Low vitamin B12 (cobalamin) levels are associated with an increased risk of lower bone mineral density (BMD), osteoporosis, and fractures.
Multiple observational studies support this link. The Framingham Osteoporosis Study (involving over 2,500 adults) found that people with plasma B12 below about 148 pmol/L had significantly lower BMD—men especially at the hip, women at the spine
This is one reason a vegan diet is not conducive to good bone health, as it lacks B12.
Vitamin B12 is needed for DNA synthesis and cell proliferation, including in osteoblasts (bone-forming cells). Deficiency can impair new bone formation.
Low B12 often raises homocysteine levels; elevated homocysteine is linked to increased bone resorption, weaker collagen cross-linking, and higher fracture risk.
Animal and metabolic research points to additional pathways, such as reduced hepatic taurine production and effects on growth hormone/IGF-1 signaling that support osteoblast function.
Vitamin B12 (cobalamin) is found almost exclusively in animal-based foods. Adults generally need about 2.4 micrograms (mcg) per day. Plant foods do not naturally contain it (unless fortified). 1 Fortified foods are best avoided.
Highest Sources (Animal Products)
These provide far more than the daily need in a typical serving:
- Clams — About 84 mcg per 3 oz (85 g) cooked (over 3,500% DV). One of the richest sources. 2
- Organ meats (especially liver) — Beef or lamb liver: roughly 60–70+ mcg per 3 oz cooked (often 2,500–3,000%+ DV). Chicken or other livers are also high. 3
- Other shellfish — Oysters (~15–25 mcg per 3 oz), mussels (~20 mcg per 3 oz). 4
- Fatty fish and seafood — Salmon, tuna, sardines, mackerel, herring, trout, and some crab or octopus varieties. Examples: salmon often provides ~2.5–6+ mcg per 3 oz serving; sardines and mackerel are particularly concentrated. 5
- Red meat — Beef (and similar): around 1.5–2.5+ mcg per 3 oz, depending on the cut. 6
Good Everyday Sources
- Eggs — About 0.5 mcg per large egg (mostly in the yolk). 6
- Dairy — Milk (must be raw, only, and best if also organic, pasture-raised) (~0.9–1.3 mcg per cup), yogurt (~0.7–1+ mcg per serving), cheese (e.g., Swiss or mozzarella can provide useful amounts). 7
- Poultry — Smaller amounts (e.g., chicken breast ~0.3 mcg per 3 oz); turkey is somewhat higher in some forms.
Most people should be able to get adequate amounts of vitamin B12 from their diet/food. However, some may want or need to supplement. When choosing a good B12 supplement, it is important to find one that is NOT synthetic (Cyanocobalamin). Appropriate forms are Methylcobalamin, Adenosylcobalamin, and Hydroxocobalamin. The product shown in the photo above has all 3 of these. It is also sublingual and is absorbed better than non-sublingual forms. I have listed the above in Vitamin & Mineral Supplements Part 1 – Vitamins as well.
An important note on supplementing B12. It interacts with Vitamins C, B1, Iron, and Copper – and turns vitamin B12 into useless analogs. 8 This is one reason to avoid B complex supplements. But be sure to take any B12 supplements away (2 hours) from vitamin C, iron, and copper supplements as well.
Remember: Healthy Bones Are Happy Bones!
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