"If you want to read only one article about B12, read this one"

[Korn]

I've posted hundreds of posts about B12 over the years, and know that most people don't have time or interest in all those details. So - although I'm not a scientist or a dietician, I'm planning an article/post/thread which hopefully can remove as much confusion as possible for those who find this topic confusing.

Some of the conclusions scientists have come to aren't at all compatible with other scientists' conclusions, and the idea behind a short version/resume is to offer a simple text (max circa one page) which in an as unbiased way as possible explains what the experts discuss and what the most recent findings about B12 suggest... of course, with an emphasis on what's relevant for people living on a plant based diet today.

If you can help me create a short list of the questions/findings that seem most confusing, it's easier for me to make a short and hopefully informative overview of what scientists know about vegan-relevant B12 topics anno 2011. Thanks in advance.

[Est]

My questions would be:

Why do I need to know about B12? (Catch people's attention!)
Can anyone be deficient in B12 e.g. vegan, veggie, meat eater etc?
Am I more likely to be deficient in B12 than a meat eater?
What's the potential impact if I am? - i.e. should I be worried?
How can I find out for sure? (Are there any tests?)
How can I get B12 in my diet in a form that my body can definitely use?
Is it possible to get too much B12?
Is there any new/exciting research out there? (One or two sentence overviews)

I think this is a really good idea as it can look like a confusing topic but probably isn't!

[harpy]

In additon to Est's questions it might be worth covering:
* what's the latest thinking on vitamin B12 analogues that may (or may not?) interfere with absorption of actual vitamin B12?
* what can I do/not do to improve absorption of vitamin B12? (i.e. what else might interfere with absorption)
* how about eating unwashed vegetables?
* I have been a vegan for x years, not taken any supplements or fortified foods, and not shown any signs of deficiency, so do I need to be concerned?
* What are the early warning signs of possible vitamin B12 deficiency and what should I do if I notice them?

(I am sure you want to emphasise that vitamin B12 deficiency isn't necessarily more of a problem for vegans than it is for anyone else, but if someone reads a file like this it's probably because they are concerned about deficiencies, which is why I suggested including the last one.)

[Korn]

Thanks for the good suggestions!

I think this is a really good idea as it can look like a confusing topic but probably isn't!

It is somehow confusing, most of all because theres still way too little research on this; research of the kind that's relevant for plant eaters.

(I am sure you want to emphasise that vitamin B12 deficiency isn't necessarily more of a problem for vegans than it is for anyone else [...])

Wrong!

[Clueless Git]

'Lo Korn

I think the most important thing to include would be where B12 actualy originates from.

[Greyowl55]

Perhaps give idiot examples for the less receptive (such as me) as to what the daily requirements are, e.g. xx millilitres of a B12 enhanced soya milk will provide xx% of your daily requirements, ditto other enhanced products, ditto B12 tablets.

[Korn]

I'll probably make a new article or thread about this, but for now, I'll respond to the suggestions that have come so far. I don't have time to make it short (yet), so it will be a long post.

My questions would be:

Why do I need to know about B12?

Because both vegans and non-vegans have certain nutrients they need to pay special attention to, and a number of studies have shown that B12 is the nutrient a vegan most likely will have low levels of. Non-vegans who regularly consume food containing a lot of B12 may also become B12 deficient. A main reason for this is that most people are exposed to B12 'enemies' in food, drink, water, medicine etc, meaning that how much B12 one consumes is only a part of the B12 problem. Another B vitamin that needs special attentions is folate, but here the situation is the opposite: meat eaters often have low levels of folate, while vegans usually don't. USA, Canada, and Australia (and other countries) have had mandatory folic acid fortification of flour for more than ten years now, and something similar is being discussed for B12: Considering the case for vitamin B12 fortification of flour. The last study I saw about B12 in vegans suggested that 50% of all vegans (in that study) had too low B12 levels, which is a very high number, and other studies have shown even higher percentages - up to 80-90%.

