Even in the modern environment, with our fastidious food cleanliness, a person consuming a vegan diet may never experience the need for vitamin B12 supplementation. Even the small amounts of B12 commonly found in the nodules of organically-grown root vegetables, and the small amounts produced by the bacteria in our own mouths, may be enough to sustain many of us. A very little of this substance can go a long way. For those who switch to a vegan diet, for example, there are usually stores of B12 in the liver that can last for several years, or even decades. However, the doctors at the TrueNorth Health Center work with a large number of vegan patients every year, and
we have documented dozens of cases of vitamin B12 deficiency, all of which corrected with supplementation. Although many of our patients are understandably resistant to the idea that they might need supplementation, we urge them to test periodically for this possible deficiency, and to take appropriate action when indicated. We also recommend that all pregnant and lactating women include a reliable source of vitamin B12 to ensure the nutritional adequacy of their milk supply.
Keeping it simple
Our advice is straightforward: If you adhere to a vegan diet, we recommend that you either (1) have yourself tested for vitamin B12 deficiency every two years, or (2) ensure a reliable source of vitamin B12. The most appropriate test for evaluating B12 status is the blood or urine test for methylmalonic acid (MMA). Elevated MMA is currently our best tool for detecting vitamin B12 deficiency, and is considered to be superior to testing for serum B12 directly. We recommend that if you choose to avoid all animal products, fortified foods, and supplements, periodic testing for elevated MMA is indicated.
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