Vitamin B12 deficiency is not just a problem for vegans and vegetarians. About 40-60% of non-vegetarians also suffer from vitamin B12 deficiency.
What is Vitamin B12?
Natural vitamin B12 is produced only by bacteria, yeast, and other microorganisms that live primarily in the soil. These microorganisms are also found in natural untreated water. They come into plants due to the plantās contact with the soil. They also enter into animals when animals eat soiled plants and other material straight off the earth.
When we eat whole, unpeeled, and untreated organic plants, these microorganisms also come into our digestive systems and multiply mostly in the gut. This is the normal route from where we get these microorganisms and the B12 they make. The problem nowadays is that the soil is heavily treated with pesticides, thereby killing most of the B12-making microorganisms.
Common symptoms of B12 deficiency
- Abdominal distention
- Chronic diarrhea
- Shortness of breath
- Swollen, red, painful feet
- Skin darkening
- Bilateral useless hand syndrome
- Numbness and tingling in the hands and feet
- Muscle cramps
- Dizziness
- Cognitive disturbances
- Difficulty walking
- Erectile dysfunction
- Fatigue
- Depression
- Psychosis
- Coma
- Blindness
But I don’t have any symptoms!
Vitamin B12 is one of the most essential nutrients our body needs. The damage done by B12 deficiency could be non-reversible. Some symptoms are subtle and can be wrongly associated with some other illnesses or deficiencies. Hence it is advised to check and maintain your B12 levels.
How to check B12 levels?
B12 serum test:
This is the most common test to diagnose B12 deficiency and is normally bundled with other blood tests. Unfortunately, this test has lots of drawbacks and the patient could be severely deficient while presenting high B12 serum test levels.
Interpreting B12 Serum results: Although most test centers mention 190-800 as the “normal” B12 range, 200-500pg/ml is a grey area where a patient could still be deficient. This is referred to as “functional deficiency” of B12 which means that B12 is available in the body, but the patient lacks other nutrients (co-factors) in order to use it.
Methylmalonic Acid or MMA test:
This test measures the amount of methylmalonic acid (MMA) in your blood or urine. MMA is a substance made in small amounts during metabolism. Metabolism is the process of how your body changes food into energy. Vitamin B12 plays an important role in metabolism. If your body doesn’t have enough vitamin B12, it will make extra amounts of MMA. High MMA levels can be a sign of a vitamin B12 deficiency. Also, note that pregnant women and elderly patients will have a higher amount of MMA regardless of their B12 levels.
Homocysteine:
Measuring homocysteine (Hcy) can help diagnose a patient with B12, B9, and B6 deficiencies. These nutrients help break down homocysteine. Elevated HCy could indicate that the patient is deficient in one of those metabolites.
HoloTC (Active B12):
The HoloTC, or holotranscobalamin, test is used to measure the metabolically active amount of B12 in a patient by measuring the B12 bound to transcobalamin. This test is generally regarded as the most specific and accurate but is not widely available.
Treatment
Following is a guideline on how to improve your B12 levels, but do consult a doctor once you get your report:
- B12 supplements:
Vegan B12 supplements are easily available in the form of pills or tablets, but the right dosage is important. If your B12 levels detected by the B12 serum test are below 450, you will probably be prescribed 1000mcg or 1500mcg tablets per day until your levels normalize. - B12 injections:
If you are facing severe symptoms, or you have absorption issues, your doctor may prescribe weekly or monthly injections for faster recovery.
Once your levels are normal, for adults under 65, the easiest way to get B12 is to take at least one 2,000 mcg supplement each week or a daily dose of 50 mcg. Note that these doses are specific to cyanocobalamin, the preferred supplemental form of vitamin B12, as there is insufficient evidence to support the efficacy of the other forms, like methylcobalamin.
As we age, our ability to absorb vitamin B12 may decline. For those over 65, the supplementation should probably be increased up to 1,000 mcg of cyanocobalamin each day. source
But aren’t supplements unnatural?
As mentioned in an earlier section, the natural way for animals (including humans) to get vitamin B12 is by drinking untreated water and by eating plants and other materials straight from the earth. But that is no longer the case.
Hence B12 supplements are a need of our time.
Are there any side effects of B12 supplements?
No. Many studies show that treatment even with very high doses of vitamin B12 supplements (cyanocobalamin) has not shown any negative side effects on the body. Watch the following videos to learn more:
Some vegan B12 supplements available in India:
- NUTRIOSYS VITAMIN B12 1000mcg
- FARM BIONICS B12 & D3
- HIMALAYA ORGANICS PLANT BASED VITAMIN B12
- CARBAMIDE FORTE VITAMIN B12
Other ways to improve B12 levels:
Note that these methods are not necessarily an alternative to supplements, but rather a way to assist them:
- Eat a lot of raw organic fruits, vegetables, leaves, sprouts, and roots. Organic farming or natural farming does not use harmful pesticides that kill microorganisms, and having the food raw prevents the microorganisms from dying due to cooking heat. If you do not have access to organic fruits, normal raw fruits will also be helpful.
- Eating fermented foods such as miso, kimchi, sauerkraut, cultured vegetables, cabbage rejuvelac, vegan curds, coconut kefir, probiotic drinks, nutritional yeast, tempeh, tamari, and natto. Make sure the ingredients that go into these preparations remain raw and organic as far as possible so that the bacteria in them are still alive.