Another reason to pay attention to B12 is the old myth about vegans getting the B12 they need from not washing their vegetables. I'm almost sure that we would have gotten all the B12 we need from a plant based diet in a world where water wasn't chlorinated, the air was clean, and the nutrient levels in soil were intact, but there are no studies I've seen confirming that not washing our plants will ensure that we get enough B12.

Can anyone be deficient in B12 e.g. vegan, veggie, meat eater etc?

Sure - and at least one country have already introduced mandatory B12 fortification. B12 results in studies always come out higher for meat eaters - but keep in mind that these tests don't include MMA (or homocysteine) tests confirming that the B12 in their blood is active, true B12. (95% of the B12 found in human feces are inactive B12 analogues.) Inactive B12 can also be found in animal products, B12 fortified food and some multivitamins. The 'inactive analog' problem is something non-vegans are facing as well, and the same is true for being exposed to stuff that interferes with B12 absorption.

Am I more likely to be deficient in B12 than a meat eater?

Yes. (For other nutrients than B12 - see this thread.)
OTOH: high B12 levels are associated with increased risk of getting some cancer types and higher mortality in hospitalized elders. There are many studies finding links betweenincreased intake of animal products (high in B12) and a number of serious diseases.

What's the potential impact if I am?

I'm planning a thread about B12 deficiency symptoms and risks, but for now, try to google eg. this: B12 deficiency symptoms.

- i.e. should I be worried?

Too low B12 levels, especially over time, can in some cases cause irreversible health problems which nobody wants, so you should be... concerned. Eating a balanced vegan diet is so healthy, so it would be silly to get health problems from not paying attention to one single nutrient...

How can I find out for sure? Are there any tests?

Yes, and if you take a B12 blood test, ask for a MMA and homocysteine test as well, since (although the validity of these tests are disputed as well), your MMA and Hcy may to a certain degree show if the B12 in your blood is active, true B12.

How can I get B12 in my diet in a form that my body can definitely use?

Although there are plant sources that are claimed to contain useful B12 for humans, the simplest solution which works for most people is to regularly take a B12 supplement - but not from a multivitamin containing copper and iron. Ninetysomething percent of the population are non-vegans, and there's too little research out there to recommend plants that we can rely 100% on as a B12 source - in a form that's commercially available for most people.

There's a certain level of B12 recirculation in the body, and B12 is also reported to be produced in the mouth, but if you want to try to live on natural (as in "not from supplements"), non-animal based B12, you should monitor your B12 levels and try to live an as 'natural' lifestyle as possible, with only fresh, organic plants, unprocessed water and so on. Having said that - the B12 found in supplements is made the same way that the B12 in nature is made: from a bacterial fermentation in a substance that contains Cobalt.

So - while it's harder to live a 'natural' lifestyle than ever, it's easier than ever to get access to B12. Check the "B12 in plants?" section for threads marked with [bio] for studies about plants that are supposed to contain bioavailable B12. Quite a few plants are said to contain B12, but have not been tested for bioavailablity. There's also some confusion re. the difference between 'active' and 'bioavailable'. (Please post any info you come across re. tests showing the ratio of inactive vs. active B12 in plants!)

Is it possible to get too much B12?

Some will claim that there's no harm in exceeding the recommended B12 amounts, but...
• there are known links between some specific cancer types and high B12 levels
• there's a general link between high risk for the 20-30 most common cancer types and consumption of animal products. A main thing that is different about animal products is that if we eat someone's blood, liver and muscles, we also eat their B12 reserves; B12 is one of the main things which makes animal products different from plant products. Many of the reports finding links between health problems and consumption of animal products may actually document a link between high B12 intake and health problems. But just handling unprocessed meat/blood and possibly inhaling the fumes from dead animals may represent a health risk (look here), which suggests that we know little about what it is with animal products that causes the biggest problems.
• we have a long thread about B12 megadose/overdose here.

Other writers focus on B12 allergies only, and some also just state that there isn't set an upper, accepted level for how much B12 we should take - but IMO there's enough information out there to be concerned about getting both too little and too much B12. Vegans won't get too much B12 from plant food in our sanitized world, and should be concerned about getting too little - but taking really high B12 amounts from supplements is a bad idea - especially long-term, unless you know you have a deficiency that needs to be addressed.

