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Adrienne Dellwo

Vitamin B for Fibromyalgia & Chronic Fatigue Syndrome

By October 28, 2010

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My 3 Favorite Supplements Series: Sublingual Vitamin B (Blog Classic, Jan. 18, 2009)

A lot of us with fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS) take supplements to manage our symptoms - some in addition to medication and some in place of them. It all depends on what works for you, and what works is different for all of us.

One of the supplements that's most consistently recommended by doctors, researchers and patients is vitamin B, and especially vitamin B12. B vitamins are essential for energy production, and a few studies show the majority of us are low in B12. Some experts on these illnesses recommend at least 50 mg daily of most B vitamins, and 500 micrograms of B12. Several treatment protocols use B12 injections.

Many doctors consider B12 injections archaic and unscientific, but many FMS and ME/CFS doctors and researchers say they make a big difference in how their patients feel. The problem with injections, though, is that you have to go to the doctor regularly to get them, and the time and expense can be too much for some of us -- if, that is, we can get a doctor to prescribe them.

A happy medium between tablet-form vitamin B and injections is a sublingual supplement. Sublingual means "under the tongue," and sublingual supplements can either be dissolving tablets or liquid. They're quicker and easier for your body to absorb, which means you get more of a benefit from them, and you get it faster.

I switched from a B-complex pill to a liquid sublingual formula about a year ago, and for me it has made a big difference. I get a noticeable energy boost within an hour of taking it, and I've even considered putting it next to my alarm clock so I can take it first thing in the morning (I decided not to, though, because I'm sure I would forget it!)

What's your experience with B vitamins? Have you tried injections, or a sublingual form? Leave your comments below!

Learn more or join the conversation!


Photo Medioimages/Photodisc/Getty Images

January 23, 2009 at 3:33 pm
(1) Terry says:

I take B12 shots. But I give them myself. So this has greatly cut down on the cost of them. Plus my insurance gladly pay 100% of the cost of the rx. I think its really simple to give yourself a shot. I know that it helps me also.

January 23, 2009 at 3:38 pm
(2) Joanne says:

I have found a HUGE difference in my energy level since I started taking liquid B12. I take it after breakfast and after lunch, and also feel an energy surge within an hour of taking it. Excellent supplement!

January 23, 2009 at 3:47 pm
(3) Judi says:

B12 injections have been way more effective than the sublingual was.

January 23, 2009 at 4:45 pm
(4) Mischa says:

Vitamin B12 yes, but with B1, B6 and Acidum foliculum.

January 23, 2009 at 6:25 pm
(5) Dena says:

I’ve been taking B complex for quite some time to help with my symptoms. I have never heard of the sublingual stuff but I have to say I am definitely going to check it out. Where can you get it? Is it at the drug store or do you have to go to ‘Good Earth’-type stores?

September 27, 2011 at 2:46 pm
(6) Babs says:

You can get it at GNC, Walmart, Puritans Pride.com

January 23, 2009 at 6:43 pm
(7) Adrienne - Your Guide to FMS/CFS says:

It’s pretty widely available – I found it in a big box store, so I’m sure anyplace that has a large supplement section will have it.

January 23, 2009 at 8:51 pm
(8) hello says:

B12 shots made my hair fall out and very dry. I realized that after the shot for 2 days clumps of hair would come out and then happen again with the next shot. Taking too much B12 by mouth/vitamin also raised my blood levels too high. I recommend getting your blood tested to see if you are low before taking more than 100% of the RDA for B 12. Some supplements have 1000% to 3000% more than the RDA. If you are just taking a multivitamin with 100% of the RDA, that amount should be fine, but I would be careful to check your blood to see if you are low if you are taking huge amounts since mine went very high. Then check it periodically after that. It is a simple blood test your doctor can order.

May 2, 2011 at 3:20 pm
(9) Mary says:

Hello… I just received my first injection of vit B-12 and also noticed my hair falling out in large amounts, am wondering if this is also from the injections that I got?! I think I will pass up this months injection to see if it was the B-12 injection….thanks for letting me know this information.

