The Quest to Find the Missing Nutrient

The goal of this two-part post is to dish the dirt on perhaps my favourite nutrient, B12, a little guy that plays hard to get in a plant based or vegan diet (so yes, its true, playing hard to get actually works, especially if you’re a cute wee vitamin). Vitamin B12 is a wonderful vitamin, a champion at keeping our nervous system in tip-top shape, protecting us against a long list of degenerative diseases, aiding DNA, blood cell and protein production, metabolising fat, protein and carbohydrates, and giving us bounce-of-the-wall energy levels. All that from one vitamin? You betcha.

Years ago, as a student naturopath immersing myself in the wonderful world of nutrition, I was introduced to vitamin B12 and became a little obsessed. I learned every plant-based source and I was pretty certain that I could, and would, get my vitamin B12 from my nourishing plant-based diet. I ate sea weed galore, I consumed fermented goods like I was Sandor Ellix Katz himself, I wolfed-down microalgae, nutritional yeast and all sorts of beautiful fungi and my B12 levels were AMAZING ! Well, so I thought, right up until the moment I received my blood test results.

That was a turning point for me. I felt like my super powers had been stripped from my body! The shock of my blood test results (My B12 levels were 142 pg/mL; optimally levels should be 500-900 pg/mL) sent me on a search for cold, hard facts, delved from the depths of scientific-research world. I learnt a lot along the way, so I thought I’d summarise it here for you.

Whether you are new to veganism or you’re a pure plant muncher from way back (actually, even more so if your long term vegan) ensuring you get adequate intake of vitamin B12 should top your list of nutritional priorities. Particularly so if you follow an unprocessed, wholesome vegan diet devoid of processed vegan meats, soy products and breakfast cereals (that have been fortified with vitamin B12). The vitamin B12 issue is probably obvious to most, but there is still a lot of wishy-washy information out there about possible sources, how it’s synthesised in the human body and how much we need.

Why exactly do I need vitamin B12?

Vitamin B-12 is an essential component to human life, a vitamin that is provided by diet and it’s deficiency resulting in possible symptoms of anaemia, irreversible nerve damage, cardiovascular disease, intense neurological and psychiatric abnormalities, immune insufficiency, infertility and ultimately death

Clinical vitamin B12 deficiency is very real and documented cases of vegans falling into deficiency and developing irreversible neurological damage do exist.

Who is most at risk?

• Infants who are solely breastfed from a B12 deficient mother
• Long term vegans who avoid fortified foods
• Long term vegans with degenerative disease including (but not restricted to) chronic pancreatitis, Crohn’s disease, coeliacs, hyperthyroidism, multiple sclerosis, mature age onset schizophrenia and ulcerative colitis.

Why are vegans at risk of vitamin B-12 deficiency?

Deficiency of vitamin B-12 can exist for two reasons, either intake or absorption is lacking, the latter a possible result of chronic disease, pharmaceuticals, pernicious anaemia, drugs or alcohol⁵.

And B12 deficiency is sneaky.

Chronic/clinical vitamin B12 deficiency can be irreversible, severe and extremely debilitating, while acute deficiency easily occurs un-noticed or undiagnosed, allowing severe deficiency to sneak up on a person. A few factors are involved in this-

• The liver stores vitamin B12 for up to 6 years, allowing long term dietary deficiency to occur without the body showing any symptoms
• Acute vitamin B-12 deficiency symptoms are very unspecific, including weakness, depression, digestive disturbances, moodiness, poor memory and skin pallor
• A diet high in whole grains and leafy greens can in fact mask a vitamin B12 deficiency (yes, really), where-by a person will exhibit no symptoms of vitamin B12 deficiency due to high levels of dietary folate (this is known as the folate trap, and you can read more about it here),

Even though a plant-based diet is generally associated with reduced risk of cardiovascular disease (CVD) and cancer, global studies show vegetarians, and particularly vegans have both B12 deficiency and, subsequently, raised homocysteine (which is linked to CVD and atherosclerosis) when compared to non-vegetarians. This means that, theoretically, we too can be increasing our risk of developing CVD, even while following a wholesome, nourishing plant based diet.

Is it possible to get vitamin B12 from my diet?

I’ve read numerous discussions that a healthy vegan diet, in western countries, can provide adequate vitamin B12 without supplementation. This is risky business and while I don’t dismiss the possibility, the reality is not too common. Here’s why.

Should you be following a wholesome, unprocessed, mostly home-grown/wildly foraged and organic vegan diet, making and eating daily fermented foods and consuming a high percentage of raw plants that you do not over wash, you may (and I coin the term may very loosely) consume some dietary vitamin B12, BUT, this can be compromised if; you consume alcohol, large amounts of garlic, onion horseradish or mustard, are exposed to environmental chemicals, smoke cigarettes, have a deficiency of cobalt, calcium or protein, take pharmaceutical or recreational drugs including over the counter pain killers, antibiotics, the oral contraceptive pill or antacids or have persistent digestive symptoms or disease. And even then, there is no way to guarantee your food actually has vitamin B12- it just might.

To learn which B-12 rich foods are best to integrate into your diet, read on to Part 2: Best Sources of B12.