Tuesday, September 21st, 2021

B-12 And The Vegan Conundrum

Published on June 13, 2013 by   ·   100 Comments Pin It

“But vegans can’t get b-12 in their diet through food!”  If you’ve heard that before, here’s a little something you need to read.

Gena Hamshaw is a pre-med, post-bacc student at Georgetown University in Washington, D.C.. She’s also a certified clinical nutritionist (C.C.N.) with many thousands of loyal followers.  Gena is incredibly well respected and brilliant.

Here’s her take on B-12 and beyond;



I touch upon the role of supplementation in a vegan diet in a recent piece on DHA in vegan diets, and it prompted concern from one of my readers. She commented:

I haven’t supplemented before, and I’m wary to start doing it. If I have to supplement to stay healthy, how can I tell others inquiring about my lifestyle that it’s a healthy choice? I think I’ll keep trying to get enough naturally. Can people eat algae?

A lot of vegans echo this sentiment. How can we try to advocate the diet to others, they reason, if there are essential nutrient gaps that demand supplementation? Vegan critics are also quick to latch onto this issue, claiming that no diet in which supplementation is vital could be “natural”. And if it’s not “natural”—if it’s not nature’s perfect diet—then why are we doing it?

This is a complex issue, both among vegans and between vegans and our critics. It’s important for vegans to address it logically, because it continues to exert a powerful influence on skeptics of plant-based diets. So today, let’s chat about supplementation for vegans: why we do it, how it fits into the broader scheme of modern nutrition science, and whether supplementation is indeed a knock against veganism. I’ll use Vitamin B-12 as my primary talking point.

As all vegans know, B-12 is the one nutrient that vegans must supplement without question. Yes, there are fortified foods that provide good amounts of B-12 (nutritional yeast, fortified non-dairy milk), and some B-12 may also be available in spirulina (though the studies on algae as a B-12 source are not conclusive), but regardless, health practitioners agree that a B-12 supplement is still necessary for vegans. Everyone likes the idea of getting everything we need and want from whole foods, but good quality B-12 supplements give us protection and insurance at essentially no cost to our health. By contrast, if fortified foods and algae fail to meet our B-12 needs—which they often do—vegans can get genuinely sick, which is harmful both to us and to vegan messaging on the whole. I agree with many that the natural supplement industry has become as large, powerful, and problematic as the big pharma industry, but that doesn’t mean that certain supplements don’t have a vital and important role in diets of all kinds.

In spite of how easy it is to obtain in supplement form, B-12 remains a topic of endless debate, in part because critics of veganism have used it as evidence that veganism is “unnatural.” Some time ago, I had my friend, Dr. Stuart Seale of the Renovo clinic in AZ, speak to the great B-12 debate on my blog. For the entire discussion, I really recommend you check out his guest post, which also contains his recommendation for supplementation dosage. But to clear up some of the details, I’ll share a portion of the post:

Vitamin B12 is an essential micronutrient for humans. “Essential” means that it must come from external sources – we can’t manufacture it in our bodies using other nutrients as building blocks. The vitamin, in its full form, must therefore be supplied dietarily. This fact is what creates a potential rub for vegetarians, because no plant foods serve as a reliable source for B12. It’s only found predictably in animal foods – meat, eggs, and dairy.

Does this mean that we weren’t designed to be vegetarians, and that plant-based diets are inferior? In order to answer these questions, we need to look at the ultimate source for all vitamin B12, which is bacteria. The vitamin is made in nature only by bacteria that reside in soil, the upper intestinal tracts of ruminant animals (cows, sheep, deer, etc.), and also the lower intestines of animals. In the case of ruminants, the B12 that is made by the bacteria residing in their stomachs can then be absorbed into their tissues. In addition, the food they eat is contaminated with soil, which contains vitamin B12. Livestock are also fed B12 fortified foods to boost tissue levels. For wild, non-ruminant vegetarian animals there likely is enough ingestion of bacteria from foods contaminated with soil to provide adequate B12. In the case of wild, carnivorous animals, B12 is supplied from the liver (the animal storage organ for excess B12) and the intestinal bacterial of their prey.

The daily requirements of B12 for humans is very low, and in the past when we didn’t live in such a sterile and germophobic society it is likely that soil and other bacterial contamination of plant foods provided all the B12 needed. But our environments are different in the modern age. We are not only living much more sanitarily and bacteria-free, but our agricultural soils have also become sterilized. Of course, there is still the bacterial production of B12 in the lower intestinal tracts of animals, including humans, but we can’t absorb the vitamin from that location. However, undoubtedly much of the B12 found in animal foods is derived from intestinal bacterial contamination during the slaughter process.

