I bet I have helped more Owners find vitamin B12 supplements on our shelves than any other single B vitamin. People’s doctors, nutritionists, and naturopaths often recommend it. But why? What is the big deal? Turns out, there are many reasons to make sure you are getting enough of this important nutrient.

Deficiencies
Vitamin B12 is a water soluble, essential nutrient that is used by the body for red blood cell formation, DNA synthesis, homocysteine regulation and nerve function. Even mild deficiencies can cause problems; and the more deficient you are, the scarier the effects. Some of the effects are not reversible.

B12 deficiencies have been linked to heart disease, dementia, depression, birth defects, low bone density, paralysis, psychosis, hyperpigmentation, myelopathy, lesions, spinal cord degeneration, polyneuropathy, anemia, stroke; the horrible list goes on. Frightening stuff! I’m sure many of you have heard horror stories about irresponsible vegan parents who unintentionally hurt and sometimes killed their children with B12 deficiencies. The most tragic part is that B12 deficiency is so easy to avoid.

B12 does not naturally occur in any plant or animal—soil and animal gut microbes create it. While we used to be able to get enough B12 by simply drinking water from a stream or a well downstream from a beaver commode, industrialized nations’ drinking water sources are now filtered and chemically purified, which means we are not able to get B12 from that source anymore. But, we don’t get cholera either, so is it really a loss? It’s a trade I’m willing to make, especially knowing how easy and cheap it is to get enough B12 from alternate and safe sources.

B12 Sources
While most omnivores can get B12 from animal products, most of the things omnivores eat regularly don’t have large amounts. Some of the best sources of B12 for omnivores are clams, beef liver, and trout. How often do you eat those for dinner? Many omnivores with good levels of B12 are getting it from supplements and fortified foods, such as cereals. Still, according to a couple of widely different ranged studies on how B12 deficient we are over the last few years, only 0.4-5.0% of omnivores were considered deficient. Vegetarians and vegans, on the other hand, should be very careful about their intake. In those same studies, they found that vegetarians are deficient by 7-68%, and vegans 52-83%! As a vegan, I’m horrified.

Vegans & vegetarians
Vegans and vegetarians have gotten a bad rap for being deficient in B12—as we should. In fact, there are three nutrients that we are often deficient in: B12, calcium and iodine. It is important to make sure we have good sources of each of those. Don’t congratulate yourselves too quickly, omnivores—you are often deficient in seven nutrients: calcium, fiber, folate, iodine, magnesium, vitamin C, and vitamin E. I digress.

Myths
Many myths have been circulating about B12 over the years, and they are dangerous. When I first went vegan 14 years ago, I heard all of them:

  • Myth 1: You only need to take an occasional B12 supplement if you’ve been vegan for three years. Not true! Our bodies do store some B12 in our liver, but you can never be sure how much is there, and how long it will take to reduce the levels enough to hurt us. B12 needs to be replenished daily, from the first day you stop eating meat. 
  • Myth 2: You can get B12 from seaweed, mushrooms, non-active yeasts (such as brewers and nutritional), and fermented foods. Not true! Most of these are B12 analogs—they look just like it, but your body cannot use it. There is some evidence that some bacteria these foods can create B12, but there is no evidence that it creates as much as we need to stay healthy. The yeasts usually don’t have enough to be considered a good source. One nutritional yeast option that is fortified with B12 is the brand Red Star. Don’t rely on others. 
  • Myth 3: You only need to supplement if you are pregnant or experiencing deficiency symptoms. Vegans and vegetarian moms need to be supplementing B12 daily for your health and the health of your baby, this is absolutely true. But we should be supplementing daily for own health, and to make sure we have good levels before we get pregnant. Once you start experiencing symptoms, you are very depleted. Again, we need a regular source of this nutrient to maintain the blood levels needed for health. 
  • Myth 4: We have the same bacteria as animals in our guts that create B12. While that is true, the production is too far downstream, so to speak, and is not absorbed. Because of that, you should supplement or eat fortified foods. 

Who should be taking it?
Omnivores—I’d check with your doctor to get your levels tested. Over 50? Might want to consider it. Vegetarians and vegans—there is no question that we need to supplement. If you are not eating meat and pregnant or nursing—it is vital that you supplement. Checking with your doctor is always an important step. There are tests to find out if you are deficient—one that is recommended is the Urine MMA level. If you doctor finds that you are deficient, she may recommend a shot of B12, or really high daily doses to get your levels back up quickly.

How much?
So, how do we make sure we are getting enough B12? To get what you need daily, you can do one of three methods, as recommended by Dr. Michael Greger:

  • Take 2,500 mcg of cyanocobalamin once a week, ideally in a chewable, sublingual, or liquid.
  • 250 mcg of cyanocobalamin daily. Again, in a chewable, sublingual, or liquid. 
  • Or eat B12 fortified foods three times a day, each serving containing at least 25% RDA on its label. 

Art therapy & CounselingWe don’t absorb everything we take in from B12—the little B12 sacks get full quickly, so that’s why we try to keep a larger amount than we need in our blood at all times. Then your body can just grab what it needs, and pee out the rest.

What about methylcobalamin?
There have been some arguments over the years that methyl is the preferred form of B12. Most of the research I’ve seen on the topic have shown that methyl is less stable than cyanocobalamin, and that if you take the methyl form you need to take at least twice as much to get the same absorption. The resources I trust recommended the cyano form.

By not taking a B12 supplement, you could be doing yourself a grave disservice. Take steps today to ensure your health, and the health of your family.