Count: 60 capsules

Dosage: One capsule daily, or more, as directed by a health care professional. If pregnant or lactating, please consult a physician.

Ingredient	Amount Per Serving	%DV
Folate [(6S)-5-methyltetrahydrofolic acid, glucosamine salt] Quatrefolic®	800 mcg	200%
Vitamin B-12 (as methylcobalamin)	500 mcg	8333%
Biotin	300 mcg	100%
Intrinsic Factor	20 mg	*
*Daily Value not established.

Other Ingredients: gelatin (capsule), rice flour, silica, maltodextrin.

Vitamin B12 is a water-soluble vitamin needed for normal nerve cell activity, DNA replication, and production of the mood-affecting substance SAMe (S-adenosyl-Lmethionine). Vitamin B12 acts with folic acid and vitamin B6 to control homocysteine levels.

Absorption of vitamin B12 is reduced with increasing age. Some research suggests that elderly people may benefit from 10 to 25 mcg per day of vitamin B12. One study of older adults with vitamin B12 deficiency suggested that as much as 500 to 1,000 mcg of vitamin B12 per day might be necessary to achieve optimal vitamin B12 status. Vitamin B12 status was measured in this study using a sensitive laboratory test (the plasma methylmalonic acid concentration).

Supplementation with B-12 Intrinsic Factor:

• Supports nervous system health
• Supports red blood cell production
• Supports energy
• Supports metabolism of fats and carbohydrates

There is no established upper limit for vitamin B12 because of its low potential for toxicity. Even at large doses, vitamin B12 is generally considered to be safe because the body does not store excess amounts.

Vitamin B12 has the potential to interact with certain medications:

Gastric acid inhibitors. Gastric acid inhibitors include proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), and histamine 2-receptor antagonists, such as cimetidine (Tagamet®) and ranitidine (Zantac®). These medicines can interfere with vitamin B12 absorption from food.

Metformin. Metformin, used as first-line treatment for prediabetes and diabetes, might reduce the absorption of vitamin B12 and significantly reduce serum vitamin B12 concentrations.

If you take any of these medications, you should speak to your health care provider about appropriate dosage of this supplement.

There is no established upper limit for biotin because there is no evidence in humans that biotin is toxic at high intakes.

Biotin can interact with certain medications, and some medications can have an adverse effect on biotin levels:

Anticonvulsants. The anticonvulsants including carbamazepine (Tegretol®, Carbatrol®, Epitol®, Equetro®), primidone (Mysoline®), phenytoin (Dilantin®, Phenytek®), and phenobarbital (Luminal®, Solfoton®) as well as combinations of these medications may reduce biotin status and absorption.

If you take any of these medications, you should speak to your health care provider about appropriate dosage of this supplement.

Source: NIH, Office of Dietary Supplements

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