If your body stores vitamin B12 in the liver for years, how does vitamin B12 deficiency happen? Even if you eat plenty of foods that supply vitamin B12 (cobalamin), such as meat and fish, you might still run the risk of developing severe vitamin B12 deficiency that can culminate in pernicious anemia or nerve damage.  What conditions and lifestyle choices affect your B12 levels?

Vitamin B12 deficiency today

Vitamin B12 deficiency is the leading form of vitamin deficiency, affecting nearly 40% of people between the ages of 26 and 83, according to a Tufts University study on B12 deficiency.  For elderly individuals, the risk of low B12 levels is 20%.

Vitamin B12 helps your body protect the nervous system’s myelin sheath; as a result, B12 deficiency symptoms may include painful tingling or numbness in the hands, feet, and tongue, muscular weakness, difficulty walking, frequent clumsiness, altered sense of taste, burning mouth syndrome, and eye twitching.

For a list of more symptoms of B12 deficiency, read B12 Deficiency: Don’t Ignore the Symptoms

Four roads to vitamin B12 deficiency

#1 Not eating meat

Vitamin B12 is a water-soluble nutrient that occurs exclusively in animal-based food items.  The basic food sources of vitamin B12 are meat, poultry, fish, eggs, and milk.  Contrary to popular opinion, brewer’s yeast does not contain vitamin B12, although it does supply other essential B vitamins.  Purple and green seaweed are the only naturally rich vegan sources of B12.  So, if you follow a vegan diet and do not eat generous portions of nori every day, then you are likely to develop B12 deficiency over the course of several years.

The top food sources of vitamin B12 are:

• lean beef and chicken
• organ meat (liver, heart)
• fish (halibut, herring, salmon)
• shellfish (oysters, clams)
• Eggs
• Cheese (Swiss, Muenster)
• Milk products (yogurt, whole milk)

Natalie Portman Chooses B12 over Veganism

#2 Not making enough stomach acid

If you’re over 50, there’s a 30% chance that you suffer from atrophic gastritis, a general wearing down of your stomach lining.  As a result, your body doesn’t produce enough stomach acids to fully absorb vitamin B12 and deliver it to the small intestines. Insufficient stomach acids may also lead to bacterial overgrowth, which also interferes with vitamin B12 absorption.

Other people at risk include individuals taking protein pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD), ulcers, Zollinger-Ellison syndrome, and long-term antibiotic use.

The 20 Do’s and Don’ts of the GERD Diet

#3 Not making intrinsic factor

Another chemical the stomach produces for digesting vitamin B12 is intrinsic factor.  Certain autoimmune disorders may inhibit your body’s ability to absorb vitamin B12 by attacking stomach cells before they have a chance to produce this necessary protein.  Regardless of how many vitamin B12 supplements you swallow, the B12 never reaches the small intestines, so it never enters the bloodstream.  Pernicious anemia, resulting in diminished red blood cell production, is a common occurrence when intrinsic factor is lacking.

“I’ve heard of the X Factor and Fear Factor…But what’s Intrinsic Factor?”

#4 Gastrointestinal conditions and surgeries

The ileum of the small intestine is responsible for digesting vitamin B12.  Located at the very bottom of the intestinal tract, the ileum grabs vitamin B12 and dispenses it to your blood supply.  But if your ileum is not working properly, then you cannot derive the many benefits of vitamin B12.

Gastrointestinal factors that interfere with B12 absorption are:

• Inflammatory bowel disease (IBD) such as Crohn’s and colitis
• Celiac disease
• Fibromyalgia
• Gastrointestinal surgery for Crohn’s
• Gastric bypass surgery

Absorbing Vitamin B12, a Metabolic Gastrointestinal Journey

What’s the solution?

It’s simple.  If you are unable to get your vitamin B12 from dietary sources, then the only other option is to bypass the digestive system and redirect B12 directly to your bloodstream.  Below are some popular methods of supplementing vitamin B12 without using the stomach.

• Vitamin B12 shots: B12 require a prescription from a doctor.  Because of the size of cobalamin molecules, B12 shots are usually painful, and must be inserted into thick muscular tissue, such as the thigh or buttock.  Even if you have a high threshold to pain, the idea of having to take vitamin B12 injections for the rest of your life can be worrisome.
• Sublingual B12 pills: The jury’s still out on the effectiveness of sublingual vitamin B12 tablets that dissolve under the tongue; whether they actually enter the bloodstream or just travel through the digestive system is under debate.  Your physician might prescribe B12 pills to be taken three times per day.
• Vitamin B12 sprays and creams: There is insufficient data to support the use of nasal sprays or lotions as a means of combatting vitamin B12 deficiency.
• Vitamin B12 patch: The B12 patch is a popular “alternative” form of vitamin B12 supplementation, although it is quickly becoming accepted as mainstream.  One vitamin B12 patch contains the same amount of cobalamin as a weekly B12 injection. For children and adults who must take regular B12 shots, this is good news.  And unlike B12 pills, you need only remember to take a B12 patch once per week.

