B12 is a vitamin that worries vegans and vegetarians the most, as it is thought to be found in meat and as a result to be creating deficiency in those who follow a plant-based (vegan) diet. A long-term deficiency in B12 is certainly a matter to be taken seriously, as it can lead to damage to arteries, shortness of breath, weakness, dizziness, constipation, diarrhea, even depression and dementia-like symptoms, leading to nerve damage. Thus, it’s essential to keep it in sufficient levels.
What’s impressive is that most people who check their B12 blood levels and try to fix them are vegans, due to the misconception that it’s a vitamin we get only from animal products. But if that’s true, why do more and more meat-eaters present low levels of B12 in their labs?
The answer to this is simple: vitamin B12 is not made by plants or animals. It is found in soil, made by microbes, and theoretically it passes from soil to animals and plants to our plate (1). But in today’s world where everything is sanitized, where soil is filled with chemicals and we do everything we can to kill of all bacteria, these microbes don’t survive as they used to, so they don’t produce enough vitamin B12. Taking this into account we must understand that all of us, not just vegans, are at risk of a deficiency.
Good thing is that vitamin B12 is being stored for a long time in our system, so a deficiency can take years to develop, if our nutrition doesn’t provide us adequate amounts. Bad thing is that if we have a deficiency we don’t know of, the results can be devastating, as there are reported cases of psychosis, paralysis, even death. Also, as we get older, the ability to absorb B12 declines so we need to take measures and stay on the safe side.
Following a plant-based (vegan) diet is certainly a good choice for our health and the planet and among all it can drop levels of homocysteine which is associated with cognitive decline and Alzheimer’s. We need to keep in mind, however, that if we’re B12 deficient, everything can get worse.
First thing we need to ensure is that our stomach and pancreas work sufficiently in order to absorb the vitamin. Above the ages of 50, for example, there may be insufficient stomach acids to absorb B12 adequately, but this doesn’t mean our age is the only factor that matters, as there have been cases below 40 with deficiency. Other factors that might play a role, especially in malabsorption, are pernicious anemia which is an autoimmune disease, alcoholism, bad nutrition, pregnancy, hypothyroidism, atrophic gastritis, pancreatic problems, autoimmune diseases and long-term use of drugs (colchicine, metformin, antibiotics etc) that interfere with the absorption of B12 (2). If you do have B12 deficiency, consult a nutritionist and check with your doctor to see if there’s a health problem.
Nutritionwise, to raise absorption if you are vegan or
vegetarian, you need to first of all keep balance in your diet, so as to stay
healthy, eating lots of raw fruits and vegetables. Organic is the keyword, in
order to ensure that the soil they’re grown into isn’t full of pesticides that
kill microorganisms that produce B12.
Keep in mind that B12 is absorbed better in small quantities, although there’s
no problem if you get too much. In case your body can’t absorb it, this might
be due to good bacteria deficiency in the gut, where you need to consider
getting some good probiotics to aid the situation.
Supplements are always an easy way to raise your B12 levels, but you need to
take the right supplement in the correct dose. Make sure you talk to your
doctor or nutritionist about supplementing at least 2000mcg each week or 50mcg
daily of cyanocobalamin, which is preferred. If you’re over 65 and on a
plant-based diet, consider increasing up to
1000 mcg of cyanocobalamin each day.
Fortified foods are also helpful, but you need to consume three servings a day, containing at least 190% of the Daily Value (see nutrition facts label) with a target of 4.5 mcg three times a day. Nutritional yeast should cover you with a dose of two teaspoons, three times a day. Tofu is also a good choice when it comes to B12 and protein for vegans, while nori is also a suitable source for vegetarians (3).
Additionally, cut back on alcohol, sprinkle pepper in your food to raise absorption and drink cranberry juice, which might also help in the absorption. Calcium is also essential in order to absorb B12 so ensure you get enough from foods like vegetables, fruit, legumes, nuts and fortified foods. Researchers have found that patients receiving metformin, have diminished B12 absorption and low serum total vitamin B12 because of a calcium-dependent ileal membrane antagonism. (4)
Having all of the above in mind and consulting a specialist, there should be no problem with your B12 and your plant-based nutrition.
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Resources
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788147/
2. https://www.ncbi.nlm.nih.gov/books/NBK441923/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042564/
4. https://pubmed.ncbi.nlm.nih.gov/10977010/
