Vitamin B12 and The Vegan Diet

Linus Pauling, in his landmark "Orthomolecular Psychiatry states that a deficiency of Vitamin B12 (whatever its cause) leads to mental illness, often even more pronounced than the physical consequences."

From: ------ 
Subject: Re: B12 study.
and Michael Grant White NCLMBT,CNE   

From Blake:
Rauma et al.78 (1995, Finland) examined the B12 status in long-term adherents of a strict uncooked vegan diet called the "living food diet".

These raw foodists assumed that their large intake of fermented foods (about 2 kg/day in this study) would provide plenty of B12 as well as modify their intestinal bacteria to provide more B12. In one part of the study, food consumption data were collected and blood samples were taken from 9 vegan "living food eaters" (1 male, 8 females) 2 years apart. Six of the 9 vegans showed slow, consistent deterioration of B12 status over this period, indicating that the supply of B12 from the "living food diet" is inadequate  to maintain the sB12. In another part of the study, sB12 and dietary intakes in 21 living food eaters were compared to 21 NV. 

Living food eaters had been on their diets for an average of 5.2 years (R 0.7-14 yrs). Vegan living food eaters had significantly lower sB12 (mean 261 R 47-551 pg/ml) compared with their matched NV controls (420 R 177-651 pg/ml). 6 vegans had B12 levels below 203 pg/ml vs. 1 NV. Blood values (MCV, hemoglobin) did not differ significantly from the NV nor was it correlated with sB12 levels. In the vegan group, B12 intake (through seaweed) correlated with sB12. The 16 vegans consuming nori and/or chlorella seaweeds had serum B12 levels (298, R 101-551 pg/ml) twice as high as the 5 vegans not using these seaweeds (142, R 47-340 pg/ml). Rauma et al. concluded that some seaweeds consumed in large amounts can supply adequate amounts of bioavailable B12. However, they also thought the high levels of iodine in the seaweeds would be detrimental over time. Davis26 (1997, USA) had strong doubts about Rauma et al.'s conclusion that some seaweeds are potentially adequate sources of B12 for vegans. 

Davis points out Dagnelie's 1991 study showing that nori and spirulina did not improve B12 status. Until better methods are found, Davis suggests that the adequacy of B12 in algae must be measured by whether it can reverse B12 symptoms. According to Davis, so far, no algae has been shown to do this and two have failed in their initial testing. Dagnelie24 (1997) also responded to Rauma et al., pointing out that the available evidence indicates that B12 in algae is not bioactive in humans. 

He says, "We are concerned that Rauma et al.'s paper could stimulate the popular vegetarian thought that vegan diets are safe as long as seaweeds are used, and stimulate the consumption of seaweeds in potentially harmful amounts". Rauma & Torronen79 (1997) responded to these criticisms by pointing out that the average consumption of seaweeds by these vegans failed to maintain sB12 regardless of whether B12 or analogue had been measured. Because of nonactive analogues and the high iodine content of some seaweeds, Rauma & Torronen did not think that eaters of the living food diet can rely on seaweed as a source of B12. 

They said, "We regret that our conclusions may have lead to misinterpretation in this respect. However, the Finnish eaters of the 'living food' diet participating in this study started to supplement their diet after finding out their low vitamin B12 status."

Rauma AL, Torronen R, Hanninen O, Mykkanen H. "Vitamin B-12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised" J Nutr 1995 Oct;125(10):2511-5.

Dagnelie PC, van Staveren WA, van den Berg H. "Vitamin B-12 from algae appears not to be bioavailable" Am J Clin Nutr 1991;53:695-7.

Dagnelie, PC. "Comments on the paper by Rauma et al. (1995)" J Nutr 1997 Feb;127(2):379.

Davis DR. "Comments on the paper by Rauma et al. (1995)" J Nutr 1997 Feb;127(2):378.

Rauma AL, Torronen R. "Reply to the letters of Davis and Dangelie" J Nutr 1997 Feb;127(2):380. 

Some vegan, especially raw food vegan, dietary advocates claim that vegans do not have to worry about vitamin B12. Research clearly shows that plant sources of B12 are not reliable and that vegans, even raw food vegans, almost all become deficient if they do not supplement in some form.

 It should be noted that part of the B12 problem is environmental and B12 deficiencies also commonly occur in the non-vegetarian population who do consume adequate amounts of B12.

