There are three primary ways you can take a vitamin B-12 supplement: orally, injected or sublingually. A sublingual supplement requires you to place a tablet or lozenge under your tongue and allow it to dissolve. The tissue under your tongue rapidly absorbs the vitamin B-12 into your bloodstream. As of this publication, there are no known safety issues associated with sublingual vitamin B-12.
B-12 Absorption
A 2003 research review in the "British Journal of Clinical Pharmacology" examined differences between oral vitamin B-12 supplements and sublingual supplements, finding almost no difference between the amount of vitamin B-12 you gain from either supplement. This is a significant indication that sublingual vitamin B-12 is entirely safe because it has been shown that large oral doses produce no side effects in humans. Vitamin B-12 is safe because your body decreases its ability to absorb the nutrient once there is a sufficient amount in your system.
Medication Interactions
The biggest concern you need to have when taking sublingual vitamin B-12 is interactions with other medications. The University of Maryland Medical Center advises that you speak to your doctor before taking vitamin B-12 if you currently take anticonvulsants, chemotherapy drugs, colchicine, bile acid sequestrants, H-2 blockers, metformin, proton-pump inhibitors or antibiotics. Vitamin B-12 may reduce the efficacy of some of these medications, or may not be well absorbed while you are taking these medications.
Pernicious Anemia
Pernicious anemia is a condition in which your body cannot produce a particular enzyme you need to absorb oral doses of vitamin B-12. This condition can cause significant side effects, so your doctor would typically treat it with injections of vitamin B-12 as a way to bypass your digestive system. There is no existing research about the efficacy or safety of sublingual vitamin B-12 to treat pernicious anemia. If you want to treat this condition with sublingual vitamin B-12 seek the advice of your doctor first. This administration route may require you to take a large volume of the supplement to have the same effect as injections.
Safe Intake
The recommended daily allowance for B-12 is only 2.4 mcg per day for adults, but patients have received doses up to 1,000 mcg orally and through injections without experiencing any side effects. The Food and Nutrition Board of the Institute of Medicine has not assigned a tolerable upper intake level for the nutrient as of August 2011. Though considered a safe drug, sublingual vitamin B-12 only should be used with your physician's approval.
References
- Linus Pauling Institute; Vitamin B-12; Jane Higdon, Ph.D.; March 2003
- University of Maryland Medical Center; Vitamin B-12; Steven D. Ehrlich, N.M.D.; June 2009
- Cox College; Vitamin B-12 Alternative Medicine; March 2010
- "British Journal of Clinical Pharmacology"; Replacement Therapy for Vitamin B12 Deficiency - Comparison Between the Sublingual and Oral Route; Amir Sharabi, et al.; December 2003
- New York University Langone Medical Center: Vitamin B12
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