Vitamin B12 (or cyanocobalamin) is an essential nutrient for neurological function. Its connection to cognitive health is gaining renewed attention – especially as more patients ask about memory, focus, and brain-support supplements. The vitamin is chemically classified as a “corrinoid,” which is a family of compounds that contain a cobalt-centered complex. For independent pharmacies like yours, it’s:
- Understand the evidence
- Identify the patients at risk
- Offer guidance to strengthen both clinical care and community trust
Why Your Brain Needs B12
Vitamin B12 is important for nerve health, red blood cell formation, and DNA synthesis. It maintains heart, brain, and skin health while also helping to regulate mood and energy metabolism. Low levels are associated with memory impairment and cognitive decline, especially in older adults. Vitamin B is marketed as brain boosters, but evidence shows supplementation is most beneficial for those who are deficient or at high risk of deficiency. People who have normal levels, additional B12 is unlikely to improve cognition.
Who is at Risk?
Your pharmacy frequently encounters patients who fall into high-risk categories for B12 deficiency, including:
- Adults over 60
- Patients who take metformin long term
- Those with Crohn’s or celiac disease
- Strict vegetarians or vegans
- Patients using proton pump inhibitors
Groups like these may benefit from screening, counseling, and targeted supplementation.
Deficiency of vitamin B12 can lead to an increased risk of macular degeneration, osteoporosis, and memory loss. Patients who are most likely at risk for vitamin B12 deficiency are older adults, people with Crohn or celiac disease, patients on long-term metformin, patients who use proton pump inhibitors, and strict vegetarians or vegans. These groups may benefit from screening, counseling, and targeted supplementation.
As a pharmacist, prepare to discuss the full range of B12 formulations with your patients. Prescription options include:
- Oral doses from 25-2000 mcg daily
- Intramuscular injections of 100-200 mcg monthly
- Intranasal formulations of 500 mcg weekly with oral and IM routes achieving similar normalization in many patients
Prescription options include:
- Oral doses from 25-2000 mcg daily
- Intramuscular injections of 100-200 mcg monthly
- Intranasal formulations of 500 mcg weekly
Oral and IM routes achieve similar normalization in many patients.
For OTC products, you can guide your patients toward reputable brands. Pharmacist-ranked options, such as Nature Made and Nature’s Bounty, remain top choices for their quality and consistency.
Be aware: Your patients are always looking out for memory and focus supplements, and vitamin B12 often appears on those lists. B12 can support cognitive function in deficient individuals. However, it’s not a universal solution. You can help your patients understand when supplementation is appropriate and when other factors (i.e. sleep, nutrition, and chronic conditions) may be more relevant. In fact, there’s evidence that suggests low levels of B12, vitamin D, or zinc may impair thinking. Thus, reinforcing the importance of individualized assessment.
A Member-Owned Company Serving Independent Pharmacies
PBA Health is dedicated to helping independent pharmacies reach their full potential on the buy-side of their business. Founded and run by pharmacists, PBA Health serves independent pharmacies with group purchasing services, wholesaler contract negotiations, proprietary purchasing tools, and more.
An HDA member, PBA Health operates its own NABP-accredited warehouse with more than 6,000 SKUs, including brands, generics, narcotics CII-CV, cold-storage products, and over-the-counter (OTC) products — offering the lowest prices in the secondary market.