Vitamin B12: Are You Getting It? by Jack Norris, B.S. Nutrition Dietetics, and Director of Vegan Outreach

This detailed article which is a recent, 6/2000, review on the literature concerning vegans and B12, clearly shows the need for vegans to supplement in some form. It references 112 research articles. This document contains extensive information on this issue!!

Dr. Fuhrman, a vegan advocate, recently said:

"I have already seen multiple hygienic/vegans with paralysis and nerve damage from B12 deficiency and others with heart damage from B12 deficiency."

and…

"It is entirely irresponsible for a health professional not to recommend B12 supplementation in some form or frequent monitoring of MMA with blood tests for those who do not consume any animal products in their diets. No controversy exists." 

In the American Dietetic Association Position on Vegetarian Diets(1997) they stated:

"Although plant foods can contain vitamin B-12 on their surface from soil residues, this is not a reliable source of B-12 for vegetarians."

and…

"Supplementation or use of fortified foods is advised for vegetarians who avoid or limit animal foods."

Studies on Raw-Foodists and vitamin B12:

• Donaldson MS., Metabolic vitamin B12 status on a mostly raw vegan diet with follow-up using tablets, nutritional yeast, or probiotic supplements, Ann Nutr Metab 2000;44(5-6):229-34

“People following the Hallelujah diet and other raw-food vegetarian diets should regularly monitor their urinary MMA levels, consume a sublingual cobalamin supplement, or consume cobalamin in their food.”

• Rauma AL, Torronen R, Hanninen O, Mykkanen H.,Vitamin B-12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised, J Nutr 1995 Oct;125(10):2511-5

“In the longitudinal study, six of nine vegans showed slow, but consistent deterioration of vitamin B-12 status over a 2-y observation period.”

Vitamin B12 recommendations for total-vegetarians! By Dr. Goldhamer

“We recommend that you test periodically to assure that this does not become a problem.”

Vitamin B12 in the Vegan Diet by Reed Mangels, Ph.D., R.D.

“Some bacteria in the small intestine do produce vitamin B12 [2]. The amount of vitamin B12 which is produced does not appear adequate to prevent vitamin B12 deficiency [3].”

2. Albert MJ, Mathan VI, Baker SJ. Vitamin B12 synthesis by human small intestinal bacteria. Nature1980; 283: 781-782.
3. Callender ST, Spray GH. Latent pernicious anemia. Br J Haematol1962; 8: 230-240.

What Every Vegan Should Know About Vitamin B12 by Dr. Stephen Walsh

“Two subgroups of vegans are at particular risk of B12 deficiency: long-term vegans who avoid common fortified foods (such as raw food vegans or macrobiotic vegans) and breastfed infants of vegan mothers whose own intake of B12 is low.”

Blake's Conclusion:

Some people are still reluctant to take a supplement as they see this as admitting the inferiority of their diet. The solution to possible vegan diet and vitamin B12 deficiency problems is if you do not supplement from a reliable form get your MMA levels checked once a year. If your levels continue to be fine without any form of supplementation great, if your levels become low then a supplement of some form must be considered. In my opinion it’s easier to just supplement in the first place.

From Mike:

What happens if you don’t have B12?

Deficiency of vitamin B12 leads to anemia and neurological disorders; deficiency in children can cause profound damage, much of which is reversible. 

A normal level of serum vitamin B12 does not guarantee adequacy; methylmalonic acid concentrations (either serum or urine) are a much more reliable metabolic measure of vitamin B12 metabolism. People following a pure vegetarian (vegan) diet are at high risk (>50%) for metabolic vitamin B12 deficiency. Metabolic vitamin B12 deficiency can be detected in as little as 22 months on strictly vegan diets.. It does not take a long time. Where do you get it in foods?

Vitamin B12 is found in all animal products (liver, muscle flesh, eggs, and dairy products are sources, in order from richest to poorest sources). Plant foods contain little if any active vitamin B12; produce grown in soil fertilized with cow dung may contain more B12 than commercially grown produce. Marine plant life (chlorella, dulse, nori, blue-green algae, spirulina) contain analogues of vitamin B12 which can interfere with normal cobalamin metabolism; to rely on seaweed for vitamin B12 is to lean on a splintered stick. Barleygreen does not supply sufficient amounts of vitamin B12 for healthy adults. Bowel flora does not make enough vitamin B12 for many healthy adults. Probiotic supplements are not a sufficient source of vitamin B12; some products work better than others. How do I know I’m getting enough?

