“The theory is that animal protein, through its acidifying action, “leaches” calcium from bones, eventually weakening them and causing bone fractures. If that’s true, it means that those of us who eat no animal protein are likely to have better bone health. And maybe even lower calcium needs.
“Unfortunately, it’s not true. Or at the very least, the evidence in support of this relationship has fizzled over the years. I’ve written about this before, but it remains such a pervasive and potentially harmful belief that it deserves an occasional revisit.”
Lactobacillus is a genus of bacteria found in some people’s digestive tracts and in most probiotic supplements. There is evidence that some species produce vitamin B12.
A 2003 study of Lactobacillus reuteri CRL1098 determined that it produces vitamin B12 and that this B12 was equivalent to cyanocobalamin (1).
In a 2006 study from Egypt, school children were fed yogurt fermented only with Lactobaccillus acidophilus, 2 cups daily with 5 X 109 colony-forming units (2). After 42 days, their B12 status was compared to children who were fed a commercially prepared yogurt. Urinary MMA levels went from 3.49 to 2.09 mmol/mol of creatinine in the experimental group (P = .02) versus no change in the commercial yogurt group.
In a 2000 study of vegan raw foodists, 4 vegans were fed a probiotic supplement containing Lactobacillus acidolphilus and other Lactobacillus species (3). After 3 months, the urinary MMA levels of 3 of the 4 subjects had decreased, though not to normal levels. More details of this study are on the page, Raw Foodist Vegans.
While Lactobacillus shows some promise, it is too soon to rely on it for keeping your vitamin B12 status at healthy levels.
Japanese fermented black tea (Batabata-cha)
A 2004 study by the Watanabe group found that fermented black tea (Batabata-cha) contained vitamin B12 analogues that, when fed to rats, improved their vitamin B12 status (4). It would be interesting to see if this tea could consistently improve B12 status in humans.
I’m afraid I’m going to have to eat some humble pie here, as I had written a company, Tonix, telling them that they should not be claiming their coconut water kefir has vitamin B12 in it based on the fact that they have Lactobacillus and Bifidobacteria in it. And looking more closely at their claims, they don’t claim their product has vitamin B12 in it, they only claim that their product contains Lactobacillus and Bifidobacteria which can produce vitamin B12. So, I really messed up on that one. Sorry, Tonix! Not that they cared – they never wrote me back.
1. Taranto MP, Vera JL, Hugenholtz J, De Valdez GF, Sesma F. Lactobacillus reuteri CRL1098 produces cobalamin. J Bacteriol. 2003 Sep;185(18):5643-7. | link
2. Mohammad MA, Molloy A, Scott J, Hussein L. Plasma cobalamin and folate and their metabolic markers methylmalonic acid and total homocysteine among Egyptian children before and after nutritional supplementation with the probiotic bacteria Lactobacillus acidophilus in yoghurt matrix. Int J Food Sci Nutr. 2006 Nov-Dec;57(7-8):470-80. | link
3. Donaldson MS. Metabolic vitamin B12 status on a mostly raw vegan diet with follow-up using tablets, nutritional yeast, or probiotic supplements. Ann Nutr Metab. 2000;44(5-6):229-34. | link
4. Kittaka-Katsura H, Ebara S, Watanabe F, Nakano Y. Characterization of corrinoid compounds from a Japanese black tea (Batabata-cha) fermented by bacteria. J Agric Food Chem. 2004 Feb 25;52(4):909-11. | link
Mild vitamin B12 deficiency causes homocysteine levels to rise. This has been a concern for vegans who do not supplement regularly with vitamin B12 because their homocysteine tends to be at a level that has been associated with cardiovascular disease and early death.
In the past few years, however, evidence has been mounting that homocysteine-reducing therapy is not effective in reducing cardiovascular disease. Two meta-analyses, from 2010 (1) and 2013 (2) indicate that there may be no benefit from lowering homocysteine levels for cardiovascular disease.
At the same time, evidence continues to mount that elevated homocysteine can cause dementia, with a 2013 study showing that homocysteine-lowering treatment can significantly reduce brain atrophy (3).
1. Clarke R, Halsey J, Lewington S, Lonn E, Armitage J, Manson JE, Bønaa KH, Spence JD, Nygård O, Jamison R, Gaziano JM, Guarino P, Bennett D, Mir F, Peto R, Collins R; B-Vitamin Treatment Trialists\’ Collaboration. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med. 2010 Oct 11;170(18):1622-31. | link
2. Martí-Carvajal AJ, Solà I, Lathyris D, Karakitsiou DE, Simancas-Racines D. Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev. 2013 Jan 31;1:CD006612. | link
3. Douaud G, Refsum H, de Jager CA, Jacoby R, Nichols TE, Smith SM, Smith AD. Preventing Alzheimer\’s disease-related gray matter atrophy by B-vitamin treatment. Proc Natl Acad Sci U S A. 2013 Jun 4;110(23):9523-8. doi: 10.1073/pnas.1301816110. Epub 2013 May 20. | link
I have been catching up on the B12 in plants and algae research.
