B12 Status of Older Indian Vegetarians

On Friday, a cross-sectional study was released from India examining the B12 status of apparently healthy people aged 60 and older (average age of 66 years). The study included both omnivores and vegetarians. Ninety-nine of the participants were vegetarian (presumably lacto-ovo) and 76 were omnivores.

There was significant exclusion criteria including cardiovascular disease as well as memory difficulties. The participants were from affluent areas.

Sixty-two of the participants were taking multivitamin supplements. They had significantly higher plasma B12, and lower methylmalonic acid (MMA)a and homocysteine (HCY)b levels. Only 2 people consuming supplements had higher than normal homocysteine levels.

61% of the vegetarians had elevated MMA levels vs. 46% of the omnivores. 17% of the vegetarians had homocysteine levels above 15 µmol/l vs. 7% of the omnivores.

There was no significant correlation between plasma B12, MMA, or HCY levels and any of the 10 cognitive tests given the subjects.

In summary, it appears these vegetarians could have been doing a bit more to improve their B12 status but so far no harm had come from their less-than-ideal levels. B12 supplements proved to be of value. Given that this was a cross-sectional study with stringent exclusion criteria, it may not be representative of the larger population.


aMethylmalonic acid (MMA) levels are a specific measure of vitamin B12 status. MMA is not thought to be harmful, particularly at slightly elevated levels.

bElevated homocysteine (HCY) is associated with low B12 and folate intakes and levels, as well as risk of early death, heart disease, stroke and dementia. More info at Mild B12 Deficiency – Elevated Homocysteine.


Shobha V, Tarey SD, Singh RG, Shetty P, Unni US, Srinivasan K, Kurpad AV. Vitamin B 12 deficiency & levels of metabolites in an apparently normal urban south Indian elderly population. Indian J Med Res. 2011 Oct;134(4):432-9.   |   Link

5 Responses to “B12 Status of Older Indian Vegetarians”

  1. TS Says:

    They’re more likely lacto-veg, not lacto-ovo vegetarian. Egg isn’t considered vegetarian in India (although it’s changing recently, but this is a study for older individuals).

  2. rick Says:


    Have you looked into transdermal B12? Proponents of the patch claim higher absorption than sublingual.


  3. Jack Norris RD Says:


    I don’t see any research on B12 absorption via transdermal:


  4. beforewisdom Says:

    Your post states that most people in the study were taking supplements. Since some of them had elevated MMA levels I’m guessing the supplements were multivitamins or simply did not include single b-12 supplements?

  5. Jack Norris RD Says:


    62 of the 175 participants were taking multivitamin supplements. I’m not sure if any were taking B12-only supplements. I just updated that post to reflect that it was multivitamins.

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