January 24, 2009 at 2:27 am
(10) Gretchen says:

My primary care dr., though generally sympathetic & helpful with my fibro, tested me for Vitamin B levels and said I am not lacking, and would not prescribe Vit. B12 injections. However, in an article I read, it said that the level shown on a blood test and the actual amt. of B12 a person uses are two different things, and you cannot learn this from simple bloodwork. After reading your article, I am inclined to go back in and “demand” that he give me the injections!! (I personally would prefer that to the sublingual method.) Thank you …

June 29, 2009 at 5:20 am
(11) Robyn says:

At least in most states, injectible B-complex is sold at most of the larger farm & ranch stores. I’ve used it (both as an IM injectible and orally, mixed with juice, grapefruit flavored soda, etc.) for close to 2 years. I’ve had nothing but positive results from it. It’s only about $6 a bottle. I still get flares; but, they don’t steam roller me nearly as badly as they did before I found this stuff; and, they don’t last nearly as long. I’m sleeping better; and, my average pain level has dropped to about 2/3rds of what it used to be. When I run out, things do seem to “go back to normal” pretty quickly; so, it’s just a management tool, rather than “a cure;” but, hey, after fighting it out with 2 squashed lumbar disks, FMS, and CMP since ’92, I’ll take what I can get… I have an aversion to letting doctors dope me up (actually, I don’t get along well with most doctors on other levels, too); and, NSAIDs only do so much. Finding this stuff has been a real God-send – FOR ME. Your results may vary. If you try this, start with just a cc or two; and, slowly find the dose that works the best for you. I’ve found that 3 to 4 cc’s works well for me; but, I’m sure that will vary according to body weight, metabolism, and the brand you buy. B-complex is “water soluable;” so, unless you “go hog wild” with it, your body will use what you need and you’ll pee out any excess.

I have NO medical training – my comments are based strictly on my own personal experiences. Use your own discretion.

July 9, 2009 at 3:38 pm
(12) Misty Dawn says:

I’ve been diagnosed as being B12 deficient. I’ve received two B12 shots so far. Yet, I’ve seen no improvement in my amount of fatigue/energy. In fact, I’m so exhausted I can hardly stand it.

Oh, I was diagnosed with Fibro back around 1999

July 28, 2009 at 8:20 pm
(13) tom says:

Sublinqual Vitamin B12 is the easy way to avoid vitamin B12 deficiency and get the B12 vitamins and other B Vitamins your body requires for so many bodily functions. You can listen to the radio interview with Dr. Libby at http://www.lpvitamins.com/vitamin_b12.htm Sublingual is as effective as B12 shots, but there’s no needle or pain.

August 27, 2009 at 3:27 pm
(14) Cherry Carver says:

My doctor prescribed B-12 injections because I was chronically exhausted. I could drink a pot of coffee and go right back to sleep. I was too tired to actually get the shots because I slept all day. So my husband went to a health food store and got me “Sublingual B Total.” Not to sound like an ad here, but after the first dose I was wired. I’m not sleepy and I have a ton of energy. What a revelation. Your experience may vary but it’s cheap, easy to take and I can say goodbye to caffeine. Bottom line: It’s worth a try.

December 15, 2009 at 9:28 am
(15) Kathy says:

I take B12 injections, really inexpensive and I feel better the first few days. I take them every week, two weeks or once a month depending on how I’m feeling. Seems to make a difference.

January 22, 2010 at 6:02 pm
(16) Sheri says:

Is the injectable b-complex that is sold for animals like cows, sheep and swine etc… safe for humans to inject if it is a brand new bottle and has never been used on an animal?

October 7, 2011 at 12:57 am
(17) Ali Murdoch says:

I’d check that out carefully…they could be in quite different forms and dosages. (animals’ bodies may require different forms of b12 to humans and so they may be synthesised into quite a different chemical…just as there are several different forms for humans). Also, the quality is not likely to be as good?

February 1, 2010 at 6:01 pm
(18) Adrienne Dellwo says:


I’d be very careful with that — check with your doctor, pharmacist, possibly even vet to make sure before using it. I’d guess that the biggest concern would be the correct dosage for your weight, but I know nothing about animal supplements and how they may be different from human ones.

October 28, 2010 at 7:11 am
(19) Angela says:

I’m on B12 injections and Vitamin D suppliments as I was deficient in both but am not getting any improvement from them after the first two months. Just started seeing a fantastic Rheumy today as I have mulbiple diagnosis’s and we’re starting on 12grams of fish oil as an alternative to anti-inflammatories as I’m unable to take any anti-inflams now. He’s found huge success in these high doses of fish oil so I am very hopeful that I too will get good results with the pain and in turn an increase in energy levels when the pain is back under control. Mine is a very complicated case though as I’m not able to tolerqte almost all medications.