There is an abundance of nutritional research demonstrating the benefits of eating whole plant foods, even if no animal foods are included. Humans are perfectly capable of eating a totally plant-based diet and maintain superior health while doing so. In our former agrarian society when bacteria-rich soils were worked by hand, there simply wasn’t an issue with humans getting enough B12, because it was supplied by soil contamination of our foods and skin. The issue of vegans requiring vitamin B12 supplementation is therefore not an indicator of a plant-based diet being inferior or unhealthy. The two really have nothing to do with each other. The fact that modern vegans require B12 supplementation is related to the sterility of our environment, not to the overall nutritional quality of the foods we eat. Humans haven’t changed, but our environment has.



So part of why vegans need to supplement is because we live in a world in which it has become harder and harder to obtain B-12 without relying on animal foods. It may indeed be possible that adequate B-12 was obtainable from plant-foods in our pre-industrial society, but that simply isn’t the case now. Does that mean we need to abandon all of the other good reasons for eating a plant based diet? Hardly. The B-12 issue is a good example of the fact that our dietary needs can shift with our environment; pondering what is “ideal” or “natural” is fallacious without considering specifics of soil, air, lifestyle, and food production.

To use another example, Vitamin D deficiency is so prevalent right now that a physician friend has called it an “epidemic,” and suggested that two thirds of her patients had been deficient at some point or another. The deficiency seems to affect everyone all over the US, not just vegans. So does that mean that omnivorous and vegetarian diets are inherently “unnatural,” too? Probably not. Vitamin D deficiency is rising for a number of reasons, the primary of which is sunlight deprivation. As counterintuitive as it seems, the prevalence of vitamin D deficiency illustrates an important reality, which is that the culprit behind vitamin deficiencies is not always to be found in what we are or aren’t eating.

If we start to make the claim that any diet that demands regular or occasional nutrient supplementation is by definition an inadequate diet, we’ll soon find that we’re condemning nearly all diets, because deficiencies can creep in regardless of how responsibly we eat. One of the advantages of living in the modern world is that we can identify potential gaps in our diets—be they due to environment, socioeconomic status, circumstances, or individual health conditions—and fill those gaps in with supplements and fortified foods. Vitamin deficiencies or nutrient gaps are nothing new: throughout time, most people throughout the world have found it hard to obtain one or a few nutrients with food alone. Nowadays, science gives us tools to help manage those challenges.

It’s also worth pointing out that vegans are not the only people who develop nutrient deficiencies in the U.S.. Indeed, B-12 deficiency is a phenomenon that extends far beyond the vegan community. To quote the National Institute of Health,

Some people—particularly older adults, those with pernicious anemia, and those with reduced levels of stomach acidity (achlorhydria) or intestinal disorders—have difficulty absorbing vitamin B12 from food and, in some cases, oral supplements [22,23]. As a result, vitamin B12 deficiency is common, affecting between 1.5% and 15% of the general population [24,25]. In many of these cases, the cause of the vitamin B12 deficiency is unknown [8]. (Click through for article and footnotes).

15% of the population is a large number, and the article does not state that all, or even a majority of those who are susceptible are vegans. Indeed, the most at risk group seems to be older adults, which is also why the article states that “the IOM recommends that adults older than 50 years obtain most of their vitamin B12 from vitamin supplements or fortified foods [5].” As my friend Ginny Messina pointed out on her wonderful interview on Our Hen House, does the fact that most people over the age of 50 are advised to take a B-12 supplement mean that we’re not supposed to live over the age of 50?

In other words, it’s overly simplistic to use deficiencies as fodder in an argument about what’s “natural” or unnatural. The reality is that most diets contain potential weak points in terms of nutrition, and demand a certain amount of planning. Whether you’re vegan or omni, you probably will need to give some amount of thought to getting proper nutrition through food choices, and there’s a good chance you’ll want to take a supplement of some kind at some point in your life. What that supplement needs to be may vary with your diet, your age, your gender, your health history, your environment, and your eating style. The idea that vegan diets need to be more “well planned” than other diets is a little misleading: smart eating habits demand consideration across the board.

