CAUTION: Vitamin B12 Sublinguals — The Citric Acid Additive Can Erode Tooth Enamel

[Hip]

CAUTION: Oral B12 Methylcobalamin Can Erode Tooth Enamel?

EDIT: later in this thread, it was concluded it is most like the citric acid preservative in many B12 sublingual supplements that causes the tooth erosion; citric acid is particularly erosive to tooth enamel.

I was using high doses of liquid vitamin B12 in the methylcobalamin form orally, and after a week or so, found that the B12 had thinned the enamel on several teeth, near the gum line and also just under gum line.

I suddenly felt felt a strong and quite horrible sensitivity every time my toothbrush touched the teeth in this area. At first I did not know what this tooth pain was, and I though it might be some new cavities. However, there were no signs of any cavities, and normally you do not suddenly get cavities in several teeth all at once, within a week.

As I had only recently started experimenting with high doses of liquid vitamin B12 placed on my upper gums, I had a hunch that this B12 might have caused my tooth sensitivity, and sure enough, an online search found some anecdotal accounts of tooth enamel loss through B12 methylcobalamin oral/sublingual use (though I cannot find any proper scientific references to this phenomenon).

I don't think this B12 tooth enamel erosion is of major concern for people here taking sublingual B12, and/or B12 on their upper gums in the excellent method described by Freddd. But is is something to be aware of, just in case you are getting increased sensitivity in your teeth and don't know why.

I think the reason that my tooth enamel was eroded so fast was because I was using high doses of liquid B12 on my upper gums, and when I applied it, this liquid was actually running into the crevices between my teeth, and under the gum line, and remaining in these crevices for hours. I was applying these liquid B12 drops several time a day too, so this B12 was in constant contact with my teeth: ie, the enamel just under the gum line was almost constantly exposed to liquid B12 all day.

The enamel just under the gum line is very thin anyway, so it is not entirely surprising that this portion of my teeth lost enamel and became sensitive.

But there is a happy ending:

I stopped all use of sublingual B12 for the moment, and got hold of some amorphous calcium phosphate tooth remineralization toothpaste (one of several types of tooth remineralization technologies), and in addition, I placed small pinches of bicarbonate of soda in my mouth a few time a day (since remineralization of teeth can only occur when the oral environment is not acidic). I also put some di-calcium phosphate powder in my mouth several times a day (tooth enamel is made from the hydroxyl ion combined with calcium phosphate, both of which are naturally found in saliva, as this is the way saliva works to constantly rebuild tooth enamel). After 5 days or so, the damaged teeth seemed to be better (the horrible sensitivity virtually disappeared), which I assume is due to the enamel being rebuilt by this remineralization process.

 

[drex13]

I found that placing sublingual mehtyl b-12 tabs in my upper lip caused my teeth to hurt something awful. When I moved them to between my lower cheek and gum, the pain went away. I don't think there was any enamel deterioration, it just seemed to make my teeth very sensitive and achy.

 

[Hip]

I found that placing sublingual mehtyl b-12 tabs in my upper lip caused my teeth to hurt something awful. When I moved them to between my lower cheek and gum, the pain went away. I don't think there was any enamel deterioration, it just seemed to make my teeth very sensitive and achy.

I am not sure how methylcobalamin B12 in contact with the gums or tooth could cause immediate tooth pain, unless this was somehow affecting the nerve that run into the teeth - B12 does have a strong action on nerves.

In my case, if think it was definitely enamel erosion, as the sensitivity was not immediate, but slow to appear and cumulative; the sensitivity was not any stronger immediately after the B12 was applied, and the sensitivity remained even after stopping B12.

 

[drex13]

I didn't mean to imply that I had pain immediately upon putting a tab in my lip, sorry. But I had pain that started slowly and continued with putting the tabs in my upper lip and went away when I stopped.

 

[Hip]

I didn't mean to imply that I had pain immediately upon putting a tab in my lip, sorry. But I had pain that started slowly and continued with putting the tabs in my upper lip and went away when I stopped.

I think yours may be due to the action of B12 on the nerve, as the B12 permeates into the gums. That's my guess.

I did not get any pain at all unless I actually touched or brushed the sensitive teeth.

 

[kurt]

HI Hip
Based on what I have always been told, to erode enamel you need acid, and I don't believe methylcobalamin is an acid (is it? any chemists here?). But what ELSE is in the B12 drops you were using? I notice that there is stearic acid and citric acid in the methyl B12 sublingual tablet I am using. Yes, acids on the teeth are a problem, if there is acid in sublinguals and the patient is already acidic in the mouth, this might be a fair warning to raise. Thanks for pointing this out! I hope keeping a sublingual under the tongue and being careful to keep the dissolving solution off the teeth is enough.

