B12 deficiency: case stories wanted

[Korn]

I think if you eat enough veggies you should be fine. Read this if you haven't. It should prove this enough:

ancient vegan civilization (http://veganforum.com/forums/showthread.php?t=4013) :D

Unfortunately, it isn't as simple as just 'eating enough vegetables'. The people in the tribe (in that thread you are referring to) have a totally different lifestyle than we have, they don't live in the over-sterilized environment we do, don't drink chlorinated water and is not exposed to nitrous oxide (http://www.veganforum.com/forums/showthread.php?t=2212) from cars the way we are (etc).

[Zero]

B12 deficiencies are actually the same or higher in omnivores than vegans. Particularly smokers, as smoking destroys B12.

Just because animal products have B12 in them does not mean your body can actually absorb it. B12 is made by bacteria in the soil and in the intestines, not directly by the animals that omni's eat.

One of the problems is pesticides, the soil used for growing conventional produce is often missing this bacteria.
Therefore Organic foods are often more likely to contain B12, and you can always eat those foods that are fortified with B12 if you are concerned.

Not only is B12 one of the most recycled nutrients in your body but trace amounts form naturally in your intestines (however there is speculation as to how much and whether it gets absorbed), it can take up to with no new B12 intake 20 years to develop a defiency.

In the end, a bad diet is a bad diet whether it's Omni, veggie or vegan. Eating healthier and more organic help with this in my opinion.

[Korn]

B12 deficiencies are actually the same or higher in omnivores than vegans. While meat eaters normally have lower levels of certain nutrients than vegans, lots of studies show that vegans normally have lower levels of B12 than meat eaters. There are lots more meat eaters that are B12 deficient than vegans, but that's just because there are more meat eaters around...

[dreama]

Not only is B12 one of the most recycled nutrients in your body but trace amounts form naturally in your intestines (however there is speculation as to how much and whether it gets absorbed), it can take up to with no new B12 intake 20 years to develop a defiency.



I've read that it's recycled for some people but aparantly this does not apply to everyone. I was very ill with ME like symptomes which could have been due to lack of B12.

The problem is that sometimes when people fall ill after being vegan they will automatically blame it on the diet wheras if they fall ill and they are meat eaters they don't. Most people fall ill sometimes especially if their imune systems aren't very robust.

[Essy Strudel]

I have been tested a few times and never had a problem, but I take a multi-vitamin now with high levels of vitamin B12 just in case.

[darkangel]

hi,Im not sure if im posting this in the right place or not but here goes,

I have been vegan for just over 6 years now, when I decided to go vegan my main health concerns were getting enough calcium and B12, however after researching and reading up on these issues I personally thought that the B12 issue was probably a bit of hype against vegans and that if a healthy vegan diet was followed then a B12 or calcium deficiency would be very unlikey.

With regards to getting enough calcium since becoming vegan I have always made sure I fulfill the RDA through fortified soya milk,yogurts and tofu along with green veg etc.

About 3 years ago,I began feeling very tired, shaky and as if my mind was in a fog, quite low in mood too and very lethargic. I had blood tests which revealed very low B12 levels, I was advised to have the course of B12 injections and after considering the possible serious effects of B12 deficiency I reluctantly had the injections. I felt so much better very soon after having the B12 shots. The doctor said I should have these injections every 3 mths but I was determined to improve my levels through diet and oral supplements to prove that avegan diet can be healthy. I made sure I had even more foods fortified wth B12, soya milk,cereals,yeast extract,margarine, energy drinks etc.

I had a further blood test 3 months later which revealed a B12 level in the low normal range, the doctor ws surprised at this as he said with the injections a higher level would be expected, I felt ok though and wasnt too worried as it was in the normal range and thought the best plan of action was to continue to ensure I was eating foods containing B12.

Around the same time as this, I was involved ina minor car accident which resulted in a whiplash injury. The pain from this went on for a while so I was referred for an MRI scan which revealed a broken bone in my neck. As this wasnt expected due to the low impact of the accident, I was sent for a bone density test which revealed osteoporosis. I was very shocked by this as I was 27 at the time and to be told this was devastating.