And let’s suppose for a moment that vegan diets do demand a little more planning than other diets—so what? Taking a B-12 supplement and considering a DHA or D2 supplement seems like a very small price to pay when we consider veganism’s many advantages—namely, the fact that vegan diets help to spare billions of sentient beings pain, suffering, and early death. For this reason alone, I’m happy to take B-12, but it’s not the only reason: vegan diets are also beneficial to the environment, and they offer us plenty of health advantages that outweigh the small hassle of a B-12 supplement, such as reduced changes of obesity and high cholesterol on average. Fretting endlessly about whether or not veganism is the “ideal” or “natural” diet is counterproductive and futile, since it’s unlikely that science will show us conclusively what the “ideal” diet—if such a thing has ever existed—is anytime soon. What strikes me as a far more urgent question is “what is the most responsible, ethical, and intelligent diet I can eat healthily in this day and age?”

We all have different answers to that question, but veganism is my answer. I believe it’s the diet that makes most sense for me, for animals, and for the planet. Fortunately for me, current science shows us without question that the diet can be healthy. If a B-12 or Vitamin D supplement is the only price of admission, well then, I’m happy to pay.

For more on this hot topic, I seriously recommend you listen to Ginny Messina’s Saturday podcast on Our Hen House! And that you consider subscribing on iTunes! Jasmin and Mariann frequently get into the nitty gritty of vegan health, and their conversations with health practitioners are illuminating and important.

Originally posted on Choosing Raw, (c) 2012 by Gena Hamshaw

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Readers Comments (100)

  1. Latisha says:

    I’m wondering why it’s always said that you can’t find plant based b12 or DHA, if we do have things such as nutritional yeast or algae. I used nutritional yeast a lot ,more as a flavor enhancer than a supplement. I purchased one brand that had more than the daily recommended amount of b12 in one serving. Is there something about nutritional yeast or algae that makes it not as good as the forms in animal products? Im also wondering what exactly vegan supplements are made of its its not animal ingredients and its not plant based. Are they completely synthetic?

    • Kathryn says:

      Because B12 is added to the yeast, it’s not a natural part of it (and not all nutritional yeasts contain it). While there are omega 3’s (which the body converts to DHA) in greens and flax and chia and walnuts, for example, there is no pre-made DHA in it. There is, however, pre-made DHA in algae (which is the source for vegan versions of it). Vegan B12 supplements are made from bacteria: http://www.biotecharticles.com/Biotechnology-products-Article/Microbial-Production-of-Vitamin-B12-665.html

    • Gena says:


      The issue is that algae and yeast, to the extent that we consume them, don’t give us sufficient amounts. They’re sources, yes, but not reliable sources.

      Some supplements are food based, but have higher potency than we could get through diet, while others are synthetic. Many synthetic vitamins are totally efficient, so there’s no need to be reflexively skeptical of them.


  2. Betsy says:

    I just had my first physical in 14 years. I’ve been vegetarian longer than that. And moved to vegan over four years ago. I was concerned about my B12 levels since thats what seems to worry people, but my levels turned out to be fine, I was just low in Vitamin D as you mentioned most people are. I started taking a chewable B12 once or twice a week about a year ago and sprinkle nutritional yeast and salsa on fried organic tofu 3 times a week for breakfast. So it doesn’t take much to get what you need. I will be looking at taking some vitamin D which everyone might want to consider, vegan or not. And thanks for posting on this topic.

  3. Rhoda says:

    I really don’t care about all the pros and cons. My blood tests turned up a deficiency in B12 so I try to remember to take a pill every day (and my my very informed doctor showed that they do work if taken daily). Also, the older one gets, the more one needs the help of such pills. I turned up low on D too so I take that supplement. I don’t care how that impacts on anyone’s opinion about such a diet or anything else on the topic, I just care about not eating animals and if my body requires a couple of supplements to do that, it is absolutely fine with me.

  4. m says:

    Quick note about a supplement referenced at the end of this excellent piece: D2 will do nothing to remedy a defficiency. It needs to be D3, and there is at least one vegan source/supplement.

    • angela says:

      That’s absolutely not true. My doctor prescribed d-2 for me and my levels were back up to optimal in no time. I now take a lower dose of d-2. I think that’s another nutrition myth that’s circulating.

