Is vitamin B12 deficiency in vegetarians and vegans a real problem? Vegan guru Dr. McDougall recommends a diet based on starch, vegetables, and fruits, and makes it sound as if B12 deficiency among vegans is a small issue:
To avoid the extremely rare chance of becoming a national headline, add a reliable B12 supplement.
Similarly, Dr. T. Colin Campbell of the famous China Study says:
If you do not eat any animal products for three years or more, or are pregnant or breastfeeding, you should consider taking a small B12 supplement on occasion.
This kind of advice is misleading. The chance of severe B12 deficiency among vegans (and to a smaller extent, vegetarians) is not rare at all, and both vegans and vegetarians should supplement with B12 on a daily basis, not just on occasion.
Just look at the data:
Vegans, Vegetarians & B12 Deficiency
Thus, with few exceptions, the reviewed studies documented relatively high deficiency prevalence among vegetarians. Vegans who do not ingest vitamin B12 supplements were found to be at especially high risk. Vegetarians, especially vegans, should give strong consideration to the use of vitamin B12 supplements to ensure adequate vitamin B12 intake.THE PREVALENCE OF COBALAMIN DEFICIENCY AMONG VEGETARIANS ASSESSED BY SERUM VITAMIN B12: A REVIEW OF LITERATURE
Higher rates of deficiency were reported among vegans compared with vegetarians and among individuals who had adhered to a vegetarian diet since birth compared with those who had adopted such a diet later in life. The main finding of this review is that vegetarians develop B12 depletion or deficiency regardless of demographic characteristics, place of residency, age, or type of vegetarian diet. Vegetarians should thus take preventive measures to ensure adequate intake of this vitamin, including regular consumption of supplements containing B12.HOW PREVALENT IS VITAMIN B(12) DEFICIENCY AMONG VEGETARIANS?
Mean serum vitamin B12 was highest among omnivores, intermediate among vegetarians and lowest among vegans . In all, 52% of vegans, 7% of vegetarians and one omnivore were classified as vitamin B12 deficient.SERUM CONCENTRATIONS OF VITAMIN B12 AND FOLATE IN BRITISH MALE OMNIVORES, VEGETARIANS AND VEGANS: RESULTS FROM A CROSS-SECTIONAL ANALYSIS OF THE EPIC-OXFORD COHORT STUDY
Nevertheless, the data are compelling, and they indicate that vegetarians should routinely take cobalamin or vitamin B-12 supplements, which in their generic form are relatively inexpensive. In developing countries, other formidable problems were incurred in attempts to implement a program of supplementation of other vitamins. Yet the lack of a comprehensive initiative to protect vegetarians from vitamin B-12 deficiency can lead to a whole generation of cobalamin-deficient children (and adults) who are incapable of making good decisions because of the additional burden of neurologic deficits induced by cobalamin deficiency. The international nutrition community must take up the challenge posed by this body of evidence and enact practical steps to ensure parity in the vitamin B-12 status of vegetarians and omnivores.VEGETARIANISM AND VITAMIN B-12 (COBALAMIN) DEFICIENCY
Vegetarian subjects presented significantly higher tHcy levels, higher prevalence of hyperhomocysteinemia, and lower serum vitamin B(12) levels than controls.Effect of vegetarian diet on homocysteine levels
No Plant-Based Sources of B12?
In contrast to animals, plants don’t need B12, so they don’t store it. Some algae like spirulina have inactive B12 analogues called cobamides, but these may actually interfere with B12 activity and increase the need for the real, active forms of B12.
Vitamin B12 is unique. It is the only vitamin that has an inherent trace element, cobalt (hence its name, cobalamin). The cobalt is found in the grass and soil, where bacteria lives and feeds on it. When herbivore animals feed on grass, they ingest that bacteria, which ends up multiplying in their stomachs, producing vitamin B12.
We, and many other mammals, get our B12 by eating those animals. It’s the natural cycle of life, because when we die, we are slowly absorbed by the earth, enriching the soil and helping new, healthy grass to grow for the same bacteria and herbivore creatures.
By the way, a very similar process happens in the ocean’s food chain, making marine animals like clams, oysters, octopus, and some fish very rich in B12 as well.
If you are vegetarian or vegan, you must supplement on a daily basis. Otherwise, the symptoms of B12 deficiency will start to appear, and the inevitable nerve damage will follow. Take this advice seriously, because damage is often irreversible.
That being said, if you’re a vegetarian who eats B12-loaded foods like fish and shellfish on a daily basis, you won’t need any B12 supplements (unless you have absorption issues, but that’s a different story). For anybody else, here’s a solution:
Since there are virtually no plant-based foods high in B12, we’d like to present a unique solution to both vegans and those vegetarians who don’t consume enough B12:
Bivalves. To be more specific, oysters:
Because I eat oysters, I shouldn’t call myself a vegan. I’m not even a vegetarian. I am a pescetarian, or a flexitarian, or maybe there’s an even more awkward word to describe my diet. At first I despaired over losing the vegan badge of honor—I do everything else vegans do—but I got over it. Oysters may be animals, but even the strictest ethicist should feel comfortable eating them by the boatload. … Biologically, oysters are not in the plant kingdom, but when it comes to ethical eating, they are almost indistinguishable from plants. Oyster farms account for 95 percent of all oyster consumption and have a minimal negative impact on their ecosystems; there are even nonprofit projects devoted to cultivating oysters as a way to improve water quality. Since so many oysters are farmed, there’s little danger of overfishing. No forests are cleared for oysters, no fertilizer is needed, and no grain goes to waste to feed them—they have a diet of plankton, which is about as close to the bottom of the food chain as you can get.Consider the Oyster
Bivalves are a brilliant idea. They could fill a lot of the nutrition holes that vegans and vegetarians often face, like retinol (bioavailable vitamin A) and B12. Ethically, oysters, clams, and mussels are similar to plants, in that they don’t have a central nervous system as we know it. Therefore, they are not considered sentients, exactly like plants.
Most important, bivalves are extremely rich in vitamin B12.
Just one or two clams or oysters a day will give you all the B12 you need. Eating these creatures regularly will make for a good vegetarian diet to prevent B12 deficiency. If you can’t bring yourself to eat bivalves (as is the case with religious Jewish people, who don’t consume shellfish), make sure you supplement daily with a good methyl or adenosyl B12 supplement, which are the two best forms (and can be inter-converted in the body).
To sum up, the problem of B12 deficiency in vegetarians and vegans is real.
Keep yourself safe.