In this post http://fixhepc.com/forum/experts-corner/500-b12-supplements-may-improve-svr.html it was noted that B12 supplementation may improve results.

Since then there has been a lot of discussion along the lines of “I’m eating lots of healthy vegetable type foods”

Here is a quick heads up: B12 is only present in foods of animal origin or “contaminated” by bacteria – it is not present in plants – not at all, not even a little bit.

http://www.veganhealth.org/articles/vitaminb12

Vitamin B12 is a complicated vitamin with a unique absorption mechanism and a number of inactive analogues (molecules that appear to be active B12, but actually are not) that possibly interfere with its function. Vitamin B12 is generally found in all animal foods (except honey). Contrary to the many rumors, there are no reliable, unfortified plant sources of vitamin B12, including tempeh, seaweeds, and organic produce. One of the earliest studies conducted on vegans, from the U.K. in 1955, described significant vitamin B12 deficiency in the vegans with some suffering from nerve damage and dementia. This, as well as many case studies since then of vitamin B12 deficiency in vegans, and a great deal of other evidence detailed here, has led to the overwhelming consensus in the mainstream nutrition community, as well as among vegan health professionals, that vitamin B12 fortified foods or supplements are necessary for the optimal health of vegans, and even vegetarians in many cases. Luckily, vitamin B12 is made by bacteria such that it does not need to be obtained from animal products.

Despite the overwhelming evidence that vegans without a reliable source of vitamin B12 are likely harming their health, some vegan advocates still believe that “plant foods provide all the nutrients necessary for optimal health,” and do not address vitamin B12 when promoting the vegan diet. Other advocates acknowledge the need for B12, but only as an afterthought. And still others emphasize that humans need only small amounts of B12 and that it can be stored in the body for years.

Here is a link to vegan sources: http://www.veganhealth.org/b12/vegansources

My list (for people who are deficient) looks like this:

• B12 injections (1000 mcg)
• B12 tablets (500 mcg or 1000 mcg) (even with B12 malabsorption small quantities of large doses get absorbed)
• B-B-B-Berrocca (but only contains 10 mcg)
• Multivitamin (dose varies but 2-4 mcg common) Note that women and pregnancy versions typically have more B12 and Folate
• Fish and Shellfish
• Meat and Liver
• Eggs
• Milk and Cheese

According to the Mayo Clinic: http://www.mayoclinic.org/drugs-supplements/vitamin-b12/dosing/hrb-20060243

Recommended dietary amounts (RDAs) are 2.4 micrograms daily for ages 14 years and older, 2.6 micrograms daily for pregnant females, and 2.8 micrograms daily for breastfeeding females. Those over 50 years of age should meet the RDA by eating foods reinforced with B12 or by taking a vitamin B12 supplement. Supplementation of 25-100 micrograms daily has been used to maintain vitamin B12 levels in older people. A doctor and a pharmacist should be consulted for use in other indications.

For vitamin B12 deficiency, 125-2,000 micrograms of cyanocobalamin has been taken by mouth daily for up to 2.5 years or longer. Five hundred micrograms of sublingual (under the tongue) vitamin B12 has been used daily for up to four weeks.