Response to: Vegan Vitamin B12 Deficiency is a Myth
On Saturday, August 21, NaturalNews.com published an article by Cindy Jones-Shoeman, Vegan Vitamin B12 Deficiency is a Myth.
The article starts out by saying that “nothing could be further from the truth” than the idea that vegans can suffer a B12 deficiency from their diet.
The article by Jones-Shoeman appears to be a rehashing of an old article (apparently from 2004 or earlier) by Vivian Vetrano, “Rethinking & Clarifying the Vitamin B12 Issue” which appears on the Rest of Your Life Retreat website: roylretreat.com/articles/b12.html.
Although Vetrano’s article is one of the most fanciful stories I’ve ever read about vitamin B12, it is rather detailed and I will only respond to the excerpts from the Jones-Shoeman article:
“According to Dr. Vivian V. Vetrano, vitamin B12 actually comes from coenzymes, which are already present in bacteria found on the human body (in and around the mouth, for example).”
Vitamin B12 does not come from co-enzymes, it is a co-enzyme. Bacteria do produce vitamin B12, but there is no proof that bacteria living in most people’s mouths produce active vitamin B12 or produce it in amounts large enough that it could prevent B12 deficiency. This is underlined by the fact that many vegans develop full-blown vitamin B12 deficiency, and in some cases permanent neurological damage, as can be seen here: VeganHealth.org/b12/cases. In addition to those cases in the scientific journals, I have known many people who have suffered from B12 deficiency and cured it by supplementing with cyanocobalamin (the most stable form of vitamin B12).
About a dozen studies have correlated low vitamin B12 levels in vegans with elevated homocysteine levels. Elevated homocysteine levels have been linked to early death, primarily from cardiovascular disease, and Alzheimer’s Disease. More details on that are at VeganHealth.org/b12/hcy.
“In fact, vitamin B12 deficiency is often, according to Dr. Vetrano, a symptom of a larger problem; that is, it’s not caused from a poor diet but rather from deficiency diseases…”
While it is true that about 2% of the population has trouble absorbing vitamin B12, the vast majority of problems that have been seen in vegans have been caused by a low B12 intake, not from absorption problems.
“Vitamin B12 deficiency due to a vegan diet is simply a lie that finally needs to be put to rest.”
Unfortunately, this could not be further from the truth. The most common, serious damage that results from vitamin B12 deficiency is when a pregnant vegan who does not supplement has a baby who also does not get any B12 supplementation. Typically, around 6 months of age, the infant’s growth and neurological development ceases and then begins to regress. In many cases, such infants have sustained permanent brain damage.
Vitamin B12 deficiency among vegans is real and is not something to be flippant about. It is so important that a number of vegan health professionals and organizations have endorsed an open letter to the vegan community, What Every Vegan Should Know about Vitamin B12 (VeganHealth.org/articles/everyvegan). This letter has been signed by The Vegan Society (UK), Vegan Outreach, and many members of the International Vegetarian Union science group.
August 23rd, 2010 at 1:53 pm
“What Every Vegan Should Know about Vitamin B12″ suggest 2000 micrograms weekly… I assume this is for adults. How much should I be giving my son (he is 5)?
August 23rd, 2010 at 2:45 pm
Nicola,
It’s somewhat arbitrary since there haven’t been studies done on weekly amounts for vegan kids. I’d give him 250 mcg, three times per week.
August 23rd, 2010 at 2:58 pm
I figured as much. Thanks for your help!
August 23rd, 2010 at 4:08 pm
What are some early signs of b12 deficiency? Are there any foods that inhibit b12 absorption? Are there foods that enhance b12 absorption?
August 23rd, 2010 at 7:07 pm
Devin,
1. They are listed here: http://veganhealth.org/b12/sympt
2. No.
3. No.
August 24th, 2010 at 7:46 am
I’m stealing and paraphrasing this from a well known vegan adovacate, but one of the first signs of a vitamin b-12 deficiency is crazy talk about not needing to get vitamin b-12
August 24th, 2010 at 10:37 am
Do you have a favorite brand or brands of b-12? I used to use solaray sublingual and they lasted a long time under the tounge, but found that twinlabs sublingual is cheaper (at our local store), but it dissolves so quickly I wonder if that negatively impacts absorption? Thanks!
August 24th, 2010 at 12:01 pm
Sarah,
I don’t have a favorite brand. Chewing the tablet up good should ensure proper absorption.
August 24th, 2010 at 2:14 pm
Ive trained/race with the best in cycling. They ALL do b12 injections on a regular basis and NONE of em are vegan.
What is the biggest demographic group of b12 supp takers?: mainstream bodybuilders and they also eat the largest amounts of animal products.
