Vitamin B12 to the Rescue!

By Jack Norris, Registered Dietitian, Executive Director

I’m pictured above in the B12 jersey that VO’s Director of Outreach, Vic Sjodin, recently bestowed upon me.

If you’re new to veganism, or VO’s work, you may not know the history of vitamin B12 and its importance for vegans. This article will bring you up to speed!

Vitamin B12 is the one nutrient that can’t be supplied by plant foods. That’s an inconvenient fact, but the good news is that vegans can easily get enough vitamin B12 from fortified foods or supplements—and if you follow the recommendations (below) you can have even better vitamin B12 status than meat-eaters.

Like many nutrient deficiencies, B12 doesn’t present itself suddenly—in fact, people who’ve eaten animal products their entire lives typically have a store of vitamin B12 that will last them for a significant amount of time. It can be years before a vegan shows signs of deficiency. Due to this slow progression, a controversy has always surrounded whether vegans actually need a dietary source of vitamin B12.

All vitamin B12 is produced by some specific strains of bacteria and the vitamin B12 found in supplements is made from bacteria cultures—it’s not obtained from animals. But animals collect it in their tissues while plants don’t. And before vitamin B12 was discovered in the late 1940s, people’s attempts to be vegan often ended in a state of fatigue or neurological damage. Once discovered, vitamin B12 quickly became available in supplement form and the final piece of the nutrition puzzle was in place for a vegan lifestyle to spread.

The term “vegan” was coined by Donald Watson, one of the founders of the U.K. Vegan Society. The Vegan Society formed in 1944, but it’s not clear to me when they started pushing B12. One of the earliest studies on U.K. vegans from 1955 (1), described significant B12 deficiency with some vegans suffering from nerve damage and dementia.

In 1976, the BBC television show, Open Door, ran an episode on the Vegan Society and interviewed Dr. Tom Sanders who said a vegan diet should be supplemented with vitamin B12.

I became involved in animal rights advocacy and veganism in the late 1980s. Although the American Dietetic Association’s position was that a vegan diet could be healthy if supplemented with vitamin B12, that news didn’t seem to be reaching most of the U.S. animal rights movement. To the extent that movement leaders realized the need for vitamin B12, it was played down so as not to make the vegan diet appear unnatural.

My activism was focused almost solely on spreading veganism, and I started to come across ex-vegans who had failed to thrive on a vegan diet. In my attempt to understand this problem, I started reading the scientific literature and writings by vegan dietitians like Ginny Messina. These writings stated that vegans should supplement with vitamin B12. At the same time, I was alarmed by the case reports of vitamin B12 deficiency in vegan infants, children, and adults—some of which led to permanent damage and death.

I went back to school and became a registered dietitian in 2001. Vegans with health issues started turning to me for help, and I saw a slow trickle of vegan activists with B12 deficiency symptoms—typically tingling in the fingers and toes.

A few others and I made it our mission to inform the animal advocacy movement of the need for vegans to take vitamin B12. In 2003, a group of vegan health professionals and organizations signed an open letter to the vegan community, What Every Vegan Should Know about Vitamin B12, urging vegans to get a reliable source of B12.

Our efforts were largely successful—there are almost no mainstream animal advocacy or vegan organizations that do not acknowledge that vegans need B12. Today, I encounter much fewer cases of vitamin B12 deficiency, but there are still many vegans who haven’t received the news or neglect it.

B12 presents two problems for animal advocacy.

The first problem is that requiring supplementation implies a vegan diet is unnatural. In my mind, this is easily solved—humans didn’t evolve as vegans. In my view, the vegan movement isn’t an attempt to bring humans back to their prehistoric ways of being, but rather to move humans forward in evolution to a more humane diet. We’re lucky to live in a world that makes it possible for us to live without killing animals for food—societies before us have not been so lucky.

See Can a Natural Diet Require Supplements? for more thoughts on this.

The second, more practical problem, is that before we do vegan advocacy in a new region, we need to make sure that vitamin B12 fortified foods or supplements are available. For example, a recent study from Pakistan found that Hindu vegetarians who were eating small amounts of dairy had a high rate of vitamin B12 deficiency with some suffering neurological impairment (2).

Vegan adults can get enough vitamin B12 by following one of these options:

Please see the Daily Recommendations for other age groups.

There are a variety of other options and amounts of vitamin B12 that will work. The amounts I recommend are formulated to have a safety factor for people who might not efficiently absorb B12 or might forget to take it now and then.

Vitamin B12 supplements come in a variety of forms and these recommendations are meant for the most common and most tested form, cyanocobalamin. For information on other forms, see Methylcobalamin & Adenosylcobalamin.

A common reaction to learning about the need for vegans to take vitamin B12 is to wonder if you should go get your B12 levels tested. If you’re apparently healthy, then this isn’t necessary—just make sure you follow the recommendations.

May you live a long and healthy vegan life—be well and B12!

Reference

1. Wokes F, Badenoch J, Sinclair HM. Human dietary deficiency of vitamin B12. Am J Clin Nutr. 1955 Sep-Oct;3(5):375-82. • Link

2. Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among Vitamin B12 deficient young vegetarians. Neurosciences (Riyadh). 2017 Jul;22(3):228-232. • Link