A urine assay for methylmalonic acid can determine metabolic cobalamin status. Check with Direct Labs for the least expensive method of that. What is the best supplement to use? 

I've read many times in professional literature that sublingual methylcobalamin is the best method for a person committed to a pure vegetarian diet to obtain their vitamin B12. 1/2 of a "Bio-Active B12" tablet twice a week should be sufficient for a healthy adult. Vitamin B12 requirement is about 1-4 mg/week for healthy adults. 

From Mike:

B12 deficiencies 
In recent years experts have become increasingly concerned about the vegan diet and vitamin B12 deficiency, especially among people over 50 and those subsisting on a vegan diet. Often called the "energy" or "longevity" or "anti fatigue" vitamin B12 contains cobalt, oxygen, phosphorus and nitrogen.  Animal proteins milk and eggs are good sources however they have potential negative side effects from steroids, growth hormones and excess mucus causing tendencies.  With the exception of red meat that already has B12 broken down for absorption, animal proteins also impede optimal digestion necessary for B12 absorption. B 12 depletions are often caused by antibiotics. Primary uses of supplementation are for anemia, weight loss and blood sugar balance.

Highest concentrations (thus needed) are found in our liver, brain, kidneys, heart, pancreas, testes, blood, and bone marrow.  Other significant food sources are nutritional yeast, un-pasteurized fermented vegetables and microalgae. 

B12 is such an important energy source and it takes quite some time to be replenished by just eating appropriate raw foods or animal proteins, the latter for which for many is not an option. Laxatives and overuse of antacids deplete B12.  Human active B12 in E3Live blue green algae is copiously available to the body. I encourage you to investigate this incredible natural organic superfood B12 source.  Click here

Are Catalytic Converters in Automobiles Creating Enough Nitrous Oxide to Deplete Vitamin B12 in Humans?

DMSO and Vitamin B12
by Dr. David Gregg
There have been a number of publications reporting studies showing that  breathing nitrous oxide may destroy a person's vitamin B12. This has been reported not only in journal articles, but has finally been incorporated in the latest books on nutritional supplements as well as books on biochemistry. What first came to my mind was the use of this gas by dentists. 

Nitrous oxide, often called "laughing gas," is commonly used by dentists to help mitigate pain. This could present a risk to patients, but probably more often it presents a risk to people working in the office who would be exposed every day. However, a far greater potential concern came to mind when I recently read a news article that stated that the catalytic converters in automobiles  are creating enough nitrous oxide emissions to contribute significantly to the greenhouse effect. It is also known to be a very stable molecule that has a lifetime in the atmosphere of approximately 150 years. 

With cars continuing to produce it, one would expect the concentration in the atmosphere, world wide, to be increasing every year, and it appears to be doing so. Is this already producing B12 deficiencies world wide, which will increase with time? This would not be surprising because we require (and absorb) only a few micrograms of vitamin B12 per day and our livers store only a few  micrograms in reserve. It would take only a very low concentration of nitrous  oxide in the atmosphere to destroy this if the destruction process is efficient, and the individual's dietary absorption process is inefficient. What are the potential health consequences and what can we as individuals do to protect against this potential problem?

I have had some personal experience which I will discuss below that makes me believe that I have discovered a significant fraction of the population is B12 deficient. It is a far greater fraction that I would have expected, since it even exists in young people who should have healthy B12 absorption systems. Is this the effect of the atmospheric nitrous oxide emissions already showing up? I believe it is a definite possibility which deserves some serious attention.

Health Consequences of a Vitamin B12 Deficiency

It is widely recognized that vitamin B12 in combination with folic acid is essential for your body to synthesize hemoglobin. A deficiency can result in a particular form of anemia called pernicious anemia. However, as we continually expand our knowledge of biochemistry, it is being recognized that these vitamins fill far more broad ranging requirements. It is doubtful that all their functions have been identified, but it is reasonable to conclude that a deficiency could result in or contribute to a broad range of degenerative processes.

The absorption of vitamin B12 requires a highly specialized process which tends to become less effective with age. For this reason it is common for doctors to give elderly people B12 shots which result in them feeling much better and more energetic. It is also common for the elderly to develop numerous degenerative diseases. (They don't all get shots.) 

