Evidence supporting the use of: Vitamin B12
For the health condition: Cardiovascular Disease

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B12 is involved in cardiovascular health primarily through its role in lowering homocysteine levels. Homocysteine is an amino acid in the blood, and elevated levels have been associated with an increased risk of cardiovascular disease (CVD). Vitamin B12, along with folic acid and vitamin B6, is essential for the metabolism of homocysteine to methionine, thereby reducing homocysteine concentrations. Early observational studies suggested a correlation between high homocysteine and greater CVD risk, leading to the hypothesis that B-vitamin supplementation could help reduce risk by lowering homocysteine.

However, randomized controlled trials (RCTs) and meta-analyses have largely failed to show that vitamin B12 supplementation, even when it effectively lowers homocysteine, results in a significant reduction in cardiovascular events such as heart attack or stroke. Notable large-scale studies (e.g., the HOPE-2 trial and others) found that while homocysteine levels dropped, clinical outcomes did not improve appreciably in most populations studied. This suggests that while B12 is mechanistically relevant, the direct impact of supplementation on CVD risk is limited or unproven for most people, especially those without an existing deficiency.

Therefore, the scientific evidence supporting vitamin B12 supplementation for the prevention or treatment of cardiovascular disease is weak (rated 2/5). It may be indicated for individuals with proven B12 deficiency or hyperhomocysteinemia, but routine use for CVD in the general population is not supported by strong evidence.

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