Can Vitamin B-12 Help Hepatitis-Related Fatigue? | Hepatitis Central

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Can Vitamin B-12 Help Hepatitis-Related Fatigue?

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To ease the exhaustion typical of hepatitis, people are constantly looking for an energy booster. Find out if vitamin B-12 could help power you through your fatigue.

Anyone living with chronic hepatitis knows that fatigue is one of this illness’s biggest challenges. Thus, rumors of vitamin B-12 shots or supplements miraculously restoring energy levels have generated a lot of interest in the hepatitis community. Before beginning a campaign to find and receive this shot, pill or tablet, learn about the situations that actually warrant taking vitamin B-12.

Essential for many of the body’s functions, vitamin B-12 is known as the “energy vitamin.” While vitamin B-12 deficiency was previously regarded as rare, recent studies from the U.S. Framingham trial show that one in four adults in the U.S. don’t have enough of this vitally important nutrient.

About Vitamin B-12

Present only in animal food sources, vitamin B-12 is an essential water-soluble vitamin that is found in fish, shellfish, meat and dairy products. Also known as cobalamin, this nutrient plays many roles including helping to:

  • Maintain healthy nerve cells
  • Create red blood cells
  • Produce DNA, the genetic material in all cells

Bound to the protein in food, hydrochloric acid in the stomach releases vitamin B-12 from protein during digestion. Once released, B-12 combines with intrinsic factor so that it can be absorbed into the bloodstream.

Vitamin B-12 Deficiency

There are two primary ways to become deficient in vitamin B-12: not getting enough in your food and losing the ability to absorb it.

  • Diet – While most Americans get plenty of cobalamin from their diet, those who are strict vegetarians or vegans have trouble getting enough B-12 from their food.
  • Age – With advanced age, the likelihood of a vitamin B-12 deficiency rises. This is because the stomach’s lining gradually loses its ability to produce hydrochloric acid.
  • Drugs – The use of antacids or anti-ulcer drugs will lower stomach acid secretion, thus decreasing the ability to absorb vitamin B-12.
  • Pathogen – Infection with Helicobactor pylori, a common contributor to stomach ulcers, can also result in vitamin B-12 deficiency.
  • Cobalamin malabsorption syndrome – This newly coined term is when the stomach lining loses the ability to produce intrinsic factor (which enables vitamin B-12 absorption). The suggested reasons for this syndrome span atrophic gastritis, Helicobacter pylori infection and long-term ingestion of antacids and biguanides.


Because it is involved with red blood cell production, cobalamin is crucial for bringing oxygen throughout the body to provide energy. This is why many people with anemia (insufficient red blood cells) are energized after taking a vitamin B-12 supplement or receiving a shot. However, those with hepatitis can have many causes for their fatigue.
Before someone with hepatitis assumes that cobalamin is the answer to his/her prayers, a physician must first look carefully at what factors could be responsible for the person’s fatigue. For more information about why someone with Hepatitis C might be tired, read Fatigue and Hepatitis C. While most people with hepatitis have fatigue for reasons unrelated to vitamin B-12, there are some exceptions:

  • Alcohol – Those with alcoholic hepatitis who obtain the bulk of their nutrients from alcohol are likely to develop a vitamin B-12 deficiency. In addition, alcohol can interfere with the absorption of vitamin B-12. Thus, a cobalamin deficiency may develop if a person consumes alcohol even if a well-balanced diet is maintained.
  • Encephalopathy – Those with hepatitis who have progressed to chronic encephalopathy are instructed to avoid eating red meat. Because they may be vegetarians, a vitamin B-12 deficiency can occur in individuals with chronic encephalopathy.
  • Diminished absorbability – Due to advanced age (over 60 years old) or a history of medications that block stomach acid, those with diminished ability to absorb vitamin B-12 could be tired due to cobalamin deficiency.

B-12 and Hepatitis C

Although there are only a few reasons that someone with hepatitis could benefit from vitamin B-12 for an energy boost, there is some interesting evidence tying this nutrient to Hepatitis C suppression.

  • As published in the April 2001 Proceedings of the National Academy of Science of the United States of America, Australian researchers found that in those with Hepatitis C, high concentrations of cobalamin inhibited Hepatitis C viral replication. While these results have not been implemented into a treatment strategy, they do demonstrate a favorable relationship between vitamin B-12 and Hepatitis C suppression.
  • According to a study by researchers from the Karolinska Institute in Stockholm presented at the 2009 Digestive Disease Week meeting in Chicago, Hepatitis C combination therapy was more effective in recipients who had high serum levels of vitamin B-12. While this provides more recent evidence that cobalamin could restrict Hepatitis C from replicating, there is not yet enough data to make this conclusion.

Hepatitis-induced fatigue can be severe. Understandably, those affected often try a wide range of products in search of a safe and effective energy boost. Whether administered by a syringe-yielding physician or purchased in a grocery store, vitamin B-12 could be a step in the right direction. Especially if you have reason to believe that you are not getting cobalamin from your diet or are not properly absorbing it, involve your doctor in your consideration of vitamin B-12 deficiency.

References:, Why You Don’t Want to Run Low on Vitamin B-12, Joseph Mercola, MD, Retrieved September 6, 2009,, 2009., Vitamin B12 Levels May Help Predict Response to Interferon-based Therapy for Chronic Hepatitis C, Liz Highleyman, Retrieved September 6, 2009,, 2009., Fatigue and Liver Disease/Hepatitis, Retrieved September 6, 2009, Melissa Palmer, MD, 2009., Vitamin B12, Retrieved September 6, 2009, Mayo Foundation for Medical Education and Research, 2009., Vitamin B12 and hepatitis C: molecular biology and human pathology, Lott WB, et al, Retrieved September 6, 2009, Proceedings of the National Academy of Science of the United States of America, April 2001.


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