October 28, 2010 at 9:42 am
(20) Brett says:

Interesting… As with the commenter Angela, I also was deficient (borderline) in B-12 (despite the fact that since my fatigue, I crave and eat plenty of meat and dairy for warmth and nutrients) and this year hugely low in vitamin D.

As many others here, I found liquid B12 helps me a great deal.

I started seeing a very proactive gastroenterologist doctor and a nutritionist, and they have pointed me to having a strong wheat gluten (and some other) allergies which are likely causing some intestinal inflammation which is preventing absorption of the likes of D and also Omega-3 DHA which also explains why I find such dramatic concentration improvements with it (and also my heartburn, not helped out by weight gain, not helped out by a lack of ability to do much exercise, not helped out by the brain fog which prevents me from getting moving on the exercise which I can do).

Besides the XMRV news, this news which offers a very rationale explanation for my added problems of concentration, gives me some actual hope after 15 years. Although obviously this will not clear up the very real fatigue, I really believe now dealing with this ought to help improve some important surrounding conditions.

In any case, when I actually get out of a brain fog to remember to take the meds, supplementing with DHA and B12 has had dramatic effects on concentration–but as these can also exacerbate heartburn, I’m particularly interested to see if a gluten-free diet will improve both naturally.

October 28, 2010 at 9:54 am
(21) Jay says:

I have taken multivitamins since my fatigue started three years ago. Recently while reviewing a CFS treatment protocol I finally noticed the alternative methods of taking B12. My research indicated that age and other digestive problems could block absorption of B12 from food and vitamin supplements.

I found a sublingual B6/Folic Acid/B12 at Trader Joe’s for around eight dollars and thought it was an inexpensive experiment. On the second day my brain fog was significantly reduced and my energy level increased significantly.

October 29, 2010 at 3:42 pm
(22) Shelley says:

Oh, THANK you, Adrienne, for reminding me!
I forgot to take MINE today! I’ve been using
Sub-Lingual B-Complex for YEARS, and I can
definitely tell when I’ve missed a day!
For those of you who want to purchase it, I
just get mine at the grocery store, near the
Pharmacy or Vitamin Aisle. It’s kind of hard
to find (it’s usually
in a very small box), so be sure to ask the
Pharmacist or Grocery Staff where it is! It’s a
Thanks again, Adrienne! As usual, you ALWAYS
have the BEST ideas!

October 29, 2010 at 6:32 pm
(23) Miranda Sterling says:

Instead of injecting, one can mix b vitamins and other things with DMSO, and rub it directly on the skin. You need to be careful with this, since whatever the DMSO touches will go straight into you as surely as an injection would, so you need 99.9% pure DMSO, and very clean hands and skin.

I’ve had fairly good results with putting a lot of b12, niacin and folic acid, and a multi-vitamin into a mortar and pestle, crushing it all up, and putting it into a dropper bottle filled with DMSO. A dropper of this on my skin every couple of days helps a lot.

On the same website where I read this, the theory was offered that CFS/Fibro is a viral infection, possibly some nasty herpes cousin. The author advised *FIRST* to quiet the virus down by taking about 1500 grams of lysine once or twice a day, and then when the symptoms begin to abate, you can add the energy production things like the subdermal B.

If you do the energy production stuff first, what will happen is that you feel better for a little while, but then the virus multiplies to eat up the new energy, and then you relapse.

So, what I’ve been doing (with some success, though not perfect) is to take 3 tablets of lysine twice a day, along with three of garlic and of ginger–both antiviral things. It does seem to help, but I’m not quite at “healthy” yet. But better!

August 26, 2011 at 7:28 am
(24) Jerri Ann says:

Miranda…could I ask what website you were reading about the above. I have fibro flare up and pretty bad right now. the narcotics just aren’t working. trying to find alternatives. your help would be appreciated. thank you and have a great day.

