Information from the Boston Nutritional Status Survey on supplement use of B12 by a free-living elderly population is given in Appendix F. For those taking supplements, the fiftieth percentile of supplemental B12 intake was 5.0 µg for men and 6.0 µg for women. Approximately 26 percent of all adults reported taking a B12-containing supplement in 1986 (Moss et al., 1989).
No adverse effects have been associated with excess B12 intake from food or supplements in healthy individuals. There is very weak evidence from animal studies suggesting that B12 intake enhances the carcinogenesis of certain chemicals (Day et al., 1950; Georgadze, 1960; Kalnev et al., 1977; Ostryanina, 1971). These findings are contradicted by evidence that increased B12 intake inhibits tumor induction in the human liver, colon, and esophagus (Rogers, 1975). Some studies suggest a possible association between high-dose, parenterally administered B12 (0.5 to 5 mg) and acne formation (Berlin et al., 1969; Dugois et al., 1969; Dupre et al., 1979; Puissant et al., 1967; Sherertz, 1991). However, the acne lesions were primarily associated with hydroxocobalamin rather than cyanocobalamin, the form used in the United States and Canada. Furthermore, iodine particles in commercial B12 preparations may have been responsible for the acne. In conclusion, the evidence from these data was considered not sufficient for deriving a Tolerable Upper Intake Level (UL).
Studies involving periodic parenteral administration of B12 (1 to 5 mg) to patients with pernicious anemia provide supportive evidence for the lack of adverse effects at high doses (Boddy and Adams, 1968; Mangiarotti et al., 1986; Martin et al., 1992). Periodic doses of 1 mg are used in standard clinical practice to treat patients with pernicious anemia. As indicated earlier, when high doses are given orally (see “Absorption”) only a small percentage of B12 can be absorbed from the gastrointestinal tract, which may explain the apparent low toxicity.