Going Vegetarian? How to Avoid Vitamin B12 Deficiency

Many people who practice yoga regularly experiment with a vegetarian lifestyle or permanently shift to a diet based on plant-based foods. But a common problem to be alert to for people who follow a vegetarian, vegan or live food diet is Vitamin B12 deficiency.

Vitamin B12 is required for a variety of vital biological processes, ranging from proper red blood cell formation, to neurological function, and even DNA synthesis. A lack of vitamin B12 can cause subtle and, over time, significant health problems, some of which may lead to permanent health issues.

Symptoms of vitamin B12 deficiency include low energy, fatigue, according to the National Institutes of Health. If sufficiently serious, vitamin B12 deficiency can eventually cause permanent nerve damage, depression, nervousness, numbness and tingling in the hands and feet, pernicious anemia and more serous behavioral and neurological changes.

What is Vitamin B12 and why do we need it?

Vitamin B12 is one of eight water-soluble B vitamins required for the proper functioning of the blood and nervous systems. All compounds with vitamin B12 activity are referred to as Cobalamins.

Though a member of the Vitamin B family, Vitamin B12 differs significantly from its other B Vitamin relatives. The majority of B vitamins are easily absorbed, while B12 involves a complex absorption process that requires unique chemical binding.

This is significant for vegetarians, because while other B vitamins are found in both plant and animal sources, vitamin B12 is not. Vitamin B12 carries a large molecular structure, which is found exclusively in the bacteria and microorganisms of animals, making people with a vegetarian lifestyle more prone to deficiency.

Often referred to as the “energy” vitamin, because it is involved at the molecular level of every cell in the human body, vitamin B12 is essential in DNA production. Here’s how it works: Vitamin B12 is stable in several unique forms, all of which contain the trace element, Cobalt. The human body requires Cobalt to function properly. Vitamin B12 is a required cofactor for the proper production of human DNA. Without vitamin B12, in conjunction with folate and Vitamin B6, the production of properly configured DNA cannot occur.

What Happens with Vitamin B12 Deficiency?

Vitamin B12 deficiency is believed to be the most common vitamin deficiency found worldwide and can lead to pernicious anemia, disorders of the nervous system and more. When levels of Vitamin B12 are low, the division of red blood cells does not occur normally. This leads to enlarged blood cells, otherwise known as macrocytosis. The laboratory finding of macrocytosis is often the primary marker, seen by physicians, that leads to a patient’s diagnosis of Vitamin B12 deficiency.

Consumers of red meat, chicken and fish are the least likely to have vitamin B12 deficiencies, due to the vitamin B12 availability in animal food sources. All strict vegetarians and vegans require supplementation of Vitamin B12 since their food sources don’t naturally provide functioning levels of the vitamin.

Here are some of the serious manifestations of Vitamin B12 deficiency:

Pernicious Anemia

One of the more serious manifestations of Vitamin B12 deficiency is pernicious anemia. This is an autoimmune disease that results in gastric atrophy, (a condition in which the stomach muscles shrink and become weak), which in turn leads to malabsorption (where the stomach cannot absorb foods).

This malabsorption syndrome makes it difficult for vitamin B12 to be absorbed, even when providing adequate dietary amounts of the vitamin. The disease process can be dramatically slowed or even halted by supplemental vitamin B12. However, if pernicious anemia is not managed adequately, patients will develop vitamin B12 deficiency-related neurological disorders and blood-born issues.

Nervous System Complications

Vitamin B12, along with folate and Vitamin B6 are necessary for the production of certain neurotransmitters. Researchers in the field of vitamin science believe that reduced levels of vitamin B12 may impair serotonin production. In addition, antidepressants that work to improve mood by elevating serotonin levels, may have their effectiveness diminished by low levels of vitamin B12.

Extremely low levels of vitamin B12 are capable of producing nerve damage. A sheath surrounds and insulates the nerve fibers. When these sheaths break down, the transmission of impulses is disrupted. This occurs initially in the extremities, such as the hands and feet. Though researchers don’t understand the specifics of why this occurs, they do know that treating patients with Vitamin B12 supplementation can slow down or even arrest the disease.

Natural Sources of Vitamin B12 

How Do You Make Sure You Get Enough Vitamin B12?

Vitamin B12 is found naturally in animal products, such as fish, meat, milk and eggs. Because it is not found in plant-based foods, if you are on a strict vegetarian or vegan diet, you should look into some form of vitamin B12 supplementation..

Though not a natural source of vitamin B12, nearly 100 percent of breakfast cereals are fortified with a bioavailable form of vitamin B12. Additionally, some nutritional yeast products also contain Vitamin B12. Fortified soy formulations, sometimes referred to as Silken Tofu, also serve as a source of vitamin B12 for vegetarians and vegans. See here, for a more in-depth list of natural sources of vitamin B12 and suitable supplements.

Vitamin B12 Supplements

Oral supplements of Vitamin B12 are available in pill form, sublingual form (when medicine is placed under the tongue) and lozenges. No difference in the delivery of bioavailable B12 has been noted with varying oral delivery products.

An intranasal gel is also available, by prescription only that is easily tolerated and effective in elevating vitamin B12 serum levels. By prescription, vitamin B12, in the form of cyanocobalamin and hydroxycobalamin, can be delivered by shots in the muscles. Historically, Vitamin B12 Injections had been used to treat more severe B12 deficiencies that relate to pernicious anemia. Within the past 20 years, however, a spike in vitamin B12 injections has been noted as part of a wellness protocol used by many primary physicians and ancillary healthcare providers.

The bottom line: If you’re on a vegetarian diet, part of a healthy lifestyle is to be sure to supplement your diet with Vitamin B12 in order to maintain adequate neurological and blood functioning. Don’t just assume you’re getting enough vitamin B12, but let your blood levels of B12 tested regularly to check for deficiency. Many hospitals offer wellness programs with blood tests for vitamin deficiency at a reduced rate, inquire with your local provider. 

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