Is there any new/exciting research out there? (One or two sentence overviews)

There's both old and new research about B12 that isn't paid much attention to. One tendency seen in newer studies is that while some people assumed that one could remove the health problems associated with homocysteine levels just by increasing the B12 levels, it's not necessarily so - at least not for all people.

In additon to Est's questions it might be worth covering:
* what's the latest thinking on vitamin B12 analogues that may (or may not?) interfere with absorption of actual vitamin B12?

There are inactive, B12 like substances which even if they are considered inactive are not B12 antagonistic. There are also apparently B12 analogues which can be active in bone marrow but not in nervous tissue. And for some people, the fact that inactive B12 analogues may exist in animal foods, fortified foods and multivitamins may also be new.

We should try to stick to finding out where we can get true, human-active B12 from, and if we consume anything B12 antagonistic (most people do nowadays), especially in large amounts, we need a higher B12 intake. I've used this thread to add new findings about inactive B12 analogues before, but that topic probably deserves it's own thread.

The really short version of all this is: try to live and eat healthy, and compensate for nutrients you may miss by taking supplements - which is how non-vegans should think as well!

what can I do/not do to improve absorption of vitamin B12? (i.e. what else might interfere with absorption)

Sugar, microwave ovens and cooking, antibiotics, tobacco, alcohol, pollution, too much soy (!), mercury, calcium deficiency, mercury/vaccines, iron deficiency, vitamin E deficiency, oral contraceptives, age (over 50-60), pregnancy and breastfeeding, bacterial overgrowth and "unclean" colons, weak digestion/eating disorders, medication, stress, inhaling certain fumes, nitrous oxide, taking potassium supplements (long-term), fluoride, ultraviolet radiation, amalgam fillings, drugs/pharmaceuticals in drinking water and much more is bad for your B12 status. Even lack of sunlight may influence the situation, since calcium need vitamin D for absorption.

So - whether you are interested in "natural" or not, the B12 vitamin itself is interested. It's fragile, and seems to thrive best with a new-age-ish, harmonic and 'natural' lifestyle. That's why many people say "better safe than sorry" and take B12. Although taking B12 supplements doesn't always mean that you are safe, most people are - in most cases - more safe by doing it than by ignoring the topic.

how about eating unwashed vegetables?

No studies I'm aware of suggests that not washing your plants will be of any benefit today. Most plants are grown in 'processed' (depleted for micronutrients/healthy bacteria) soil anyway, and most likely already washed in or even watered with chlorinated water.

When B12 (active or not) has been found in plants, it has been found in root nodules, stems and leaves - but the B12 on the surface of plants is probably the first to "die", because once the plant is cut off from it's cobalt/bacteria source (soil), not only does the B12 production stop - but B12 is light sensitive. For that reason, B12 supplements are never sold in transparent containers, but if there's B12 on the surface of a plant, we don't know if the B12 still would be there (or active) a few days after it was picked. And due to lack of research, we wouldn't know if it was active in the first place.

"I have been a vegan for x years, not taken any supplements or fortified foods, and not shown any signs of deficiency, so do I need to be concerned?"

IMHO you should always be concerned - unless you'd live some centuries ago (you don't! ) and only would drink water from natural brooks/water streams and eat fresh plants from unspoiled soil.

Maybe some people who even live today produce/recirculate/consume enough B12 to never have problem - depending on their lifestyle, food/water intake etc - I wouldn't know. There are stories of vegans who have never taken any kind of supplements for around 40 years and have no problems. These are even used as examples of why vegans sooner or later will become B12 deficient - which IMO is non-valid logic, since these people - who are around 70-80 - may have become B12 deficient even if they weren't vegans. Many elders do.

The fact that several sources claim that you can develop serious problems without noticing initial, mild symptoms means that even the person in your example should either monitor his B12 levels regularly or take B12 regularly.

What are the early warning signs of possible vitamin B12 deficiency and what should I do if I notice them?