October 30, 2010 at 12:58 pm
(25) linda says:

when first meeting with my D.O., he had just returned from an international symposium on fibro. After the week, 5 protocols were established that proved helpful for most fm people:
B12—4 weekly injections than liquid
Evening primrose
vit. C
lipoic acid
haven’t noticed a surge in energy after taking B12, but the cocktail has produced positive results

November 9, 2010 at 7:10 am
(26) Amelia says:

I have not actively used a B vitamin supplement as a treatmetn for my fibromyalgia, but, i have always used ot to “help” when i feel tired or I know that i have long days ahead. It odes make a big difference with energy levels and this I noticed long before i was diagnosed with fibro.

MAy i also say that this resource has been so helpful. Where i am from, doctors do not pay much attentio or regard for fibromyalgia, and without this resource i would has been very ignorant and quite frustrated. THanks you so much!!

November 16, 2010 at 2:55 pm
(27) phylor says:

I’ve had B12 injections in the past due to low B12 levels. The usual supplements either weren’t absorbed or processed correctly by my digestive system.
Now I take gummy B12 vitamins (some other gummy types of supplements as well). Of course, that also means I’m taking in sugar, etc., but my last blood test showed good B12 numbers. Since I have absorption issues, often regualr supplements didn’t break down in my digestive system. Gummies have been the answer for me, though not for everyone due to cost, delivery method (ie. sugar, and other ingredients).
I actually now remember to take my vitamins, too, because it’s more of a treat than before.

February 25, 2011 at 5:54 pm
(28) Brit says:

Does anyone know how vit B12/B complex/B6 would interfere with fertility and conception?

February 26, 2011 at 5:45 am
(29) calyson says:

People who are health conscious can enjoy B12 benefits by using them as a food supplement and can maintain their health for long time. These supplements can be taken from the foods, pills or in the form of injections. Vitamin B12 along with other family members of B vitamins can helps to ensure the vital life of the human body. It is very good for healthy and active nervous system and is the best for the growth of DNA cells. It helps to form new red blood cells in the body. Another benefit is to maintain and retain the energy level of the body

April 14, 2011 at 11:48 am
(30) Jade says:

B12 patches are popular these days but can be too expensive for many people. But they are quite convenient and quite efficient in delivering the B12 dose. But Sublingual Vitamin B12 is the method that is gaining in popularity, as more people realize how convenient and cost-effective it is. It gets straight into your bloodstream and inexpensive. Sublingual vitamin B12 has many benefits such as faster absorption, instant effect, and great for insomnia.

August 20, 2011 at 11:23 am
(31) Linda says:

Two important things I don’t see mentioned in your article or any of the comments.

Anyone taking a single B vitamin should also be taking a B complex. Because the B vitamins work together, this will avoid depletion of any of the others.

B-12 commonly comes in two forms, cyanocobalamin, the stable and less expensive form, and the active form, methylcobalamin. The second is much better absorbed and utilized.

October 7, 2011 at 1:24 am
(32) Ali says:

Yay Linda, glad you mentioned this.

The type of b12 is very important. Most people with fibro (and other illnesses) do not have a well functioning methylation cycle, and so cannot convert b12 well. Most supplements come in cyanocobalamin which is synthetic and difficult for the body to convert into useable forms. It also drops a cyanide molecule when it’s converted and so then the body requires more antioxidants to deal with the cyanide. This can be counterproductive for people trying to combat a lack of antioxidants or fatigue. It shouldn’t be used by anyone with kidney problems. If you’re taking sublingual cyanocobalim and not getting good results, then it might be worth switching.
Methylcobalamin is the main type required by the body and so many people get better results with that form as it doesn’t have to be converted. It will help kickstart the methylation cycle (along with folate and b6).
There is also hydroxycobalamin which is made from bacteria and many people get good results with that. Injections are often made with hydroxycobalamin.
There’s also another form called adenosylcobalamin that b12 has to be converted into for some functions in the body but that is rarely seen in supplements.

It’s really important to be getting b12 in sublingual or injected form because people with fibro and other illnesses generally have disrupted digestion and won’t be making enough intrinsic factor required to absorb the b12 from food or swallowed suppliments.

November 21, 2011 at 7:40 pm
(33) Sharon Anne says:

I tend to suffer pins and needles throughout when I am B12 deficient. Since I learned how to give myself shots for Methotrexate for my Rheumatoid Arthritis (in my thigh muscle) giving myself B12 shots isn’t at all difficult. Yes the size of the needle can give you pause, but simply locate a less sensitive spot and go for it. Sure beats the pins and needles and fatigue.