Personally I feel everyone can get some benefit from taking a b12 supp as we live in such a sterile world thesedays. We put b12 in dog, cat, fish food. Just read the packaging next time your at the supermarket.
I didnt supp for years cos I thought it was ‘unatural’ but in hindsight, living in this society is unatural and a b12 supp is like a ‘getting back to nature’ ticket healthwise.
Ive got a lot of raw meat eating mates and we get their b12 serum levels checked and they are all borderline deficient or deficient in b12.
August 25th, 2010 at 12:04 am
Great post. I’d like to add that there is sound scientific evidence from UK that has demonstrated that 50 % of vegans can be considered as B12 deficient ( “Half of the vegans were categorized as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency.”) Gilsing AM, et al. Eur J Clin Nutr. 2010 Jul 21
August 25th, 2010 at 7:22 am
Well, now I feel silly. I foolishly assumed that my daily multivitamin was giving me adequate B-12; I mean, it says on the bottle, “100% of daily requirement.” Yet the actual amount/pill is only 6mcg! Which means I’m only getting 42mcg/week (not counting whatever I get through food), right? Yikes. Do you agree, then, that adults should be getting 2000mcg/week?
August 26th, 2010 at 7:18 am
Devin,
“Preliminary evidence suggests that vitamin C supplements can destroy dietary vitamin B12. … Clinical significance is unknown, and it can likely be avoided if vitamin C supplements are taken at least two hours after meals.”
http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-vitaminb12.html
August 26th, 2010 at 7:59 am
Reijo,
Although they were just recently reported, the B12 levels in that study were measured from 1994 to 1997 with some follow-up measurements in 2001. This was before many vegan nutritionists made a push to get the vegan community to recognize the need for B12. We hope things have improved a lot since then.
August 26th, 2010 at 8:01 am
Marya,
The less often you get B12, the more you must take. Here are my recommendations for taking it on a daily basis: veganhealth.org/articles/dailyrecs
August 26th, 2010 at 7:44 pm
In regard to nutritional yeast, you list redstar and twinlabs as being fortified. I have seen Bob’s Red Mill listed as fortified/vegetarian support. is it the same as Red Star? I know that you don’t recommend it as a sole source of B12 but I loved the stuff and would like to have an idea if what I’m eating has any B12 in it so I can make decisions about what/how much other supplements to take.
August 26th, 2010 at 8:09 pm
Laurie,
Not all Red Star yeast is fortified. If the package doesn’t say it’s B12 fortified, then you should assume it isn’t. If there is no packaging, you should assume it isn’t fortified. Not sure about Bob’s Red Mill.
August 27th, 2010 at 5:03 pm
I’m so glad you wrote about this. Some fellow vegans have posted it (the original article) on their Facebook pages and I got worried that people would take it as gospel. It is such a serious issue- you don’t mess with the brain!
September 3rd, 2010 at 12:43 am
Thanks a lot for your response to my comment. I could not imagine that almost ten years old data is published but your right. In a cross sectional setting this old data does not as much value.
September 22nd, 2010 at 7:21 pm
After about 2 1/2 years being vegan I was sent to a neurologist for a b-12 deficiency. I had lightheadedness when getting up sometimes my heart would race and feel like I was about to black out. I had numbness in my fingers from nerve damage (they did a nerve test), my left shin was very sore, I was very tired irritable and white spots of dry skin on forearms. My neurologist did not spend much time with me, his patients are pushed along like cattle with many months between appointments. I supplemented with sublingual losenges and after about a year I almost recovered. Now the symptoms are coming back, I am supplementing about 2,000 mcg or more per day. I have no more health insurance. My theory is this……I think alcohol flushes the B-12 out of my liver. Do you agree? I quit drinking alcohol and continue supplementing. I am hoping for the best. I am concerned about my heart as a result. I wish there was a natural way to get b-12 without having to supplement.
September 23rd, 2010 at 3:32 pm
Patrick,
I’m sorry to hear about your problems. Have you been supplementing with sublingual lozenges every since your first diagnosis of B12 deficiency? How often?
How long have you had your latest bottle of B12? You might want to get a new bottle just to make sure the one you have isn’t too old or was messed up in some way.
To answer your question, I have never seen any research suggesting alcohol flushes B12 out of your liver.
September 23rd, 2010 at 4:16 pm
No I didn’t always supplement with sublingual losenges. I was taking a multivitamin. When I became aware of the deficiency I started the losenges. It took a while to diagnose. At first they were sending me to a hemotologist for tests because my white blood cell count was getting low. The hemotologist found nothing wrong. I started the sublingual losenges and noticed a slow but steady improvement. I notice when I drink alcohol the symptoms seem to worsen.Mthylcobalamin, cyanocabalamin, nutritional yeast, fortified milk (soy or coconut), and bee pollen is where I get my b-12. I have had fresh bottles. Thank you for your reply.
