Exploring the Truth of Vitamin B12 and Vegans

Vitamin B12 (Cobalamin) is a vitamin that plays an important role in the function of the brain and nervous system, the metabolism of cells, DNA regulation, and the creation of blood. The "normal" range in a standard blood test is 200-900 pg/mL (picograms per milliliter). Levels below 80 represent B12 deficiency. A blood test is not an accurate test for vegans who also consume algae or spirulina because they contain B12-analogues that mimic true B12 in blood tests while actually interfering with B12 metabolism. A blood test may not be totally accurate for other reasons too, explains Dr. Gina Shaw: "Just because there is a low level of B12 in the bloodstream, this does not mean that there is a deficiency in the body as a whole, it may well be being utilised by the living cells (such as the central nervous system). More reliable tests appear to be that of homocysteine levels and Methyl Malonic Acid tests." Dr Gina Shaw, D.Sc, M.A.- source. When the vegan community has been surveyed, there were long time vegans that did develop Vitamin B12 deficiency. Some developed deficiency only after 5 years of being vegan (it is estimated that we have a 5-20 year reserve in our liver).

Some health practitioners don't feel that vegans get B12 deficiency any more than non-vegans; a certain percentage of the general population becomes deficient; for various reasons such as: they lose their own Intrinsic factor (a glycoprotein necessary for the absorption of B12) - malabsorption problems, age, or alcohol, drugs, antibiotics, and smoking could affect ones’ stores of B12. However, if a vegan does not supplement B12, it can result in a dietary deficiency. Because of the re-circulation of B12 in our bodies, it may take 20-30 years to become deficient after eating a strictly vegan diet. Generally speaking, all people over 50 are advised to take Vitamin B12 from supplements or fortified foods. 

Vitamin B12 is apparently a necessary nutrient; but only a miniscule amount is needed (less than 3 micrograms per day). Vitamin B12, no matter where it is sourced from is a compound produced by micro-organisms. Rather than killing a cow or a pig to eat him/her for the B12 stored in their gut, vegans choose to take a liquid B complex (with B12) or a vegan sublingual nugget/dot (proven effective) and sprinkle B12 fortified good tasting nutritional (savoury) yeast on their meals - and let the cow live his/her life. It's not widely known that the cows people eat for B12 are often fed B12 supplements. 90% of the B12 supplements made in the world are fed to farmed animals. 

It is debated whether we can or cannot reabsorb Vitamin B12 in our own body (there is controversy over the bacteria being produced too low down in the intestines to be reabsorbed). Some sources say there is B12 in the natural environment when we drink from rivers and eat out of organic/veganic gardens, but this has not proven to be reliable. Rumor has it that purple Nori (may have B12 but also has B12 analogs that interfere with B12 absorption), Chlorella (see link below), unpasteurized miso, a certain mushroom, or Comfrey contain some active B12, however B12 that is sourced from micro-agriculture; cultivated on a bed of yeast, seems to be more count-on-able. - This study proves Chlorella has active B12 - this study says Nori has active B12, but others say it has more B12 analogs that interfere with real B12 absorption, so who knows?

When being compared to the “normal range” – we are being compared to flesh eaters and those who are drinking the milk of another species; this is not the “normal” that vegans want to be compared to (because frankly, we don’t think it’s normal to exploit, harm and eat other animals or steal the milk meant for their calf.) I question if there are some answers that we do not yet know. After 33 years of being vegan, I’m totally convinced that we should be powered by plants, so therefore we should be able to get all we need directly from plant sources and sunshine, easily. That’s the B12 controversy. That’s the issue that has not been resolved in the minds of some vegans. Perhaps vegans need less Vitamin B12 than their omnivorous counterparts. Perhaps people didn’t wash the microorganisms off their food and were less sterile than we are today, or some other possibility. For now, vegans should supplement, because very low B12 intake can cause anemia, nervous system damage, and has serious consequences such as dementia or fatality!

"We do have to look at the reality that most grain products, especially those that are called "enriched grain products," cereal, breads, and pasta, and whatnots, are typically enriched with B12, which means you're taking a B12 supplement every day. What we call the normal level of B12 is based on testing people who are supplementing with B12 at every meal. This is an abnormally high level of B12 compared to the normal population or compared to a population which isn't supplementing..."  Douglas Graham; doctor of chiropractic, long-time raw foodist, author of the 80-10-10 Diet, and professional fasting supervisor. 

After investigation, it’s reasonable for vegans to supplement Vitamin B12 or they are putting themselves at serious risk. It’s an absolute must (according to vegan medical doctors) for pregnant vegan mothers and children! Infants that drink only their vegan mother’s milk might have limited reserves of B12 and can develop deficiency within months of birth. Untreated, vitamin B12 deficiency in infants can result in severe and permanent neurological damage. That explains this:

"The American Dietetic Association recommends supplemental vitamin B12 for vegans during both pregnancy and lactation to ensure that enough vitamin B12 is transferred to the fetus and infant. Pregnant and lactating women who follow strict vegetarian or vegan diets should consult with a pediatrician regarding vitamin B12 supplements for their infants and children.”

It is inexpensive to supplement, it is water soluble and won’t accumulate in the body over time, and has no known side effects even when taken in large quantities, and is a precautionary measure. If vegans supplement with B12, generally they are at far less risk of heart disease than the general population. However, if vegans don’t supplement with B12, they might be at more risk! 