When I read these papers and see the not-insignificant amount of preparation and analysis that goes into the laboratory methods for trying to measure and accurately describe the B12 in these foods, it seems a lot easier just to feed the foods to humans and see if it improves their B12 status. Instead, we have a never-ending flow of research trying to quantify how much B12 is in various plants which does us almost no good because:
– Even if you find some molecules that seem to be vitamin B12, you don’t know how it will interact with other inactive B12 molecules inevitably also prevalent in these foods.
– We do not know how the B12 got there: whether the plant made it (unlikely), whether it has come from symbiotic bacteria, or whether it came from fecal or insect contamination. Thus, we do not know how reliable it would be in other batches of that food throughout the world.
– The packaging, storage, transportation, and preparation methods can differ greatly between the careful laboratory methods used in these reports and the versions someone might buy in a grocery store.
Nevertheless, this topic is of great interest to much of the vegan community and I will summarize some of the latest papers I’ve come across, though not all are recent.
The Watanabe group, as I refer to them because Fumio Watanabe is often the lead author, is a group of researchers from Japan who regularly publish on these subjects. They published a review of the research in 2013 (1) which was almost an exact duplicate of their review from 2007 (2).
There wasn’t much to report from their 2013 review, but a reader questioned me about one statement they make about B12 being degraded in the presence of both copper and vitamin C. Since many multivitamins contain both copper and vitamin C, is the B12 in these supplements useless? It’s a good question, but the research they base their observation on is, once again, not measuring whether a multivitamin with B12 and copper can improve vitamin B12 status (3). Rather, they took vitamin B12 and added vitamin C and copper to it and then analyzed the B12 to see if it was damaged – a process that significantly differs from eating a multivitamin.
I have not seen research looking at multivitamins and their effects on B12 status, which is a question that needs to be answered even for multivitamins without copper and vitamin C. As a bit of reassurance, I cannot recall any vegans who regularly take a multivitamin with B12 coming down with overt deficiency. That said, it would probably be best for vegans to avoid copper in their multivitamins. I don’t think it warrants throwing out a bottle of multivtiamins, but if you can get a multivitamin without copper, other things being equal, I’d suggest it. I’ll have more on copper absorption in a future post.
The Watanabe group published another paper in 2013, this time testing to see if hydroponically grown lettuce would absorb vitamin B12 if it was injected into the growing medium (4). Indeed, it does, at a rate of .02% to .03%. Enough B12 was absorbed that two lettuce leaves could meet the RDA of 2.4 µg. But it would seem much more efficient to get the B12 directly from fortified foods or supplements rather than running it through hydroponically grown lettuce and losing over 99%.
An Indian research group published an article in 2010 examining the vitamin B12 content of spirulina (Spirulina platensis) (5). They found 35 – 38 µg of methylcobalamin per 100 g of dry mass. Unfortunately, it doesn’t mean much based on the bulleted points above and the fact that other batches of spirulina have not improved vitamin B12 status (see B12 in Tempeh, Seaweeds, Organic Produce, and Other Plant Foods).
Interestingly, the Watanabe group didn’t cite the Indian paper in their 2013 review which included a section on spirulina, so apparently I’m not the only one to hear about these papers years after they’ve been published.