September 28th, 2010 at 9:22 am
Patrick,
I don’t know what more to tell you then. If your b12 levels are good then the problem must be with something else. You might want to cut back on the B12 supplements to a more normal level of supplementation, like 10 to 25 mcg per day.
Jack
October 24th, 2010 at 10:42 am
Patrick – I was diagnosed with B12 deficiency a couple years ago. I’m not vegan, have not had surgeries to warrant it and IF is fine.
Sublingual lozenges (1000 mcg/day) restored my levels (blood tests) w/i one year.
I used to fall asleep at work in the afternoons, had horrible thigh muscle heaviness, couldn’t run my daily 6 miles, or walk the dog for more than 20 minutes for that matter, had neuro problems (balance, spatial depth problems, tingling, etc.)
Fortunately, the supp resolved everything except ongoing fatigue and, like you, feeling wiped if I have alcohol. Interesting to hear someone else is experiencing the same thing as me!
It’s the strangest thing. I had no problem with light wine drinking over the years (45yo) and then, concurrently with B12 fatigue, I couldn’t handle any alcohol. I would be wiped for 2-3 days after one glass of wine. I wonder if the wine does alter B12 accumulation in the liver. But how would we even test for that… B12 levels are blood tests.
Liver cancer does run in the family so maybe the alcohol is correlational and not causative. Any liver cancer in your family?
Best,
Sandra
October 24th, 2010 at 11:26 am
Sandra, thanks for sharing. I have had no liver cancer but my father had kidney cancer. I am convinced that alcohol can prevent absorption of many vitamins including b-12 and there is a direct correlation with drinking alcohol and b-12 symptoms getting worse. I don’t think I need a test, I think I know now. I have cut out alcohol and it seems my b-12 symptoms are under control. I am glad to hear that supplementing has improved your b-12 condition. On a more positive note, I have noticed since I became vegan my immune systom has gone through the roof. I never get sick anymore. Not even a cold. There have been times where my whole family was sick and I was surrounded by it and thought I would catch it too but I don’t. It has been about 6 years now. I will be 46 next month and I am the healthiest I’ve ever been. I give credit to fresh fruits and vegetables.
April 12th, 2011 at 10:19 am
It is SO irritating that I constantly see people on Twitter and Facebook perpetuating this idea that there is Vitamin B12 in unwashed produce, and spirulina and vegans don’t need to worry. Plus there is no point in arguing with them since they get all of their information from raw food gurus who think we can all live on nothing but bananas and air.
July 19th, 2011 at 12:56 am
Dear Mr. Norris,
I have been vegetarian all my life. I am trialing to be vegan now. I was referring to your link :-
http://veganhealth.org/articles/dailyrecs
I am unsure how to interpret the table on B12. The US RDA (µg) is 2.4, while the Daily Dose (µg) is 25 – 100, which is 10 to 40 times the RDA. So are we supposed to take the RDA (2.4) or the Daily Dose (25-100)?
Thanks
July 19th, 2011 at 6:08 pm
Manish,
Because people can only absorb a small amount of vitamin B12 at one time, the doses for taking once a day or once a week (or even twice a day) are much higher than the RDA. You also might be interested in this:
http://jacknorrisrd.com/?p=1038
August 15th, 2011 at 10:35 am
Oh thank you, just found this blog post of yours, so I don`t have to worry about Cyanocobalamin ( roylretreat.com/articles/b12.html. )
October 12th, 2011 at 2:45 pm
I have been vegetarian since I was under 10 and became vegan almost 5 years ago. I do not supplement, I rarely eat fortified foods, I have had 4 healthy pregnancies (2 of them while vegan) and all of the boys are healthy vegans. I recently had blood work and it did not show any deficiency. I am not saying this to be argumentative but just to put it out there.
October 12th, 2011 at 3:50 pm
Chrissy,
Many people haven’t been as lucky as you. Did you have your homocysteine or MMA levels checked?
January 21st, 2012 at 5:04 pm
Do the martial artists at the schools in China take supplements everyday? Because most of them (maybe all) don’t eat meat.
I seem to think it’s due to people’s diet before they became Vegan. Acidic foods, chemicals and all kinds of crap damaging the body. RawFamily.com books have some nice info on acidic diets damaging bacteria in the body and they say it takes a while for the good bacteria to build up again after changing to a plant diet.
January 21st, 2012 at 5:06 pm
This whole B12 is a fantastic way to keep you all on the drip.
January 21st, 2012 at 6:16 pm
manbearpig,
Studies of B12 levels among raw foods vegans have shown them to be just as B12 deficient as any other group of vegans who do not supplement. You can read more here.