One other thought, B12 also can help nerve function. If the nerves work better with the B12 you may feel things that had been masked by poor nerve function. In other words, maybe part of the tooth/gum pain was already there, just being hidden by B12 deficiency. CFS is often associated with periodontal disease, perhaps B12 supplementation makes a person more aware of that, if neuropathy is hiding the signals.

But the issue of acids in sublinguals seems valid, I think this should be brought up in B12 discussions, good catch! Maybe people with periodontal problems should be injecting the B12, or find a sublingual form that is ACID-FREE.

If you have litmus paper, maybe a good test would be to put a drop of that sublingual on the paper and see if the pH is < 7, which indicates it is acidic.

 

[Adster]

I mentioned in another thread that I went to SC injections because of the tooth pain with the sublingual tablets. After using a sensitive tooth toothpaste for several months I can now tolerate them under my tongue at least. I haven't tried against the gum yet.

 

[Hip]

HI Hip
B12 erode tooth enamel? Does not seem likely. Based on what I have always been told, to erode enamel you need acid, and I don't believe methylcobalamin is an acid (is it? any chemists here?). But what ELSE is in the B12 drops you were using? I notice that there is stearic acid and citric acid in the methyl B12 sublingual tablet I am using.

Hi Kurt

Yes, that's what I thought, that you need acid to erode enamel.

In fact, the B12 drops I used do contain citric acid, but the quantity I believe is small, as these drops do not at all taste sharp or tangy on the tongue.

Nevertheless, this citric acid might be a more reasonable explanation for the enamel erosion I experienced.

The B12 drops I used were Holistic Health Methyl B12 Mega Drops, at dose of around 5 drops on my upper gums, two or three times per day (each drop has 1,000 mcg of B12). These drops always tended to run into the crevices between my gums and teeth. Plus I was also using two Jarrow Methylcobalamin B12 5000mcg tablets slowly dissolving (over two hours) on my upper gums.

The Holistic Health Methyl B12 Mega Drops have the following ingredients: B12 1,000 mcg, purified water, trehalose, vegetable glycerine (palm), citric acid, potassium sorbate, and rosemary extract.

The Jarrow Methylcobalamin B12 has the following ingredients: B12 5,000 mcg, xylitol, cellulose, stearic acid (vegetable source), cherry flavor, citric acid and magnesium stearate (vegetable source).

So even the Jarrow B12 tablets have some citric acid.

I guess if citric acid is the cause of the problem, one possible solution to this enamel erosion might be simply to take a pinch of sodium bicarbonate powder and spread this around your mouth and gum line before taking the B12, as the bicarb should neutralize the citric acid.

The anecdotal reference I found for methylcobalamin B12 causing enamel erosion is on this forum here (see the first comment), but I found no reliable references.

 

[Freddd]

Hi Kurt

Yes, that's what I thought, that you need acid to erode enamel.

In fact, the B12 drops I used do contain citric acid, but the quantity I believe is small, as these drops do not at all taste sharp or tangy on the tongue.

Nevertheless, this citric acid might be a more reasonable explanation for the enamel erosion I experienced.

The B12 drops I used were Holistic Health Methyl B12 Mega Drops, at dose of around 5 drops on my upper gums, two or three times per day (each drop has 1,000 mcg of B12). These drops always tended to run into the crevices between my gums and teeth. Plus I was also using two Jarrow Methylcobalamin B12 5000mcg tablets slowly dissolving (over two hours) on my upper gums.

The Holistic Health Methyl B12 Mega Drops have the following ingredients: B12 1,000 mcg, purified water, trehalose, vegetable glycerine (palm), citric acid, potassium sorbate, and rosemary extract.

The Jarrow Methylcobalamin B12 has the following ingredients: B12 5,000 mcg, xylitol, cellulose, stearic acid (vegetable source), cherry flavor, citric acid and magnesium stearate (vegetable source).

So even the Jarrow B12 tablets have some citric acid.

I guess if citric acid is the cause of the problem, one possible solution to this enamel erosion might be simply to take a pinch of sodium bicarbonate powder and spread this around your mouth and gum line before taking the B12, as the bicarb should neutralize the citric acid.

The anecdotal reference I found for methylcobalamin B12 causing enamel erosion is on this forum here (see the first comment), but I found no reliable references.

Hi Hip,

This has been discussed for some years. Some folks went to their denttists, who upon examination said "no erosion" that they could tell. The dentists did suggest a re-mineralization toothpaste if they were concerned and that seemed to be pretty much the end of the situation. My daughter complained of such as well but upon examination by the dentist, none was found. In any case, a non-acid formula may be under way. The Enzymatic Therapy brand doesn't have the same acid content.

 

[Hip]

Hi Hip,

This has been discussed for some years. Some folks went to their denttists, who upon examination said "no erosion" that they could tell. The dentists did suggest a re-mineralization toothpaste if they were concerned and that seemed to be pretty much the end of the situation. My daughter complained of such as well but upon examination by the dentist, none was found. In any case, a non-acid formula may be under way. The Enzymatic Therapy brand doesn't have the same acid content.