For the last few weeks I have been feeling very lethargic again, in a mental fog and unusually tired, Ive had a blood test and yet again my B12 levels are low, my folate level is crazily high which is related to B12 deficiency and my liver functions are abnormal apparently asa result f this. I am due to have the B12 injections again. Im aware that this could be an absorption issue and have had tests for coeliac disease which affects the absorption of B12 but these have come back negative.

I have been a committed vegan for 6 years and durin that time have always tried to ensure I eat a healhy balance diet,and have always believed passionately that to follow a vegan diet is the most natural and ethical way to live. However I am curently experiencing a loss of faith if you like, I appreciate that B12 deficiencies and osteoporosis does occur in omnivores and have read research and literature on both of these conditions but now I cant help feeling that the mainstream medical view on these health conditions and thevegan diet may have some substance.

As these health conditions are both potentially very serious, should I look after my own health and introduce dairy back into my diet and accept that the vegan diet has not physically suited me or do I continue being vegan? I find this dilemma very difficult as im not even sure I could bring myself to eat dairy again but I have my health to consider.

My partner and his mum are both vegan and have also developed B12 deficiencies in the past remedied with the injections.

[darkangel]

sorry that was a long post, Thanks for reading it and I look forward to hearing your thoughts

x

[sandra]

I'm sorry to hear about your health problems darkangel. I'm sure there are many more qualified people on the forum who can advise you, but have you considered that you may have developed these conditions even if you weren't vegan?
Surely, if you were insuring your diet was adequately providing you with the RDA of calcium and B12 you shouldn't have developed a deficiency. As you said deficiencies occur in non-vegans too, my own mother who was neither vegetarian or vegan developed pernicious anaemia.
I do understand why you are worried though and as I said before I'm sure someone on the forum will be able to give you good advice as to what to do. :)

[eco]

As these health conditions are both potentially very serious, should I look after my own health and introduce dairy back into my diet and accept that the vegan diet has not physically suited me or do I continue being vegan? I find this dilemma very difficult as im not even sure I could bring myself to eat dairy again but I have my health to consider.
Hi darkangel, have you had tests to see whether your B12 deficiency is due to intrinsic factor problems? http://en.wikipedia.org/wiki/Intrinsic_factor If it is you'll need to take B12 injections or take a high dose supplement sublingually (disolves under the tongue) for the rest of your life. If you do have an intrinsic factor problem your B12 deficiency is not due to your vegan diet but you may have exhibited symptoms sooner than if you were omni. If you don't have an IF problem and your low B12 status is purely due to diet then I'd say do what you have to do to make sure you are getting adequate amounts of B12, your health is paramount.

Osteoporosis can occur at a young age due to various medical conditions. Have you had tests to see whether that could be the case?
http://en.wikipedia.org/wiki/Osteoporosis It may be that you're not absorbing enough calcium due to lack of vitamin D. Have you had tests done to see whether you are deficient in that vitamin?
http://www.nos.org.uk/

It's quite possible that you'd have had these health problems if you weren't vegan but for peace of mind you need to have confirmation of that. If I were you I'd ask for as many tests as possible to see whether it's diet or underlying conditions that have led to them. I wish you all the best :)

[Korn]

Hi Darkangel,

I'm sorry to hear about your health problems too.
Unfortunately, there's a tendency to think that if a veggie becomes sick, it's because he or she is a veggie, but if a meat eater becomes ill, he just... becomes ill.

Have you seen this thread: Nutrient deficiencies more common in meat eaters than in vegans (http://www.veganforum.com/forums/showthread.php?t=24)?

As you can see, lots of meat eaters are deficient in various nutrients, but unfortunately, most of them still aren't considering going vegan... they should, because it would be better for them, for the animals, and for the environment.

There are lots of reasons that people become B12 deficient. The list in 50 ways to develop B12 deficiency (http://www.veganforum.com/forums/showthread.php?t=196) is far from complete.

Today's soil is generally very nutrient depleted, and can be low in cobalt and microorganisms needed for B12 synthesis. The water most of us use is chlorinated. Most of us work indoors, get too little vitamin D - and vitamin D is needed for B12 absorption... and the list does on.

Anyway, whether you are suffering from some of the many reasons that could imply a (vegan-independent) B12 absorption problem, or you are deficient for other reasons, you need a solution.