  5. GetSkinnyGoVegan says:

    Vegans are fortunate in that they pay attention to b12. I would add that the serum tests or levels they use to say are normal, very well may be pretty inaccurate at telling you anything about your active b12 levels. The MTHFR “issue” is a genetic one and has to do with folate metabolism. But folate metabolism has to do with being able to use b12. And taking anything with synthetic folio acid (which INCLUDES tons of “foods” and nutritional yeast,) can actually cause harm to nearly 1/2 the population. Your folate and B12 serums can e totally fine, even in “optimal” levels, and it doesn’t mean your body is using B12. The answer (at least beginning answer) may be as easy as taking the active form of the vitamins, meaning MTHFR 5 and Methylcobalamin. Because no matter what, if you can only metabolize a small percent of naturally occurring folate, and cannot metabolize folic(which is the synthetic form) then it doesn’t matter if you ate green smoothies and beef (folate and B12) all day, your body won’t be able to use it and your tests appear normal maybe, and the doctors notic a thing. Checking Homocysteine and getting MMA tests for B12 can be clues. But just getting the MTHFR test, which is done at “normal” labs, may save your life. Early heart attacks, strokes, autism, digestive issues, neurotransmitter issues, etc…..are associated with folate metabolism/methylation issues. MOST people don’t even get their B12 checked using ANY test :) So I think Vegans can be ahead of the game on this issue. There can be a lot of other genes associated with this, but MTHFR is the big, easy one to test. And can let you know if eating that white bread, enriched flours, etc…or even the beloved “nutritional” yeast with folic acid and cyno b12 can actually hurt you. SO important to get checked and know, because if you get pregnant, you want to KNOW that your body has active B12 and folate that it can use. We don’t know everything about the methylation issues, but it seems pretty clear that we shouldn’t be supplementing with fake vitamins, but food based ones and active forms. And that our blood tests for so many things don’t truly reflect what our body is using. But I am THANKFUL that I am vegan because I ask SO many questions and ask for blood tests, and have now discovered why fatal heart attacks in early 40’s has existed in my family. It may not be “all” of the equation, but knowing your MTHFR status and if you have a mutation, and if it is homo/hetereo, could probably save a LOT of lives. I would make sure to take Methyl form of B12 and get homocysteine checked (not just vegans, but everyone). Vegans are lucky that they even pay any attention to this stuff! :)) It does STINK that even if you drink green juice day in and day out, that if you are MTHFR 677TT, you probably aren’t going to get your active folate fix (because you still can’t metabolize it correctly), BUT think just KNOWING this, and making sure you are getting active forms of these vitamins can save your life, and also help a lot of your family out.

    • Val says:

      Im another vegan with MTHFR ! (Homozygous A1298C). Just wondering if you had any other supplementation tips? I’ve learned to take methylfolate and methylcobalamin in chewable form for absorption but Im wondering if you feel benefits from SAM-E or MSM?

  6. […] B-12 And The Vegan Conundrum | GirlieGirl Army. […]

  7. […] B-12 And The Vegan Conundrum – GirlieGirl Army | GirlieGirl Army. […]

  8. TH says:

    Who determines the need for b-12? Why can’t we trust the natural intuition of our bodies?

    • Val says:

      TH, nutritional science actually determines and proves the need. The alternative to not getting it can be detrimental to our health. It’s just not worth the risk. Vegan health professionals have great info on this. :)

    • Kathryn says:

      Our bodies determine the need. It is an ESSENTIAL nutrient. If we lived in a truly natural world, and drank from unpolluted streams and ate plants straight from the ground (grown in soil that contains sufficient cobalt, which the B12-making bacteria need to be active), then we could rely on just eating and drinking naturally. But we’d also expose ourselves to other bacteria. And, as the article states, modern hygiene practices (as well as water treatment) make B12 unavailable. You could also try not brushing your teeth, and relying on the bacteria in your mouth to create B12, but it’s both unreliable, and pretty skanky!

      • Gena says:

        What Val and Kathryn said! The anti-supplement stance is unrealistic, given the world in which we live. Taking a B-12 supplement ensures that we’ll be healthy.

  9. Rebecca says:

    Great article Gina and thanks Girliegirl for all this information. I am glad someone above clarified it is D3 we need, not D2 (typo?)

    I have been vegan for almost 9 years (vegetarian most of my whole before that/am in my 40s) and my B12 continues to be fine. Funnily enough, the one person I know who was B12 deficient (and not absorbing it) in tests was my mom who is an Omnivore. So I am REALLY glad this article clarified that B12 deficiencies are quite prevalent in omnivore diets as well! I get so tired of hearing people gripe about the possibility of deficiencies with our clean, positive, super healthy and conscious vegab diet – but when you really compare notes, it is the Omnivore community where disease and deficiency are rampant. Again, thanks for a lot of very important info!

  10. Rebecca says:

    And excuse MY typo in that comment – although maybe we can invent a VeGAB diet (vegans who talk alot? A good blog name for someone – LOL.)

