B12 MIC Injections: Benefits, Side Effects and What to Expect

Key Takeaways

• B12 is part of how your body turns the food you eat into usable energy.
• In one trial, adults with low-normal B12 who added B12 shots to their usual care had better mood scores at three months.
• B12 helps keep your nerves and red blood cells healthy and working well.
• B12 + MIC pairs vitamin B12 with methionine, inositol and choline in one shot, which a licensed pharmacy prepares for you.
• You give it as a small shot under the skin once a week, after a starting phase your provider sets.

Low B12 is more common than you might expect. In national health survey data from 2007 to 2018, about 1 in 8 US adults had borderline-low B12 levels. B12 + MIC is a weekly shot built around that vitamin, prescribed by a licensed provider.

What B12 Does in Your Body

Your body needs B12 for healthy nerves and red blood cells, and for making DNA.

Energy That Keeps Pace

B12 is part of how your body turns the food you eat into usable energy.

A Steadier Mood

Adults with low-normal B12 who added B12 shots to their usual care had better mood scores after 3 months, in a randomized trial.

Why a Blood Test Helps

Your body stores roughly 1 to 5 mg of B12, so changes in your levels tend to show up gradually, over years rather than days. Because those changes are slow, a symptom list alone can't tell you where your B12 stands.

What's in B12 + MIC?

MIC stands for methionine, inositol and choline. B12 + MIC pairs vitamin B12 with those three in one weekly shot.

• Methionine: an amino acid, and the one your body uses to start building nearly every protein. B12 helps your body make methionine from homocysteine.
• Inositol: a form of sugar your body makes to give your cells structure, also found in foods such as meat, fruit, beans and grains. It's sometimes called vitamin B8, though it isn't really a vitamin.
• Choline: a nutrient your body needs to build cell membranes and make acetylcholine, a chemical messenger your brain and nervous system rely on. Your liver makes some, but not enough to cover what you need.

It's compounded, which means a licensed pharmacy prepares it for you, to the prescription your provider writes.

Two Forms of B12

Liv's blend comes in two versions, one made with methylcobalamin and one with cyanocobalamin, and each has its own ratio of ingredients. Your provider chooses the one that suits you, based on your health history.

Why a Shot Instead of a Pill

A shot places B12 under the skin, so it doesn't depend on your gut, which can only take in so much B12 at once. Your body absorbs about 2% of a 500 mcg B12 pill. For a 1,000 mcg dose, it's about 1.3%.

To absorb B12 by mouth, your body pairs it with a protein made in your stomach, called intrinsic factor. A shot skips that step, which helps when your stomach or gut doesn't absorb B12 well. Pills can still work for some people: MedlinePlus notes that some people can be treated with large B12 doses by mouth.

Start with an evaluation

Who Is More Likely to Run Low on B12?

Some people are more likely than others to have low B12:

• Older adults.
• People whose stomach doesn't make enough of the protein needed to absorb B12 (a condition called pernicious anemia).
• People with a stomach or gut condition, such as celiac disease or Crohn disease.
• People who've had stomach or intestinal surgery, including some weight-loss surgeries.
• People who follow a vegetarian or vegan diet, since B12 comes naturally from animal foods.

Your Plan, Step by Step

You start by telling us about yourself in an online health form: your health history and the medicines you take. A licensed provider reviews your answers and decides whether B12 + MIC is right for you.

If it is, your provider sets a starting phase. After that, it's one small shot under the skin each week, with instructions in your shipment. Before each refill, you let Liv know how you're doing and your provider reviews your progress. You'll also check in every three months.

Side Effects and What to Tell Your Provider

Most people feel nothing beyond a little redness or tenderness where the shot goes in. A mild headache or looser stools can happen and usually pass. Your provider will ask about:

• Your health: any liver or kidney condition, and whether you're pregnant or breastfeeding.
• Allergies: any allergy to vitamin B12 or cobalt.
• Other medicines: metformin and acid reducers can lower B12 over time.

Let your provider know if a side effect lasts or gets worse.

Ready to Talk It Through?

Bring your questions about energy, mood and the weekly routine. When you're ready, start with an evaluation. If you're wondering how soon you might notice a difference, our timing guide covers it.

Frequently Asked Questions