Read more about vitamin B12 deficiency:

Gastrointestinal Surgery for Crohn’s (IBD) and B12 Warnings

6 Food Cravings that Signal Vitamin Deficiency

Ten Bites to Better Brain Power

Sources:

Are you getting enough of this vitamin?

B12 Deficiency May Be More Widespread Than Thought

Spirulina and Vitamin B12

Vitamin B₁₂ Sources and Bioavailability

Brewer’s yeast

Images, from top:

In Sendai , euthman, pikimota

Meatless Meals with Protein & B12

Anybody who has ever cried during Walt Disney’s Bambi has probably flirted with the idea of converting to veganism, a diet which mindfully excludes eating, wearing or utilizing any product which is derived through the slaughter of animals. Who hasn’t fantasized about growing their own organic vegetables, tossing out their leather sneakers in favor of a pair of cruelty-free recycled-material loafers, and living off a steady diet of barbecued tofu sandwiches, mixed bean sprouts and Matcha green tea?

Many of us have tried being vegetarian for at least a day; some of us for even longer. What eventually makes or breaks your commitment to the vegan lifestyle is the inevitable need to maintain the same nutritional balance that you had back in your meat-eating days; namely, you need to replace the iron, vitamin B12 and protein you used to get from meat, fish, milk and egg sources, and find new plant-based foods or supplements which meet the same nutritional needs.

Also read: On Becoming Vegan: Avoiding Vitamin B12 Deficiency and Others

Vegans who neglect to include sufficient amounts of vitamins such as B12 in their diets often end up with vitamin B12 deficiency, which may lead to pernicious anemia, chronic fatigue syndrome, fibromyalgia, increased risk for heart attack and severe neurological damage. (Read: Vegan Dieters at Risk for Cardiovascular Disease, After All.)

A good preventative measure is to take regular supplementation, such as iron pills and a vitamin B12 patch, in addition to including the following 6 vegetarian-based nutrients:

#1 Vegan Protein: Beans, soy products, nuts and seeds

The dilemma about not getting enough protein in a vegan diet has nothing to do with availability; most foods, vegan or non-vegan, have adequate amounts of protein in them. Vegetables, beans, grains and nuts are rich in protein. Especially healthy protein sources are almond butters, tempeh (mock meat), quinoa, lentils and kidney beans. But in order to obtain enough amino acids, you must include a variety of protein foods in your diet, as none (except for the soy products) are single whole sources of complete protein.

#2 Vegan Vitamin B12: Soy milk, fortified cereals

A majority of the foods which are rich in vitamin B12 are animal-based: lean beef, chicken, organ meats, eggs, fish and dairy products. Don’t skimp on vitamin B12; your body needs it to produce red blood cells, maintain the nervous system and convert food into energy. Vegan milk substitutes often have vitamin B12 added in order to prevent vitamin B12 deficiency. But don’t become too complacent; B12 levels can plummet steadily without your realizing it. Make certain your doctor gives you a vitamin B12 blood screening at every checkup, and become familiar with the basic symptoms of vitamin B12 deficiency.

For more info on recognizing the symptoms of B12 deficiency, read  B12 Deficiency: Don’t Ignore the Symptoms

#3 Vegan Iron: Dark leafy greens, beans, raisins and fortified breads

Iron is essential for collecting oxygen produced in our lungs and distributing it to the rest of the body. Of all the vitamin deficiencies, the most common is caused by low iron levels, affecting up to 20 percent of women. Iron sources obtained from meat are the most easily digested, but vegan sources are available. The highest sources of iron in the vegan diet include:

• soybeans;
• blackstrap molasses;
• lentils;
• spinach;
• quinoa.