  11. […] this amazing article written by Choosing Raw’s Gena Hamshaw which was recently posted on the website Girlie Girl Army. It is probably the best article I have read, to date, discussing the B-12 matter. Click here if […]

  12. Ingrid says:

    This is great, Chloe! Thanks for posting!

  13. seth says:

    D2 is vegan D3 is animal based. So, if you are vegan you should be taking D2

  14. seth says:

    There is one vegan version of D3
    http://www.vitashine-d3.com/ although D2 is just as good as D2 so I’m not sure of the need.

    • Kathryn says:

      According to Dr. Fuhrman, D2 is not as long-lasting as D3, so should be taken twice a day instead of once a day.

  15. If a safe, inexpensive pill lets us spare billions of animals from suffering and brutal, premature death, isn’t that the ethical and natural choice?

    Also, slaughterhouses aren’t very natural.

  16. Calypso says:

    New here. Question for all of you since you all seem to know so much!! I’m super nauseous often. I’m vegan and healthy but I don’t take any supplements. Do you think I’m b12 deficient? And if so what brand do you recommend taking?
    Thank you GGA readers in advance!!

    • Gena says:

      You should chat with your doctor about your symptoms, Calypso, since no one can say in this context what the cause is. If you do need to take B-12, there are many vegan brands (Deva and Country Life come to mind).

  17. Dr. McDougall has written prolifically about getting Vitamin D from the sun. I was deficient a few years ago and did research to find what I should do for my skin type. My dermatologist said my risk of getting skin cancer was very low and to “just get out there.” You can research what’s right for you, but for me, 40 minutes exposing skin generally not exposed to sun to the point of just starting to turn pink, between the hours of 11-2 (least cancer forming rays then) knocked the deficiency out in 6 weeks when I retested. Go mama nature! ;)

    • Forgot to mention that even as a morning runner living in FL, I believe my deficiency was not caused by diet, but by spending too much time indoors during most of the day, especially midday, at the computer. Imagine that! ;)

  18. Jaime says:

    I hate when non-vegans come at me with things like this, claiming that supplementation is not “natural.” In my opinion, there is nothing “natural” about the modern western diet. Someone said to me that it was natural for humans to eat meat. I came back at him with, no, not unless we cook it. We have to process all of our meat or we get sick and possible die. That isn’t natural. Getting a vitamin from a sub-lingual pill is as natural as anything else we see at the grocery store these days.

  19. Lynn says:

    I read that in the UK the B12 level of 500 that is the adequate level in the blood test is too low. In Japan for instance one is deficient up to 600. Also our test is not necessarily indicative of a deficiency. As has been mentioned a homocysteine test should be done as high levels of this indicates a deficiency. I mentioned this to my doctor who said it was only done at specialist hospitals and another test I had read about and mentioned she wrote down as ‘the patient asked for a fancy test I haven’t heard of’. So much for the NHS.

  20. I am a long-term vegan of 35 years. I was veg 10 years prior to that. I ran out of my B12 stores after 25 years of being vegan. I know many other long-time vegans, and some, not all, do run out of their stores – and therefore I believe in supplementation. I ate unwashed vegan-organic food and drank directly from our stream and was still found to be highly deficient. As soon as I supplemented, I was fine and tested fine, over and over. I used various brands from the dots to sublingual; they all seem to work. I wrote this post on the issue:


  21. Johnny says:

    Why is it that nowhere is in this article does it suggest to check your current vitamin B12 levels, before automatically supplementing?

    Just because you are vegan does not automatically drop you B12 deficient. Deficiencies take time to come.

    Please people take proper B12 blood tests and also checking all levels of a persons nutrient level is advisable.

    For anyone reading this i suggest you ask your doctor to check for your B12 levels through the standard serum b12 (cobalamin) test but also add in a Methylmalonic Acid (MMA) test and a Holotranscobalamin (HoloTC).

    The reason why there are so many is because there can be false negatives and positives with the first two test. the last test has been shown to be more accurate.

    I would also suggest reading a book called “could it be b-12?” it shows more of an in depth look as to what else a b12 deficiency can be the cause of such things as depression, autism and dementia.

    P.S checking homocsysteine levels has also been link to diagnosing a B12 deficiency but i still highly recommend getting all vitamin and minerals checked and supplementing with pills but deficiency adding more of a plant based sources to get you of the pills and fully

    • Gena says:

      Of course getting checked is vital, but most health professionals suggest supplementing regardless, as a means of ensuring adequacy before a deficiency develops.

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