B12 is found in animal-based foods like fish, meat, poultry and dairy. This means that if you are on a vegan or vegetarian diet, you may be at greater risk for a B12 deficiency, Silverstein said. There are certain health conditions that can result in a B12 deficiency, too.

HealthLink BC points out that B12 is normally absorbed by your digestive system, meaning your stomach and intestines.

“Vitamin B12 deficiency anemia usually happens when the digestive system is not able to absorb the vitamin,” the government site says.

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“Patients become B12 deficient when they… take certain medications or have certain conditions that affect its absorption, including Crohn’s, colitis and pernicious anemia,” Silverstein said.

Symptoms of B12 deficiency include fatigue, weakness, constipation, loss of appetite and weight loss, according to the U.S. National Institutes of Health. For seniors, symptoms can include anemia, memory difficulties and trouble with walking, Silverstein said.

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Stephanie Hnatiuk, a Winnipeg-based registered dietitian, says that if someone is concerned about their B12 level, they should get blood work done. She does not advise getting any vitamin or mineral injection without consulting a doctor first.

“Most Canadians do not need to take vitamin B12 injections,” Hnatiuk said.

“The only people who need vitamin B12 injections are those who are unable to maintain normal vitamin B12 levels from food or oral supplements.”


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