Vitamin B12 is an essential nutrient, but one that is eventually depleted if dietary sources are inadequate or absorption mechanisms are compromised. B12 deficiency is especially common in the elderly, Alzheimer’s disease patients, vegetarians, and as the result of a variety of malabsorption syndromes, including those caused by the use of acid-blocking medications. Symptoms of deficiency include anemia, fatigue, nerve damage, cognitive dysfunction, and mood changes. Oral B12 therapy is as effective as injections as long as sufficient amounts are taken. Karuna’s B-12 Liquid is a high-potency formulation using methylcobalamin, preferred by many over cyanocobalamin.

• Vitamin B12 absorption decreases with age due to reduced production of hydrochloric acid, digestive enzymes, and/or intrinsic factor, and as a consequence of infection with Helicobacter pylori (Annu Rev Nutr 1999;19:357-77; J Am Diet Assoc 1999;99:725-727).
• Use of acid-blocking medications can impair B12 absorption and cause a deficiency (Int J Vitam Nutr Res 1999;69:169-172).
• Most cases of B12 deficiency, even pernicious anemia, can be managed with megadoses of oral vitamin B12 ( Ann Pharmacother 2002;36:1268-72).
• Vitamin B12 deficiency may cause fatigue, neurological dysfunction, impaired cognition, and mood disturbances, even when anemia is not present (Am J Psychiatry 2000; 157:715-21; N Engl J Med 1988;318: 1720-8).
• Vitamin B12 supplementation supports healthy levels of homocysteine (Lancet 2002;359:227-228).

Supplement Facts Serving Size - 1 Dropper Full ( 0.7 ml / 707 mg) Servings per container 84
Amount per serving:		%DV
Vitamin B12 (methylcobalamin)	1041 mcg	17,350%
† Daily Value (DV) not established

Other ingredients: USP purified water, alcohol 25%, vegetable glycerin, natural strawberry flavor, natural vanilla flavor, citric acid.

Suggested use for adults:

• One-half to one dropper daily (approximately 521-1041 mcg), preferably with a meal, or as directed. Hold the solution under the tongue for a few moments before swallowing.