How To Use Vitamin B12 For More Energy When You Are Hypothyroid

B12 for energy

Many hypothyroidism and Hashimoto’s patients have a hard time to restore their health and energy levels even when they are taking thyroid medication. The truth is that most patients also have other imbalances that come together with thyroid problems and can affect their energy.

If you feel constantly tired it may be the result of a vitamin B12 deficiency that is so common in thyroid patients.

B12 and fatigueHypothyroid and low B12 symptoms overlap. Consider vitamin B12 deficiency when fatigue, memory issues, weakness, lethargy, depression, numbness and tingling persist even if you are on an adequate thyroid hormone therapy replacement.

When your B12 levels are low it means that your organs are not getting enough oxygen due to a lack of red blood cell production and this is causing extreme fatigue.

Here are 5 facts about vitamin B12 deficiency thyroid patients need to know if they want to overcome low energy and start feeling better.

5 Important Facts About Vitamin B12 Deficiency In Hypothyroid Patients

1.B12 deficiency is one of the most common causes of fatigue and about 40% of people with hypothyroidism are, in fact vitamin B12 deficient.

2. Clinical signs of vitamin B12 deficiency can take a long time to appear. However, it doesn’t mean that there are no consequences. Even suboptimal levels of B12 can cause fatigue, weaker immune system and lower your metabolism.

3. Vitamin B12 levels in low-normal range are associated with clinical signs and symptoms. Anemia may not be present and tend to occur later in B12 deficiency.

Even in patients with clinical pernicious anemia, up to 28% do not have anemia and up to 33% have normal red blood cell volume yet neurological signs of deficiency may occur in patients who do not show anemia.

4. Vitamin B12 levels are not routinely tested by most physicians. Checking your vitamin B12 levels should be done at the time of hypothyroidism diagnosis irrespective of thyroid antibodies status and periodically thereafter.

If you are having a hard time to get your B12 tested by your doctor you can order a B12 test yourself without health insurance or a doctor’s referral and get your test results interpreted by a functional medicine practitioner at this holistic lab (currently at over 80% off).

5. It is very important to start treatment within 6 months of when symptoms begin to appear because a long-term vitamin B12 deficiency can cause permanent nerve damage.

Studies show that in people with hypothyroidism B12 treatment improves symptoms within 3 to 6 months. The key is to choose the B12 form that your body can use because not all forms of B12 are equal.

How Much Vitamin B12 Do You Need

B12 tiredWhen it comes to vitamin B12 the boundary between healthy levels and disease is not clearly defined in conventional medicine.

Vitamin B12 levels between 200 to 900 pg/mL or 135-650 pmol/L are considered to be normal lab values. Values of less than normal are a possible sign of a vitamin B12 deficiency and people are likely to have or develop symptoms.

However, this normal reference range is too wide and set too low. As a result it may not reflect the true B12 status in all population groups.

For example, older people with vitamin B12 levels between 200 and 500 pg/mL may still have symptoms such as memory decline, dementia and weakness.

Pregnant women, vegetarians, people with some health conditions such as Crohn’s disease, IBS, H. Pylori infection, hypothyroidism and Hashimoto’s thyroiditis are at a significantly higher risk for B12 deficiency than healthy people.

However, most doctors will only treat for B12 deficiency if your B12 levels are below 150 pmol/L. Yet, recent research suggests adequate levels of B12 should be much higher.

One research study found out:

“If the total vitamin B12 concentration is in the lower reference range, 156 to 400 pmol/L, vitamin B12 deficiency cannot be ruled out. Clinical signs of vitamin B12 deficiency can be seen in persons with vitamin B12 concentrations within the reference range (>156 pmol/L) and metabolically manifest (functional) vitamin B12 deficiency.”

Another research study suggests:

“We believe that the traditional cut-off value of 148 pmol/L is too low. We suggest that physicians should consider treating patients who show symptoms but have vitamin B12 levels above this value, particularly those in the low-normal range up to approximately 300 pmol/L [or 405 pg/ml], to see whether their symptoms are relieved.”