1. Watanabe F, Yabuta Y, Tanioka Y, Bito T. Biologically Active Vitamin B12 Compounds in Foods for Preventing Deficiency among Vegetarians and Elderly Subjects. J Agric Food Chem. 2013 Jul 17;61(28):6769-75. | link
2. Watanabe F. Vitamin B12 sources and bioavailability. Exp Biol Med (Maywood). 2007 Nov;232(10):1266-74. | link
3. Takenaka, S.; Sugiyama, S.; Watanabe, F.; Abe, K.; Tamura, Y.; Nakano, Y. Effects of carnosine and anserine on the destruction of vitamin B12 with vitamin C in the presence of copper. Biosci., Biotechnol., Biochem. 1997, 61, 2137-2139. | link
4. Bito T, Ohishi N, Hatanaka Y, Takenaka S, Nishihara E, Yabuta Y, Watanabe F. Production and Characterization of Cyanocobalamin-Enriched Lettuce ( Lactuca sativa L.) Grown Using Hydroponics. J Agric Food Chem. 2013 Apr 12. [Epub ahead of print] | link
5. Kumudha A, Kumar SS, Thakur MS, Ravishankar GA, Sarada R. Purification, identification, and characterization of methylcobalamin from Spirulina platensis. J Agric Food Chem. 2010 Sep 22;58(18):9925-30. | link
A case study of B12 deficiency from 2009 has been sitting in my “to read” folder and I finally got to it due to being confined to an airplane for a few hours today. The patient was a 31-year old Taiwanese male. Over the course of a few years he became more and more paranoid and schizophrenic until he was admitted due to alarming paranoid behavior. At first he was placed on an anti-psychotic drug. 7 weeks later, he was back in the hospital and this time it was discovered that he had been vegetarian since his teenage years with his only source of vitamin B12 being “minimal intake of dairy products.” The anti-psychotic drug was replaced with 1,000 µg per day of oral cobalamin. His state improved in 2 weeks and 1 year after discharge he had not had another episode. His B12 levels went from 136 to 227 pg/ml in the first 2 months of therapy.
Another more recent paper (2013) reported that of 19 patients demonstrating psychiatric illness at an Indian clinic, 14 had followed a “strict” vegetarian diet. Not many details were given, though 15 of the 19 patients had low B12 levels, defined as < 225 pg/ml.
I have no more papers on B12-deficient vegetarians in my “to read” folder. I hope it lasts for awhile…
1. Kuo SC, Yeh CB, Yeh YW, Tzeng NS. Schizophrenia-like psychotic episode precipitated by cobalamin deficiency. Gen Hosp Psychiatry. 2009 Nov-Dec;31(6):586-8. | link
2. Jayaram N, Rao MG, Narasimha A, Raveendranathan D, Varambally S, Venkatasubramanian G, Gangadhar BN. Vitamin B₁₂ levels and psychiatric symptomatology: a case series. J Neuropsychiatry Clin Neurosci. 2013 Spring;25(2):150-2. | link
It has been two months since I asked for support. I got some good support in June so I didn’t send out a request, but I received very little in July.
I didn’t make too many posts in July due to being out of town and because two of the posts I made required a lot of research. Still, when I look over the posts from June and July, I am stunned at the amount of info! Here are the highlights:
Now I ask you — where else can you get this sort of information?! I write about the good, the bad, and the ugly, all in an effort to cut through the propaganda and keep vegans as healthy as possible.
Please support my writing by giving a donation if you can afford one (click here). And also please like and share my posts and use the links in the box below to purchase items you buy online. Thank you very much – it really does allow me to write more!
I get questions about carrageenan fairly often so I’m passing on the latest Nutrition Facts video, Is Carrageenan Safe?
Carrageenan is a seaweed that is used as a thickener in many non-dairy milks and other products. It apparently can cause intestinal inflammation in some (or many?) people. Check the very short video out for more information.
Readers have asked me to keep letting them know about these cases, so here it is:
A 62 year old woman in Switzerland, strict vegetarian, was found wandering the streets. Her delirium was determined to be vitamin B12 deficiency. She was treated with 1,000 µg injections weekly and within 4 weeks she had regained a stable mental status and returned to full-time work. (1)
It turns out that she had suffered from B12 deficiency on a number of previous occasions but without the neuropsychiatric symptoms. I hope she will start taking B12 and not rely on being found wandering the streets which might not end so well the next time.
I researched the issue and added the following section to VeganHealth.org’s article Cadmium:
In 2001, Krone et al tested six zinc supplements from Seattle area health food stores to see if they contained cadmium (1). According to the authors, “Because the chemical properties of [zinc] and cadmium (Cd) are so similar, these two elements invariably occur together in nature.”
They found that the single zinc supplements had very low levels of cadmium whereas the multi-mineral supplements had enough that taking the RDA of zinc would provide up to 2 µg of cadmium (20% of the daily limit recommended by the US Federal Drug Administration (FDA)). It also happens that three of the supplements with low levels of cadmium were in the form of zinc gluconate whereas none of the multi-mineral preparations were the gluconate form. So, it could be that zinc gluconate is unlikely to have much cadmium or that single zinc supplements are unlikely.
According to their website, the supplement manufacturer Kirkman, from Oregon, does a rigorous job testing their supplements for contamination of cadmium and other impurities (more info). They also have an article on their site, Cadmium: A Serious Heavy Metal and Topic. They ship outside the United States.
1. Krone CA, Wyse EJ, Ely JT. Cadmium in zinc-containing mineral supplements. Int J Food Sci Nutr. 2001 Jul;52(4):379-82. | link