There are two 'unnatural' solutions available: taking supplements, or eating animal products from living beings that have been given minerals and vitamins, been grassing on fortified soil and kept in captivity for their whole life. Often, there's no natural solution to an unnatural problem, and even if you wouldn't care if you had to kill wild, free, 'natural' animals for nutrients, there simply aren't enough wild animals out there to satisfy humans' "needs'.

If you would eat animal products to get nutrients, you would actively contribute not only to animal suffering, but you would also contribute to damaging the environment in ways that just would make the list over reasons to become B12 deficient longer. One reason the soil IS depleted is that humans for some reason use huge amounts of land for animal food - growing the land in the most 'efficient' way (using pesticides etc)... and they need a lot of land to eg. make animal protein compared with growing protein rich plants there.

There are more than 1 billion people living in Europe and USA alone. Conservative estimates suggest that 10% of these people are B12 deficient, and when it comes to other nutrients, the numbers are much higher (among non-vegans). Some people suggest that everybody should take B12 supplements, and some studies show that 40% of all people are deficient. Remember that the 10% of all people that are B12 deficient are not based on real tests - they only measure B12 in blood, and a third of the B12 we carry around is inactive B12 analogues. Studies show that twice as many people are considered B12 deficient if MMA and homocysteine tests are taken into consideration. And: not only does lots of these non-vegans take supplements and eat fortified food, they also eat 'fortified' meat and milk...

Anyway, If only 0.5% of this billion are vegans/vegetarians that don't eat animal products, that's 5 million vegans. If we should have the same rate of B12 deficiency as non-vegans, that would be 500,000 B12 deficient vegans - except that these numbers are wrong, because B12 tests in blood aren't reliable, the real numbers are approx. twice as high. In other words, if we would have the same B12 deficiency rate as non-vegans, there would be one million B12 deficient vegans in a group of 1 billion people. And again: Remember that unlike non-vegans, vegans don't eat anything from B12 'fortified' animals...

Maybe there aren't 0.5% vegans in the Western population, maybe there's less - but you get the picture. Even with only 0,1% vegans in a population group, there would be 200,000 B12 deficient vegans pr. one billion people with the same deficiency rate as non-vegans. Vegans have a higher rate of B12 deficiency than non-vegans (we don't eat others muscles or liver, and B12 is stored in muscles and liver), but lower rate of other deficiencies.

I hope you choose one of the 'unnatural' solutions that's best for you/animals/the environment.... The good news is that by not relying on dairy/meat etc for your B12, you avoiding the many health issues associated with eating animal products!



should I look after my own health and introduce dairy back
Definitely yes to the first question, definitely no to the last one... If you have one of the many variations of absorption problems, B12 is better absorbed from supplements than from animal products anyway (this has to do with protein-bindings etc). If your doctor really insists that you can't get sufficient B12 orally (from supplements - which may contain loads more B12 than any dairy product out there), adding dairy products doesn't make sense at all - even if you wouldn't have been a vegan.


I personally thought that the B12 issue was probably a bit of hype against vegans and that if a healthy vegan diet was followed then a B12 or calcium deficiency would be very unlikey.
The B12 issue IS used against vegans, but just like non-vegans are more likely to develop certain deficiency than non-vegans, vegans are more likely to develop a B12 deficiency than non-vegans in our de-naturalized world. B12 issue is a bit of a hype against being, but on false premises. There are still valid reasons to monitor your B12 levels as a vegan (and also as a non-vegan), and it wouldn't be wise to pretend that vegans never can become deficient in any nutrient. Of course we can, and B12 is the nutrient we most likely will be deficient in. Knowing about all the 'enemies' the poor B12 molecule has out there (it's a very vulnerable nutrient) I'm surprised that there aren't more B12 deficient people than it is.


Anyway... good luck with your health conditions! I'm sorry to hear that you think eating plant based food is the cause of your problems, and I don't blame you - many non-vegans and a few vegans present info about nutrition in ways that gives the impression that veganism is some kind of disease that needs to be treated.