> This whole B12 is a fantastic way to keep you all on the drip.
Actually, it’s not.
February 15th, 2012 at 4:35 am
Can we learn anything from our vegan animals like the elephant or the giraffe? They seem to be needing b12 as well, but where do they get it from?
February 15th, 2012 at 9:01 am
Ishai,
http://veganhealth.org/b12/animal
March 24th, 2012 at 1:55 pm
is vegan a lifestyle choice, a religion, an advocacy group, or …
After how many decades will there begin to be measurable evidence – i.e.: life expectancy – that vegans (or vegetarians) benefit from their choice? Diatribe posted by adherents in the likes of wikipedia does not qualify. My blood pressure has hovered consistently WELL below 120/80 for over two decades, last three measurements around 100 over 60 (that’s not a typo) and I consume meat or fish just about daily. However, I am a “careful” eater, I do not consume the likes of fried foods, and have never smoked. I also put 100 miles on the bike weekly. Vegetarianism is likely conducive to better health because it seems to make the practicioner more nutritionally aware, otherwise I remain convinced that it is nonsense, while veganism may be dangerous. If it is a religion, or a preferred lifestyle, then fine, go for it. However, I do wish somebody would start producing some independent research to settle all the nonsense such as the B12 related nonsense spewed by “true believers”.
March 24th, 2012 at 2:01 pm
Curious,
I’d be the first to say that you don’t have to be vegan to have good health. But, that said, on average vegans have very low cholesterol levels, rates of diabetes and hypertension, and body mass indexes. You can see the research here: http://www.veganhealth.org/#res.
We will probably have some good measurements of vegan mortality within the next 10 years coming out of EPIC-Oxford and Adventist Health Study-2 cohort studies.
May 30th, 2012 at 11:24 pm
Bravo Jack for continuing to get the research and truth/facts out about B12!!!
Here is my B12 allegory using Gas Station Attendant = GSA and (fuelish) Car Driver = CD
GSA: Do you need some gas?
CD: No, I don’t have any symptoms of being low on gas.
GSA: Yes, but you won’t have any symptoms till it is to late.
CD: Yes, but I have no symptoms.
GSA: What does your gas gauge show you? (testing for MMA, homocysteine, holotranscobalamin…)
CD: I took out my gas gauge because my reasoning is that if they didn’t have gas gauges in the very first cars why should I. I prefer the natural approach of using my intuition and feelings?
GSA: So you are saying you have no objective metrics to indicate if you are getting low on gas, and you prefer to rely on your intuition and feelings as to when you need more gas?
CD: Yup!
GSA: WOW… Good luck with that!
September 21st, 2012 at 3:14 pm
curious . . . here is a link to research on B12, the short videos are made by Dr. Greger who sources the research studies from Medical journals and pub med. I hope this helps. http://nutritionfacts.org/?s=b12 The recent research confirms B12 is directly responsible for floppy baby syndrome where the baby died shortly after birth and the mother was charged and went to court. How sad.. . . regards
September 28th, 2012 at 9:29 am
Some health advocates (Mike Adams of Natural News, Matt Monarch of Raw Reform, and Gabriel Cousens from Tree Of Life) suggest that cyanocobalamin, the most common form of supplementary form of Vitamin B12, isn’t the most readily bioavailable form. They all suggest taking methylcobalamin. In fact, there are Vitamin B12 patches available by the company Healthy Habits that contain 1000mcg, as well as 400mcg of folic acid.
Is this transdermal method more effective at getting the B12 where it needs to go, and is methylcobalamin indeed more bioavailable? At what point do we begin to split hairs over this issue?
Thank you for your time! This is a a great thread.
September 28th, 2012 at 10:16 am
Mel:
Methyl vs. cyano:
http://veganhealth.org/b12/noncyanob12
I haven’t seen research on transdermal.
April 30th, 2013 at 4:02 am
First things first, you’re doing great job running this blog Jack. Up to date knowledge about nutrition stored in one place is priceless.
Anyway, my question relates to level of absorption of the B12 taken from supplements. I’ve just read an interview with Roman Pawlak Ph.D., RD, who claims that b12 absorption from supplements is only about 1%, therefore daily dose for vegans is 240-250 μg of the b12, which is two and a half more then I can read in your Nutrient Recommendations for Vegans chart. Could you please relate to this issue?
best regards
Maciek
April 30th, 2013 at 8:42 am
Maciek,
It actually cannot be overstated that if you take B12 in two doses a day, you’re going to be much better off than one dose. That said, I have no problem with someone taking 250 µg per day. Here is how I formulated my recommendations:
http://veganhealth.org/b12/formula
I’m actually considering getting rid of all but the two-doses-per-day recommendations because the others are much more theoretical.