More about symptoms and signs of B12 deficiency later - I'll have a closer look at this before I write about it, for a few reasons. Early symptoms that often are mentioned are numbness/tingling in the fingers and tiredness. Among the listed signs of B12 deficiency are memory problems, depression, hair issues, insomnia, eye/sight problems, cronic coughing, shortness of breath, fever, diarrhea, sore tongue or mouth, impotence, infertility, anemia, ringing in the ears/tinnitus. Many of these symptoms that can be caused by other factors as well.

I think the most important thing to include would be where B12 actualy originates from.

Microorganisms, primarily bacteria, are the only known organisms that manufacture B12. Cobalt is needed too.

Perhaps give idiot examples for the less receptive (such as me) as to what the daily requirements are [...]

Please stay tuned!

[Crusty Rat]

Would it make any difference about the soil if you eat mainly organic/homegrown food?
I think it would be ace if you go ahead with this, I don't know anything about B12! Are there currently no known natural/plant sources of B12?

[fresherthanlife]

What about Kombucha?

[Korn]

Hi Crusty Rat and FTL - sorry for not having responded yo your questions! The idea behind this specific threads is to focus on only the most important B12 stuff for vegans. Please check out our existing threads about B12 for references to studies and various viewpoints about more specific 'side topics', but read on...

Are there currently no known natural/plant sources of B12?

Please check these threads:

B12 - is there something wrong with nature?


B12: How natural is the vegan diet?


"All natural" vegan diet lacks B12?


In the B12 in Plants? subforum, there are at least 5-6 threads linking to studies which insist that the B12 found in certain plant products actually IS "bioavailable" - a term which often is used to confirm that the B12 isn't only an 'inactive' B12 analogue, but actually useful for humans. This is a hot topic, and lots of people have conflicting opinions about 'bioavailable'. I've also seen that many of those who have strong opinions about these things are unaware of many of the existing reports.

Re. Kombucha: If I would rely on these plants which are reported to contain bioavailable B12 (algae, Korean Purple laver, AFA, Chlorella, Nori, certain fermented products and sea buckthorn), I'd still take a B12+MMA (and homocysteine) test before and after starting to do that, to see the measurable real life effects of these products. There are dozens of other plants reported to contain B12, but many/most of these reports don't insist that the products are bioavailable/active for humans, or at least: they don't demonstrate that they are aware of the active/inactive dilemma.

Would it make any difference about the soil if you eat mainly organic/homegrown food?

You'd need to conduct your won blood tests to get a valid answer to that. Even if plants are grown in B12 rich soil, and even absorb it, that B12 may be gone when it enters our bellies... because the plants are not fresh when eaten + are cooked + are cleansed in chlorinated water and so on.

Some pro vegan organization with money in the bank should conducts such tests, really. But Peta doesn't seem to care, such studies are probably out of scope for what used to be called American Dietetic Association (not a vegan organization at all, but the world's largest organization of dietitians - who write good stuff about eating vegan), and The Vegan Society haven't (AFAIK) even posted the result of a similar test conducted a few years ago. It seems we have to test this on ourselves. Please report what you find!

[spade]

Have you considered this article: http://www.veganhealth.org/b12/int
Makes me wonder how much of one's own feces one has to eat to get enough B12 ;-)

[Korn]

feces one has to eat

Yes, I have read it and consider veganhealth.org the most useless information site about B12 on internet. It's in many ways misleading. Of course nobody wants to use human feces to get B12, and the referred study doesn't talk about consuming human feces - and neither about food which has used human feces as a fertilizer.

But this thread is meant to be a short and informative thread abut B12 - not a discussion about old, misleading myths generated by anti-vegans (and certainly not about spreading myths about myths)... so I'll remove both your comment and my response within not too long. What the study possibly suggests is that one lives in an area with a lot of animals, the soil may have a natural high amount of B12, or B12 friendly bacteria. According to your link, they "speculated that because they lived among their farm animals and their living areas were littered with feces, they picked up enough B12 through contamination". A more likely explanation would be that they could have higher levels of B12 because the plants they eat come from a B12 rich soil (se a study by Mozafar about plants' ability to pick u B12 from B12 rich soil). But the study - both these studies, actually, may not have much real value, mention if the B12 in the blood tests were active B12 or inactive B12.