(PS - Maybe this thread is interesting for you: Is oral B12 as effective as intramuscular injections? (http://www.veganforum.com/forums/showthread.php?t=9391))

[Mzee]

darkangel,
please start taking a B12 tablet every day - starting now! This is recommended by the Vegan Society; even if we might not be too worried about our own health, we must all try to be healthy vegans and set an example to unhealthy omnis. Don't let them get a chance to justify continuing to eat animals by being able to point to a single unhealthy vegan!

It is difficult to find low-dose tablets. The ones I use (held under my tongue until it starts to dissolve) every morning just before breakfast has 25 micrograms, which is theoretically 25 times what you need. However, that doesn't matter; it's very cheap and the excess will be stored, broken down or excreted. I've been following this advice since becoming a vegan nearly 5 years ago; I've kept healthy and never had any need to have a blood test.

There's nothing wrong with taking supplements that have been made to vegan standards. Many of the nutrients that omnis get from animal products (e.g. calcium in dairy products) are only there because the animals were fed supplements! [I'd also recommend one kelp tablet every other day to ensure you get enough iodine, a small pinch of powdered chalk a day for calcium, one Brazil nut a day for selenium and a heaped dessert spoon of crushed flax seed each day for Omega 3 fatty acid]. Point out to any omni who criticises you that the supplement market is an enormous one. Vegans are a very small part of this market, so most of these supplements are consumed by omnis, who are still unhealthy due to the harmful effects of their diet!

B12 is made under controlled conditions in tanks by fermentation of a plant source by the same type of bacteria that would naturally produce it in an animal's gut. There may or may not be some B12 in some plant products; I wouldn't want anybody to take the risk of getting enough from this source; just take one tablet a day then you don't have to worry.

[Korn]

With all due respect, Mzee, a person who actually have serious B12 deficiency may not get much help from a 'normal' amount of B12 from a supplement. There seem to be a lot of confusion about when 'normal' amounts of B12 is needed and when medical treatment is needed, and there are lots of things lots of us are exposed to that mean that a 'normal' amount won't even be enough (vegan or not). Some vegans also claim that if a 'normal' amount of B12 found in plants can't treat a deficiency, it isn't really useful, which of course is wrong, because a deficiency often needs much more than a 'normal' amount of B12.

Darkangel, you mention that you experience 'a loss of faith', but there are almost nobody who have claimed that you can't develop a deficiency if you live on a 'healthy vegan diet'... You definitely can. You also mention that you feel that the mainstream medical view on these health conditions and the vegan diet may have some substance, and if we remove all the hype, all the fanatical stuff ("vegans will never become ill"), there isn't really any difference between vegan and non-vegan viewpoints on B12 - as long as these viewpoints are based on actual facts, and not assumptions. The Vegan Society published a book about vegan nutrition in the eighties that presented a lot of facts but somewhat gave the impression that one could easily get B12 from plants (more about this later), and they published another book a few years ago that went very far in the other direction... I wouldn't recommend any of these books, but rather just accept that vegans and non-vegans may develop deficiencies, and - as discussed many times - B12 is the main nutrient to pay attention to for vegans. Trusting any kind of general advice may potentially cause health problems for a lot of people.

There are literally thousands of studies on B12 out there, and most of us don't have time to spend our lives on medical research, so many vegans take B12 regularly to be 'on the safe side' (which again is based on the assumption that we have the same B12 intake needs and that there's such a thing as being on the 'safe side'....). Don't get me wrong; I'm not trying to make this confusing - it is confusing.

There's a great chance that you have an absorption problem that can be dealt with with oral supplements. There are millions of B12 deficient people out there, and based on 100% mathematical information (no opinions of any kind involved) you are more likely to become B12 deficient than a non-vegan, and it won't help you if meat eaters are more deficient in folate and phytochemicals etc., than us.

I read somewhere that only one percent of all people do not have a nutrient deficiency - deficiencies are normal.... vegans just need to deal with them like everyone else. My experience is that vegans are more aware of what we may be deficient in that non-vegans are about what they normally are deficient in, and there is no reason not to use all the knowledge out there to remain healthy and make sure we get the nutrients we need.

[Mzee]

Oops, sorry, darkangel! Korn is right of course.

I take a 'low' dose of B12 because I have no known problem with absorption.