Well mixing the B12 with a pinch of sodium bicarbonate powder should neutralize the acid and solve the problem (providing the sodium bicarbonate does not interfere with the B12).

I have often crushed down the B12 tablets with a tablespoon and placed the resulting B12 power over a wider region of my upper gums, in the hope of getting better absorption from greater surface contact area. This B12 powder could be mixed with just a pinch of sodium bicarbonate powder before you place it on the gums.

Next time I will buy the Enzymatic Therapy though.

 

[Hip]

... CFS is often associated with periodontal disease, perhaps B12 supplementation makes a person more aware of that, if neuropathy is hiding the signals ...

As a completely separate issue, I definitely have periodontal problems anyway (receding gum line, increased oral bacteria, and increased plaque deposition), and these periodontal problems came on very rapidly very soon after I caught the enteroviral infection that I believe caused my CFS.

I am trying to figure out how an enterovirus can cause periodontal problems. My oral health was excellent prior to catching this virus.

 

[kurt]

Another remedy is to rinse the mouth after the sublinqual or drops have dissolved. We eat acids all the time in foods, tomatoes for example have acid. I believe the problem is not having the acid, but leaving the acids on the teeth for a long time. Thus the constant reminders to clean the teeth after eating (advice I wish I had listened to as a youth, sigh).

 

[Rockt]

I'm having issues with the sublingual Mb12 as well. A lot of sensitivity and even some ache. I'm rinsing like crazy after using them, but it's not helping.

It would be great if they could manufacture a pill that wouldn't cause this.

 

[richvank]

Hi, all.

Note that citric acid is a chelator for calcium, so having citric acid in contact with the teeth for long times will remove calcium from the enamel. I don't know if an alkaline pH, based on use of sodium bicarbonate will slow or stop the chelation, since sodium citrate may still exchange sodium for calcium, due to the fact that the chelation bond involves a double chemical bond with the calcium, versus having a single bond with sodium, and the double bond would be stronger.

Some related experience has been reported from the use of lemon juice. Lemon juice can help to increase stomach acid, which is usually low in ME/CFS, and it also (paradoxically) causes the urine to become more alkaline, which has the benefit of improving the kidney excretion of toxins that are chemically present as weak acids. Some people who repeatedly drank lemon juice and did not use a drinking straw or flush their teeth with water afterward reported that they lost the enamel on their teeth.

I don't know how to harmonize this with long-term use of citric acid containing supplements in contact with the gums and teeth, but some of the ideas discussed by others here sound promising.

Best regards,

Rich

 

[L'engle]

Perhaps if enough people send messages to Jarrow they will make a formulation without citric acid.

Jarrow's website has a pretty standard contact page with their e-mail address.

 

[Freddd]

Perhaps if enough people send messages to Jarrow they will make a formulation without citric acid.

Jarrow's website has a pretty standard contact page with their e-mail address.

Hi L'engle,

I think that they will listen to the need for a b-complex without folic/folinic acid and with Metafolin if possible (not under their control) and mb12 without citric acid. If a lot of people are asking I think they will pay more attention sooner.

 

[liquid sky]

The b-12 caused all my teeth to ache at first for about a week. Now, they are just super sensitive. I am using sensitivity toothpaste, but I think I will have to find a different way to get my b-12.

Fredd, is there any other b-12 that doesn't have the acid in it?

 

[L'engle]

Liquid sky, the Solgar brand doesn't seem to have acid, but I don't know about its effectiveness. I will try it soon. You might want to look into it as well on iherb. It's about the same price as the Jarrow.

The additives in Solgar mb12:

"Mannitol, Microcrystalline Cellulose, Silica, Vegetable Cellulose, Vegetable Stearic Acid, Vegetable Magnesium Stearate, Natural Cherry Flavor. "

These are the same as the additives in Solgar Metafolin, except for the natural cherry flavour. So I imagine if you are ok with with the metafolin this would be good. I dissolve metafolin the same as I do the mb12, rather than swallowing it. It doesn't seem to hurt my teeth or my mouth.

 

[Hip]

Liquid sky, the Solgar brand doesn't seem to have acid, but I don't know about its effectiveness.

Thanks L'engle. Be aware though that most liquid B12 brands I have seen, including the Solgar, are a bit weak. They contain 1,000 or 2,000 mcg per dropperful (a dropperful is 1 ml - around one inch of liquid in the dropper pipette).

By contrast, the brands like Holistic Health B12 Mega Drops contain 1,000 mcg per drop (there are around 20 drops in a 1 ml dropperful).

If anyone knows any other B12 brands that have this high potency 1,000 mcg per drop, please post the info.

 

[L'engle]

Oh, it isn't liquid, it's in tablets. "liquidSky" is the user who posted above me. I didn't include a quote, just addressed the post to them. Apologies for the confusion.