January 30, 2012 at 11:18 pm
(34) Heather says:

I was told I had fibro then my doctor decided to check my b12 levels and found them to be extremely low. I had to go in weekly for shots for a month then once monthly. After the first month I felt a lot better. Then after the first year I started losing the weight I had gained when I first “got sick”. My doctor told me I will have to take monthly shots for the rest of my life because I have pernicious anemia. She wrote me a script for the shots so I could give them to myself. The pharmacy helped me find a needle size that works for me, I spend less than $5 for a years worth of shots. I don’t know if fibro and the b12 anemia are related, but I do know that the shots help my fibro symptoms more than I could have ever hoped.

February 10, 2012 at 10:51 am
(35) mary Lally says:

I’ve suffered for 15 years from fibromyalgia without much relief from various treatments. Recently I started taking 1000ug Vitamin B12 daily with folic acid in the hope of preventing alzheimers (which affected my mother) and am delighted to report that my fibromalgia pain and fatigue have gone away. I walk 2-3 miles daily now and can do normal activities afterwards. So, checking to see if there is a connection, I’ve googled fibromyalgia and Vit B12 and find myself here sharing the good news.

April 28, 2012 at 10:48 am
(36) Renee says:

Like Heather, I have pernicious anemia and have taken my first three weekly injections to get back to a normal level. I was told fibro is directly related to my PA, as muscle and bone pain are both symptoms. I’m trying to be optimistic that the fibro will improve after I get my levels of B12 back up sufficiently. Mine were drastically low, so my doc said it will take several months to get to a good place – been undiagnosed for a lot of years.

For what it’s worth, I found relief from fibro by eliminating dairy from my diet (I was already vegetarian), but now with the PA diagnosis, I’m going back to lacto-ovo vegetarian. I crave too much dairy because my body wants the B12, even though PA is an auto-immune disease where my stomach can’t absorb B12. Just putting it here in case other fibro suffers may benefit from reducing their dairy intake.

September 4, 2012 at 7:59 pm
(37) Kerry says:

I started taking the b12 sublingual about 2 months ago, I also cut gluten and dairy out of my diet, I have noticed an enormous change in my energy level as well as I sleep a good 7 hours a night now. I was diagnosed with FB about 3 1/2 years ago and have been in horrific pain and had the worst insomnia! I was taking melatonin nightly just to try to stay a sleep, it helped but it was building up in my body and a was exhausted all day, so I stopped using that and started taking the b12 sublingual!! I haven’t slept this good in years!!!! And I never imagined I could have this much energy again!!! I had to spend most my summers locked in the house in the AC cause the heat caused me so much pain, I have 2 young boys and I was feeling awful as a mother!!! I can finally keep up with them! And enjoy the summers with them:)

September 16, 2012 at 12:39 pm
(38) Karen says:

I have tried sublingual B12 after getting shots for 4 months in order to get my levels up. Once I switched to the sublingual tablets I noticed a decrease in my energy and increase in my shortness of breath and an increase in headaches, all which had improved a fair bit with the injections. So I went back to the injections, then about 3 months ago my Doc asked if I’d like to try getting the shots with a smaller needle therefore going into the fatty tissue rather than the muscle…less painful.
Here I am 3 months later with increased headaches, increased fatigue and increased shortness of breath again…
I guess it is a no brainer for me…back to the deep muscle shots. I find it weird how so many people have different reactions.

August 21, 2013 at 8:46 am
(39) michelle says:

I’m having problems getting my doctor to consider the B12 injections. Did any of you have bloodwork taken that came back within low normal range and were still given the B12 injection?

August 29, 2013 at 4:29 pm
(40) Carolyn says:

I’ve been having vitamin B12 injections one a week for the past 8 weeks and have notice a massive difference in my chronic fatigue symptoms. I have another two weekly injections to go and hen I will have one a month for a year. My levels were normal and although the treatment that I am receiving is not licensed for CFS, the hospital wrote to my doctors to advise them that they might like to consider it. It’s brilliant. I also take a folic acid tablet once a week.

January 9, 2014 at 3:22 am
(41) Henman says:

Orthomol vitamin b2 consider not very well?

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