Does a B12 (and folic acid) deficiency contribute to the development of many degenerative diseases that we commonly associate with aging? It would not surprise me at all if it does. It doesn't appear to be so common to give vitamin B12 shots to young people, so we may have not discovered a deficiency that may exist. Is there a similar deficiency in younger people resulting in a different set of medical problems? I have reason to believe there might be, and my only explanation for such a surprising and unnatural development is the growing nitrous oxide concentration in the atmosphere.

The individual solutions and my evidence that the problem might be broad ranging over all age groups. If a serious vitamin B12 deficiency is being caused by automobile emissions, we certainly want to change that process. However, this will require changes in cars that are beyond our individual control. So, what can we do individually?

I am a strong believer in oral dietary supplements. It is the best start. You can get B12 and folic acid supplements at any health food store and follow the directions on the label. Since vitamin B12 requires a special absorption system that may not be healthy in a particular individual, some people may not benefit from oral supplements. 

For such people, one form of B12 is available, called sublingual tablets, which are designed to be held under the tongue while the B12 is absorbed through the skin. Many may find this approach to be advantageous. Available by prescription are B12 shots, which may have to be administered by a doctor. I discovered another approach which I experimented with personally and which eventually led me to discover what I interpreted to be a very common Vitamin B12 deficiency, independent of the age group. This surprised and puzzled me very much. 

Back in 1994 when I was focusing on learning as much as I could about vitamin B12, an experiment came to mind which I decided to try on myself. I saw a bottle of DMSO (dimethylsulfoxide) on the shelf of my health food store and remembered that DMSO is not only absorbed directly through the skin, but it also would carry with it any impurities dissolved in it. This can be a serious problem if the impurities are toxic. 

However, I also realized that if I dissolved vitamin B12 in it, it might carry it directly to my bloodstream through my skin. I tried it and the results were dramatic for me, far greater than any impact I had ever felt from oral or sublingual tablets. I put some of my vitamin B12 tablets obtained at a health food store into a two liquid ounce bottle with an eyedropper and filled it  with DMSO. It took a couple of days for the tablets to fall apart. Once they did, I put an eyedropper load on one arm and rubbed it in. In approximately one hour I started to feel very good, which was a sense of general strength and well being. This lasted all day. 

When I tried it again the next day, I got no such feeling. I also didn't experience any bad effects either. Since I knew that approximately one month’s requirement of B12 is stored in your liver, I reasoned that my system was simply fully supplied with Vitamin B12 and that I wouldn't need to use it again for a month or so. When I tried it again a month or so later, I got a significant boost from it again. Since then I have continued to use it on a once every month or so basis.

With time I decided to also add folic acid and a multivitamin-multimineral tablet to give the solution a broader base of nutritional support. I use a two ounce bottle with an eyedropper, add 10mg of vitamin B12 (ten 1000 mcg tablets), 9.6 mg of folic acid (twelve 800 mcg tablets) and a single multivitamin-multimineral tablet and fill it with 99.9% DMSO (leaving a bubble at the top so it can be mixed when shaken). All ingredients were obtained from my local health food store. 

The tablets are mostly binder and take a few days to fall apart. They don't fully dissolve, but that doesn't seem to matter in terms of potency. I now use this regularly on approximately a once every month or two basis. It serves as a reasonable mood elevator for me, and I believe it contributes significantly to my general health. My interpretation is I seem to become deficient in vitamin B12 even though I take oral supplements regularly. Over time I have told a number of other people about this and many have chosen to try it. (I strongly recommend that they consult their physician first.) Of those who have chosen to make up solutions and try it, approximately 50% have told me that they noticed a very significant energy boost, and this was not limited to elderly people. It seemed to be independent of age, from age 25 and up.

Some also found a benefit if they used it as frequently as once every two weeks and others were like me, finding the best time span between use to be in the once-a-month or so range. If I interpret this to indicate B12 deficiencies, the 50% number is much higher than I would have expected, and the impact on young people was particularly unexpected. Is this an indication that there is something happening in our environment that is causing a broad base of Vitamin B12 deficiencies? When I read the news article about automobile exhaust and the production of enough nitrous oxide to affect the greenhouse effect, a light turned on. This may be the cause. If so, it is a very important issue.

It is my hope that this article will stimulate a thorough investigation into this issue to systematically evaluate if it is true, and result in an organized effort towards a solution.