Some experts don’t rely on the normal B12 reference range alone but also use other markers and recommend B12 treatment for patients with normal B12 who have elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin.

Other countries such as Japan and Europe have increased the lower limit for B12 to 500-550 pg/mL or 365-405 pmol/L because it is associated with improvements in behavioral and psychological symptoms including dementia, Alzheimer’s disease, cognitive decline and memory loss.

How To Increase Your Energy With Vitamin B12

In a person who had vitamin B12 deficiency for some time getting B12 from the diet alone is not enough and a long-term B12 supplementation is necessary to normalize their metabolism.

B12 absorptionWhile people with pernicious anemia and those who had surgical procedures done on their intestines do better with injections, others who cannot absorb B12 due to digestive issues may not need to go this route.

Vitamin B12 supplementation can be effectively used for both treatment or prevention depending on whether a person is at risk or is already affected.

According to a study that compared the efficiency of B12 replacement with injections and pills:

“The need for B12 injections is questionable for patients with low stomach acid and for those with a marginal or low serum B12 level but no signs or symptoms of deficiency.”

While some people with hypothyroidism and Hashimoto’s have low B12 levels due to pernicious anemia the majority have indeed a malabsorption of B12 caused by digestive issues:

• Low stomach acid

• Disorders that affect the gastrointestinal pH

H. Pylori

• Indigestion

• Autoimmune gastritis

Leaky gut syndrome

• Drugs (metformin, ibuprofen, antacids, contraceptive pills)

• Inadequate intake of vitamin B12 with a diet

Celiac disease

Supplementing with B12 can protect people at risk from symptoms of deficiency. Since malabsorption is a common and important factor in people with thyroid disorders, the key is to choose the right form of B12 supplement that ensures the best absorption possible.

Liposomal B12 is a highly specialized formula that delivers the highest quality B12 directly to your cells and ensures a greater absorption than other supplements. This Liposomal B12 from Purathrive is up to 20 times more absorbable.

Try This Morning Drink (Instead Of Coffee) To Kick Start Your Day

Watch this video and learn how to make an easy and effective morning energy drink using Purathrive’s liposomal vitamin B12 supplement drops. This recipe is demonstrated by Thomas DeLauer who is a celebrity trainer and Purathrive Advisory Board Member and Organic Foods Expert.

Using this liposomal vitamin B12 drops as an ingredient promotes energy production in multiple ways. It supports the adrenal glands, red blood cell formation and helps convert carbohydrates to glucose which is the fuel your body uses for energy.

For best results try this as a morning drink to start your day with more energy, a better mood, clear head and fuel your body with electrolytes to keep you hydrated.

B12 without injectionsP.S. But take note: Vitamin B12 is water-soluble. This means that you’re continually excreting it from your body through urine, sweating and detoxification pathways.

In order to reap its full benefits and ensure that you are getting enough, you need to take B12 everyday.

I am not a big proponent of taking supplements, however when it comes to vitamin B12 be sure to make PuraTHRIVE Liposomal B12 a part of your daily regimen because you are running a risk of just not getting enough from your diet alone when you have hypothyroidism and autoimmune Hashimoto’s disease.


1.Vitamin B12 deficiency common in primary hypothyroidism. J Park Med Assoc. 2008 May;58(5):258-61.

2. Vitamin B12 deficiency: underdiagnosed, overtreated? Hosp Pract 1995 Jul 15;30(7):47-52; discussion 52, 54.

3. Do we need to reconsider the desirable blood level of vitamin B12? J Intern Med. 2012 Feb;271(2):179-82.

4. Causes and Early Diagnosis of Vitamin B12 Deficiency. Dtsch Arztebl Int. 2008 Oct; 105(40): 680–685.

About Marina Gutner, PhD

Marina Gutner, PhD, researcher, medical writer, thyroid blogger, founder and Admin of Outsmart Disease who writes about life-changing treatments for hypothyroidism, Hashimoto's thyroiditis and autoimmune disease and how to balance hormones in women