“But there is room for improvement in any diet, and the analysis, published in the Journal of Agricultural and Food Chemistry, suggested that vegans who have low intakes of vitamin B12 and possibly omega-3 fats could lose out on the benefits of healthful plant-based eating. Inadequate B12 is associated with elevated levels of homocysteine, an amino acid that is linked to increased heart disease. But that's an issue only for vegans who fail to supplement with vitamin B12. Those who consume recommended amounts of B12 have healthy levels of homocysteine.” Source link 

"Studies have found that people who have low levels of vitamin B12 (including those who are not classified as deficient in B12) tend to have high levels of homocysteine. This reduces life expectancy and increases the risk of cardiovascular diseases (such as heart attack and stroke) and dementia. This is another reason why it is very important to ensure an adequate intake of vitamin B12, from supplementation and fortified foods. It is not simply about avoiding overt vitamin B12 deficiency, but about avoiding high homocysteine levels and the negative health consequences of this. I recommend that vegans supplement with 5 to 100 mcg of vitamin B12 per day, or 2000 mcg as a weekly dose."Amanda Benham, Accredited Practising Dietitian and Nutritionist www.humanherbivore.com

Position of the American Dietetic Association:

"The vitamin B-12 status of some vegetarians is less than adequate due to not regularly consuming reliable sources of vitamin B-12. For vegans, vitamin B-12 must be obtained from regular use of vitamin B-12-fortified foods, such as fortified soy and rice beverages, some breakfast cereals and meat analogs, or Red Star Vegetarian Support Formula nutritional yeast; otherwise a daily vitamin B-12 supplement is needed. No unfortified plant food contains any significant amount of active vitamin B-12. Fermented soy products cannot be considered a reliable source of active B-12. Vitamin B-12 status is best determined by measuring serum levels of homocysteine, methylmalonic acid, or holotranscobalamin II." 

A B12 deficiency can cause an interruption of normal metabolism and result in the accumulation of substances like ‘methylmalonic acid’ and ‘homocysteine’. Tests showing increases in these metabolic products are used to early diagnose B12 deficiency. Elevated homocysteine levels occur long before any of the following symptoms are noticeable:

Some reported Symptoms of B12 deficiency

*Mild problems with the nervous system characterized by numbness and tingling in the hands and feet, or down the side of the body. For example, symptoms have been described like this: “a weird ‘zinging’ thing that went from jaw down the arm.” -or- “sharp stabbing, tingling pain in the palm of one or both hands”. These sensations are reversible in early stages; however, damage to the nervous system can become irreversible.

*Fatigue, weakness, weight loss, loss of appetite, constipation

*Itchy, tingly or sore tongue, sores at the corners of the mouth and sometimes along the edge of the lip.

*White spots in the skin, resulting from melatonin becoming absent in the area –or- paleness

*Nerve shock in the side of the body. It can be felt coming on a few seconds before it hits, and then it hits almost like a mild but deep electric shock and quickly subsides.

*Shortness of breath, when walking just a few yards, respiratory problems

*Eye twitch, usually in one eye or the other -or- facial pain, usually on only one side of the face at a time, blurred vision, abnormal gait, memory loss, disorientation, confusion, hallucinations, personality changes, cognitive decline, depression

*deafness has been associated with B12 deficiency link

*Infants typically show more rapid onset of symptoms than adults. B12 deficiency may lead to loss of energy and appetite, failure to thrive, movement disorders, or developmental delays. If not promptly corrected, this can progress to coma or death. It is very important for pregnant vegans to supplement and supplement their young child with B12 (and vegan DHA).

Doctor Recommendations and dosage: 

"I knew forty years ago that vitamin B12 would become the last bastion for meat-and dairy-lovers (and the industries that profit from them), because this is the only criticism with any merit that could be lodged against the McDougall Diet (a plant diet). In order to avoid that condemnation and the small risk of harming anyone, I have recommended and printed in the beginning of my books and DVDs the following advice: If you follow the McDougall Diet for more than 3 years, or if you are pregnant or nursing, then take a minimum of 5 micrograms of supplemental vitamin B12 each day." John McDougall, MD drmcdougall@drmcdougall.com

"In over 60 years of vegan experimentation only B12 fortified foods and B12 supplements have proven themselves as reliable sources of B12, capable of supporting optimal health. It is very important that all vegans ensure they have an adequate intake of B12, from fortified foods or supplements. This will benefit our health and help to attract others to veganism through our example. National recommendations for B12 intakes vary significantly from country to country. The US recommended intake is 2.4 mcgs a day for ordinary adults rising to 2.8 mcgs for nursing mothers. The German recommendation is 3 mcgs a day. Recommended intakes are usually based on 50% absorption, as this is typical for small amounts from foods. To meet the US and German recommendations you need to obtain sufficient B12 to absorb 1.5 mcgs per day on average. This amount should be sufficient to avoid even the initial signs of inadequate B12 intake, such as slightly elevated homocysteine and MMA levels, in most people. Even slightly elevated homocysteine is associated with increased risk of many health problems including heart disease in adults, preeclampsia during pregnancy and neural tube defects in babies." Stephen Walsh, Ph.D., Trustee of The Vegan Society [U.K.]

We're vegan because using other animals needlessly for human purposes is unjustifiable. As vegans, we oppose all harm, sexual assault, oppression, slavery, and murder - no matter what species the victim is; human or any other fellow sentient animal. Therefor we will remain vegan, and B12 supplementation is in order, at this point. But the facts are not all in on the B12 controversy. It would greatly benefit the vegan community if we could create scientific studies comparing vegans and their B12 levels. Upon the recommendation of vegan health professionals, it is wise for vegans to supplement; even if it is just sprinkling fortified nutritional yeast (which adds a delicious cheezy flavor) on your meals, daily. Sublingual (under the tongue) is the preferred method for B12 absorption.

Finally, many don't realize that farmed animals are supplemented with Vitamin B12. It is more reasonable to just take the supplement rather than killing animals that were supplemented.