For CCI’s Patients, B12 is Not Magic. It’s Critical

Log on to almost any social media platform — whether Facebook, Instagram, TikTok, or YouTube — and you’re likely to see vitamin B12 shots advertised as a magical elixir for everything from brain fog and persistent fatigue to hair thinning and mood changes. In the United States, vitamin B12, sometimes called the energy vitamin, has become a popular wellness trend, promoted with a simple message: if you’re tired, stressed, or run down, B12 might be the answer.

In the Dominican Republic and other developing countries, where food insecurity is widespread and access to medical care is limited, vitamin B12 is not a trend. Vitamin B12 deficiency — depriving the body of a nutrient essential for nerve health and red blood cell production — is a serious medical concern, with real consequences, especially for people living with chronic diseases such as diabetes and without access to a healthy diet.

Enter CCI

Chronic Care International (CCI) recognizes this reality.

As part of its comprehensive treatment for people living with diabetes in the Dominican Republic, CCI has recently begun testing vitamin B12 levels, particularly because many patients are prescribed metformin, a widely used and essential medication to control blood sugar.

“While metformin is highly effective at improving the diabetes control in our patients,” says Hans Dethlefs, president of CCI, “long-term use can interfere with the body’s ability to absorb vitamin B12, increasing the risk of deficiency.”

Many of CCI’s patients are elderly and may have limited access to foods that naturally contain vitamin B12, such as meat, dairy, fish, eggs, and fortified cereals. At the same time, providing B12 supplements to every patient is not always feasible, since even vitamins can represent a significant financial burden for patients.

According to the American Diabetes Association Standards of Care in Diabetes (summarized by the National Library of Medicine), people taking metformin — specifically over the long term — should have their vitamin B12 levels monitored as part of routine care.

Taken together: age, limited nutrition, and long-term metformin use make the risk of vitamin B12 deficiency particularly acute in this population.

Enter Rachel Dowd

For Rachel A. Dowd, registered nurse and certified diabetes care and education specialist, vitamin B12 deficiency has been on her radar throughout her decades-long career as a diabetes healthcare practitioner, including work in endocrinology. Drawing on her extensive experience advocating for underserved people with diabetes in Omaha, she has emphasized the importance of addressing vitamin B12 deficiency as a critical, yet often overlooked, component of diabetes care. In fact, Rachel’s background was key to her recruitment to CCI from the outset, not only as a practitioner and educator, but also as part of the organization’s leadership as a board member.

“I’ve been down to the Dominican Republic more than a dozen times over the years, and the work CCI is doing for our patients is truly impressive,” says Rachel. “Adding vitamin B12 testing provides another important data point and a meaningful step forward in the care CCI provides.”

A one-time grant from the Heaney Family Fund made it possible for CCI to begin vitamin B12 testing for patients with diabetes in the Dominican Republic in 2025. Sustaining this testing over time — so that it remains part of CCI’s routine care — has been a priority Rachel has consistently emphasized. Ninety-two percent (92%) of every dollar donated goes directly to programs like this one, and your support can help ensure that this vital vitamin B12 work continues for patients who depend on it.

To learn more about Chronic Care International, its patients, programs, and mission, visit our About Us page.