With a serious deficiency you will of course need a much higher dose. I believe you can get B12 tablets that contain 1,000 micrograms - 40 times as much as I take. So you could try that. If you quickly start to feel better, then eventually you might be able to consider an intermediate dose.

However, if you don't, it means that you have such poor absorption that injections may be the only answer. But that wouldn't mean that there is anything wrong with the vegan diet, you'd still be getting all the other benefits.

[KrissStress]

Mzee,

could you link us to the B12 supplement you use?
How many tablets do you get in each bottle? and also, if each pill is 25 times what you need, would it be acceptable to have one every few or couple of days as opposed to EVERY day?

[Jippia]

I have never had it tested, so I do not know my B12 level. I have been thinking of getting one, also for iron etc. I am always ill when something like flu is going round. Not sure if that is genetic disposition or diet or something else. My dad has the same thing.

Mirjam

[darkangel]

Thanks for all your comments and thoughts, I am going to research B12 in more detail I think and have the injections next week so should hopefully feel better soon.

[pavotrouge]

and also, if each pill is 25 times what you need, would it be acceptable to have one every few or couple of days as opposed to EVERY day?

I don't think this would work. The body can only absorb a certain amount of a nutrient at a time and will get rid of the surplus.

[Korn]

I don't think this would work. The body can only absorb a certain amount of a nutrient at a time and will get rid of the surplus.

Some people who need B12 supplements take them weekly, but take much more than 7 times the recommended daily amount, because B12 is more efficiently absorbed in small amounts. Food for thought: At what levels is B12 absorption best? (http://www.veganforum.com/forums/showthread.php?t=2721)

Thanks for all your comments and thoughts, I am going to research B12 in more detail I think and have the injections next week so should hopefully feel better soon.


Thanks for all your comments and thoughts, I am going to research B12 in more detail I think and have the injections next week so should hopefully feel better soon. Maybe it would be a good idea to ask your doctor if you actually need injections. Lots of people don't seem to know that studies have shown that in most cases, oral therapy apparently is a good - and cheap - alternative for those who need to treat a deficiency. (I just added some more links to the thread (http://www.veganforum.com/forums/showthread.php?t=9391) about oral B12 therapy...)

[KrissStress]

I don't think this would work. The body can only absorb a certain amount of a nutrient at a time and will get rid of the surplus.

that's sensible. It would have been far too logical for me to have figured that out for myself. hahah :)

[Mzee]

KrissStress,
I think the others have probably given you most of what you asked me for. The Vegan Society's recommendations (from 'Plant Based Nutrition', 2001) say that you would need:

3 mcg over the course of the day (e.g. from fortified foods) OR
10 mcg supplement taken once per day OR
2000 mcg taken once per week.
[Korn's information is more up-to-date ]

Personally, I like once per day, as I'm less likely to forget! With 25 mcg, I suppose it's unlikely to matter too much if I occasionally forgot (e.g. while traveling). I would find the first option unattractive, as I'd need to make sure I had some fortified food at every meal.

I buy my tablets from a health food shop, usually from a UK company called Holland & Barrett www.hollandandbarrett.com I don't know if they'd do mail order to the US; I expect you could find the tablets locally...
There are 100 tablets in a small bottle; I forget how much they cost. I do remember noticing that the stronger tablets were not proportionately more expensive.

[ivandurago]

I had a bloodtest done last summer due to my moms complaining, and everything was perfect, very healthy :P

[Mzee]

Congratulations to another healthy vegan!
And one less worried Mom! :)

[Megan89]

hello i have a B12 deficiency, according to my recent blood tests. Of to see the doctor tomorrow, if she recommends these injections or whatever are they vegan?!?!

[darkangel]

Megan 89,

the B12 injections which I have had have been vegan, I asked to see the leaflet and it said suitable for vegans, however it has been tested on animals in the past so I struggled with that but realised I needed to look after my health.


I had a course of injections a few years ago, 2 injectons in one week then another a week later when my b12 was very low. I had an injection last week and need another in a months time as my levels are not as low this time.

Why do you feel that you have a B12 deficiency? have you been vegan long? do you ensure you have fortified foods?

[eclectic_one]

I just had mine tested just to be safe and it actually came out above normal. I think I was taking too much supplementation:o I've decided to cut back a bit on B12 supplements!