Vitamin B12 recommendations for total-vegetarians!
By
Alan Goldhamer, D.C.,
and Douglas Lisle, Ph.D.
Individuals
seeking to support their health by following a vegan (total vegetarian) diet often
face a multitude of advice-laden comments from friends, family, and even their
physicians. Typically, these communications suggest that vital nutrients are
commonly deficient in the vegan diet. The old standby, “But you can’t get
enough complete protein without meat,” recently has been joined by, “But you
need fish oil for essential fatty acids.” Such advice is, of course, incorrect,
being little more than the “deficiency paranoia” of the ill informed.
Knowledgeable people have few serious health concerns about the adoption of a
vegan diet. Vitamin B12, however, is the rare exception.
Reason for concern
The
concern over whether a vegan diet can ensure adequate vitamin B12 is a question
that vegans must face squarely. For those who have been philosophically
committed to the notion that a strict vegan diet can and will give you
everything you need, we have a warning: Vitamin B12 is a material essential for
your optimal health, and a strict vegan diet may not be providing this vitamin
at adequate levels for you. There are legitimate scientific questions about how
best to assure adequate B12 intake. In this article, we will examine carefully
the “B12 Question,” and offer suggestions that we believe may prove to be
helpful.
Overview of vitamin B12
Vitamin
B12 was first isolated in 1948. It is derived exclusively from bacteria. Since
that time, research has established that vitamin B12 is required for a number
of important functions, including the synthesis of thymidylate—a
substance necessary for DNA synthesis. In addition, vitamin B12 is necessary
for chemical interactions that make possible the recycling of methyl folate. If a person is deficient in vitamin B12, this
recycling process can be disrupted. The deficiency then can result in problems
identical to those caused by a folate deficiency,
such as the death of hematopoietic cells in the bone
marrow. Vitamin B12 deficiency also can result in inadequate myelin synthesis.
Myelin is the fatty substance that insulates some nerves, allowing for normal
neurological communication. If myelin synthesis is impaired, neurological
problems can result. Difficulties can include numbness in the hands and feet,
unsteadiness, poor muscular coordination, and even cognitive deficits such as
confusion, mental slowness, and memory problems.
Most
people obtain the majority of their vitamin B12 intake from animal products.
Although most people associate vitamin B12 deficiency with vegan diets, the
majority of cases occur among people who regularly consume animal products. So,
it should come as no surprise that vitamin B12 deficiency can occur in vegans.
Finding a good source
There
is no dispute that we must be concerned about obtaining adequate vitamin B12.
The question is, “Do vegans need to resort to eating animal products—and expose
themselves to the well-documented health risks of these foods—in order to
maintain adequate vitamin B12 reserves?”
Before
attempting to answer the above question, we need to consider whether animal
products are naturally necessary for humans to maintain vitamin B12 reserves.
This raises two important questions: “Have animal products always been the sole
purveyor of vitamin B12 in the human diet?” and, “Are they the best source of
this nutrient?”
We
believe that the answers to both of these questions are likely to be “no.” Upon
reflection, we should note that in a more primitive setting, human beings
almost certainly would have obtained an abundance of vitamin B12 from the
bacterial “contamination” of unwashed fresh fruits and vegetables—regardless of
their intake of animal products. Human vitamin B12 deficiency is very unlikely
to occur in such a setting. Only very small amounts of dietary vitamin B12 are
needed because our bodies do a fabulous job of recycling this essential
nutrient. A person living in the ancestral environment regularly would have
consumed fresh fruits and vegetables that were not consistently, fastidiously
cleaned—as we routinely do today. Our current unusual degree of hygiene is
useful for combating many health threats—but may leave long-term, strict vegans
vulnerable to the potential problem of vitamin B12 deficiency.
A little goes a long way
Even
in the modern environment, with our fastidious food cleanliness, a person
consuming a vegan diet may never experience the need for vitamin B12
supplementation. Even the small amounts of B12 commonly found in the nodules of
organically-grown root vegetables, and the small amounts produced by the
bacteria in our own mouths, may be enough to sustain many of us. A very little
of this substance can go a long way. For those who switch to a vegan diet, for
example, there are usually stores of B12 in the liver that can last for several
years, or even decades. However, the doctors at the
Keeping it simple
Our
advice is straightforward: If you adhere to a vegan diet, we recommend that you
either (1) have yourself tested for vitamin B12 deficiency every two years, or
(2) ensure a reliable source of vitamin B12. The most appropriate test for evaluating
B12 status is the blood or urine test for methylmalonic
acid (MMA). Elevated MMA is currently our best tool for detecting vitamin B12
deficiency, and is considered to be superior to testing for serum B12 directly.
We recommend that if you choose to avoid all animal products, fortified foods,
and supplements, periodic testing for elevated MMA is indicated. The laboratory
utilized by the
If
you would like to avoid MMA testing, we then would recommend that you include a
reliable source of vitamin B12 in your diet. For people without a deficiency, a
single sublingual B12 tablet (250-500 micrograms), once or twice per week,
should be sufficient to maintain most individual’s serum B12 levels and body
reserves. For those with a known deficiency, a consultation with a Hygienic
physician is indicated. However, in most cases, this problem can be readily
addressed with oral supplements without resorting to the injection of vitamin
B12.
We believe that a diet that includes animal
products, although adequate in vitamin B12, poses many health risks that are
best avoided.
Playing it safe
Unlike
many unfounded “deficiency problems” associated with the vegan diet, the issue
of potential vitamin B12 deficiency is real. However, B12 deficiencies, when
they occur at all, take years to develop—so don’t take our cautioning like the
blaring of a five-alarm fire. If you choose to consume a diet consisting
exclusively of whole natural foods, as we recommend, it is possible that—partly
as a result of our modern cleanliness—you may become B12 deficient.
We
recommend that you test periodically to assure that this does not become a
problem. If it does, consult with a doctor who can advise you on how to take a
responsible course of action.
With
a bit of prudence, you can have the best of both worlds—all of the benefits of
a vegan diet and none of the problems with animal products.
For more
information see our WEB site at www.healthpromoting.com