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Vitamin B12 is essential for our health, playing a central role in DNA synthesis, red blood cell formation, and brain function. Known as cobalamin, B12 supports energy production, making it a popular supplement in today’s fast-paced world. Many people rely on animal-based foods like meat, fish, and dairy for their B12 intake, while vegetarians and vegans may seek fortified cereals or plant-based supplements to meet their needs. Given its importance, it’s no surprise that B12 injections have become widely available in the wellness sector, often promoted as quick energy boosters. But is there a point where “too much of a good thing” turns into a bad thing?
In the UK, B12 injections are increasingly offered outside medical settings, sometimes administered by beauticians or wellness providers without medical qualifications. While many people believe that excess B12 simply gets “peed out,” the truth is more complex. The body stores B12 in the liver, so while deficiency can lead to fatigue, nerve damage, and cognitive decline, excessive intake can bring its own risks.
Research shows that excessive B12 may cause more harm than the energy boost it’s marketed for. Studies indicate that B12 overload can lead to skin issues like acne and rosacea, particularly when administered via injections. High levels of B12 can disrupt the skin’s delicate balance by altering the microbiome, often resulting in unwanted breakouts.
But skin concerns are just the beginning. One of the most critical risks of high B12 intake lies in its impact on homocysteine and folate balance. Typically, B12 acts as a cofactor for methionine synthase, an enzyme that converts homocysteine into methionine—a necessary amino acid for protein building. However, when B12 levels are excessive, this balance can be disrupted, leading to homocysteine buildup. Elevated homocysteine, a neurotoxic amino acid, is associated with increased risks of cardiovascular disease and neurodegenerative conditions, as it causes oxidative stress and inflammation that can damage central nervous system cells. Excess homocysteine may also generate free radicals, which harm neurons and impair DNA synthesis, which can raise the risk of neurodegenerative diseases.
High B12 intake can also reduce the bioavailability of active folate. When B12 levels are too high, the one-carbon cycle that B12 and folate participate in becomes overwhelmed, causing unmetabolised folate to accumulate in the bloodstream rather than converting to its active form, which is essential for DNA synthesis and repair. This folate imbalance is particularly concerning for pregnant women, as research shows that extremely high B12 and folate levels during pregnancy correlate with a 2.5-fold increase in the risk of Autism Spectrum Disorder (ASD) in offspring.
Researchers describe this as a “U-shaped” risk curve, where both too little and too much B12 can be harmful. Deficiency can cause nerve damage, anaemia, and cognitive decline, while excessive intake may disrupt nutrient levels, raising risks for conditions like autism and multiple sclerosis. Imagine this relationship as a balance scale, with optimal health at the centre; tipping too far in either direction—whether through deficiency or over-supplementation—can lead to negative outcomes. This U-shaped relationship highlights that with a nutrient as potent as B12, more isn’t necessarily better.
As B12 becomes increasingly accessible in aesthetic and wellness circles, it’s essential to approach supplementation with caution. A professional assessment is crucial to avoid potential harm, as the body’s B12 stores can last for years and more isn’t always better. Medical professionals can assess unique biochemical needs with blood tests and provide tailored recommendations that avoid the pitfalls of both deficiency and overload. With an informed, balanced approach, B12 can support metabolic and neurological health without tipping the scales into imbalance and risk.
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