Vitamin B12 and the Vegan Diet

From: "Blake Graham" pgraham@iinet.net.au
Subject: Re: B12 study
and Michael Grant White NCLMBT,CNE

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's21 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."

1. Rauma AL, Torronen R, Hanninen O, Mykkanen H. "Vitamin B12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised" J Nutr 1995 Oct;125(10):2511-5.

2. Dagnelie PC, van Staveren WA, van den Berg H. "Vitamin B12 from algae appears not to be bioavailable" Am J Clin Nutr 1991;53:695-7.

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

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

5. 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.

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 B12 on their surface from soil residues, this is not a reliable source of B12 for vegetarians."

and...

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

• 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 B12 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 B12 status over a 2-y observation period."

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

"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. Nature 1980; 283: 781-782.

3. Callender ST, Spray GH. Latent pernicious anemia. Br J Haematol 1962; 8: 230-240.

"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 breast-fed 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 B12 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 lest 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 increasing concerned about 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 mucous 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. B12 depletions are often caused by antibiotics. Primary uses of supplementation are for anemia, weight loss and blood sugar balance.

Highest concentrations (thus needs) 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 micro algae.

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 super food B12 source. Click on #599 E3Live™