#4 Vegan Omega-3 fatty acids: Walnuts, flaxseed, wheat germ, supplements

The richest sources of omega-3′s are in seafood, particularly mackerel, trout and tuna. Omega-3 fatty acids are commonly derived from Linolenic Acid, and are vital for brain functioning, boosting the immune system, preventing heart disease and promoting all-over well being. Vegan foods which are high in omega-3 fatty acids are:

• flax, soy and canola oils;
• hemp, sesame and pumpkin seeds;
• nuts, such as walnuts and Brazil nuts;
• wheat germ and wheat germ oil

#5 Vegan Zinc: Legumes, seeds, grains, brewer’s yeast and green veggies

Zinc is important for helping our bodies fight infections, produce new cells and utilize protein, carbohydrates and fats. Foods which provide the most zinc nutrients are shellfish, meat and milk, but there are many plant-based sources as well. To get enough zinc in a vegetarian diet, include plenty of:

• whole grains, including cereals and breads made with whole grains;
• nuts and seeds, especially pumpkin seeds;
• brewer’s yeast;
• beans and lentils;
• wheat germ;
• dark green vegetables

#6 Vegan Iodine: Iodized salt, seaweed

Vegetarians are more likely to not consume enough iodine, as some or the richest sources of iodine include many seafoods. According to one study, 80% of vegans and 25% of vegetarians do not consume sufficient amounts of iodine. Make a point of using iodized salts, and try incorporating toasted seaweed into your diet. Or better yet, learn how to make vegan sushi, complete with nori sheets, avocado, cucumber slices and compressed tofu.

Also read:

B12 Deficiency can really Get on your Nerves

Natalie Portman Chooses B12 over Veganism

Sources:

http://www.huffingtonpost.com/eatingwell/foods-to-eat-if-skipping-meat_b_861059.html

http://www.marksdailyapple.com/top-ten-protein-sources/

http://www.vrg.org/nutrition/iron.htm

http://www.savvyvegetarian.com/articles/omega-3-vegetarians-vegans.php

http://www.vegetarian-diet.info/zinc-vegetarian-diet.htm

As reported by Us Magazine, Pregnant Natalie Portman, Oscar winner for The Black Swan, has reportedly taken a leave of absence from her vegan ways; whether this change is permanent or just an extra precaution to deliver more vitamin B12 to her unborn baby remains to be seen.

The 29-year-old actress, who is expecting a child with boyfriend Benjamin Millepied, has always been an outspoken advocate for the vegan lifestyle, which excludes such vitamin B12 sources such as eggs, meat, milk products and fish. Ms. Portman made the decision to become Vegan after reading Jonathan Safran Foer’s Eating Animals in 2009, according to the Daily Mail.

Recent news, such as the death of an infant in France who was exclusively breast-fed by her vegan mother, has brought to light the health risks involved with vitamin B12 deficiency and anemia,  which are common risk factors of veganism.

Are Vegans in France Responsible for Breast-fed Baby’s Death?

Natalie, who called in on the Q100 Bert Show, admitted, “I know there are people who do stay vegan, but I think you have to just be careful; watch your iron levels and your B12 levels, and supplement those if there are things you might be low in in your diet.”

Oprah Pledges 7 Days to Vegan Challenge

Don’t expect to see Natalie heading for the steak house just yet, though; the Star Wars actress is following more of a traditional vegetarian diet, including eggs and dairy products which are rich sources of vitamin B12.

The symptoms of vitamin B12 deficiency include:

• Chronic fatigue;
• Depression;
• Feebleness;
• Short term memory loss;
• Aggression;
• Irritability;
• Numbness or tinging in hands and feet;
• Change in taste perception;
• Sleep disturbances;
• “Brain fog”

Left untreated, vitamin B12 deficiency could result in pernicious anemia, neurological damage or in severe cases, death.

Also read:

Benefits and Sources of Vitamin B12, and How to Avoid Deficiency

B12: Celebs Say it’s the New C

Sources:

Us Magazine, Babble, New!, OMG! Yahoo, Daily Mail, Herald Sun

For many vegetarians and especially vegans finding food which can replace other foods nutritionally is still a fair feat. To locate food which tastes like something you had to give up due to your convictions is an even greater experience. However as the world begins to accommodate the lifestyle/dietary choices of all individuals more and more products become available which not only taste like the old times, but as well provide the proper nutritional value.

Nutritional Yeast is one of these wonderful food replacements. It is an inactive yeast which is said to have a strong nutty, pungent smell reminiscent of parmesan cheese. This item is used mostly by vegans as a cheese replacement when can be added to pasta, soups, and even popcorn for a great cheesy flavouring. However, this is just the surface benefits of this yeast.

Nutritional Yeast is a complex source of nutrition, and just happens to contain a full B-complex in its makeup and also happens to be a complete protein, bearing great nutritional value. It is low in fat and sodium and is extremely beneficial for the health of the GI tract and absorption. Currently most brands of nutritional yeast fortify the yeast product with vitamin B12 produced by special bacteria and then added to the mix. The resulting product becomes not just a cheese substitute in flavour, but one in function, as it provides the much needed nutrients normally found only in animal products.