As with all dietary supplements, it’s important to discuss B12 supplementation with your healthcare provider, especially if you’re vegetarian or vegan. Your healthcare provider can help you determine how much (if any) supplementation is right for you. It’s important to consider that folate-typically high in the vegetarian and vegan diets can mask the presence of vitami
B12 deï¬ciency. The preferred form of B12 supplements is cyanocobalamin.
Generally speaking, if you’re vegan (meaning you don’t eat ANY animal products), B12 supplements are recommended at levels that meet 100% or more of the recommended daily allowance. In fact, the Vegetarian Nutrition Dietetic Practice Group suggests that vegans consume much higher levels of vitami
B12 (250mcg/day for adults) to compensate for poor absorption of supplements. Regardless of diet preference, the National Institutes of Health recommends that all adults over 50 years of age receive most of their
vitami
B12 through supplements and fortiï¬ed foods, due to impaired absorption that occurs during aging.
Vegan Vitamin B12 – Very low B12 intakes can cause anemia and nervous system damage. The only reliable vegan sources of B12 are foods fortified with B12 (including some plant milks, some soy products and some breakfast cereals) and B12 supplements. Vitamin B12, whether in supplements, fortified foods, or animal products, comes from micro-organisms. Most vegans consume enough B12 to avoid anemia and nervous system damage, but many do not get enough to minimize the potential risk of heart disease or pregnancy complications.
To get the full benefit of a vegan diet, vegans should do one of the following:
1. Eat fortified foods two or three times a day to get at least three micrograms (mcg or µg) of B12 a day
2. OR Take one B12 supplement daily providing at least 10 micrograms
3. OR Take a weekly B12 supplement providing at least 2000 micrograms.
If relying on fortified foods, check the labels carefully to make sure you are getting enough B12. For example, if a fortified plant milk contains 1 microgram of B12 per serving then consuming three servings a day will provide adequate vitami
B12. Others may find the use of B12 supplements more convenient and economical.
The less frequently you obtai
B12 the more B12 you need to take, as B12 is best absorbed in small amounts. The recommendations above take full account of this. There is no harm in exceeding the recommended amounts or combining more than one option.
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If you don’t read another word about B12, you already know all you need to know. If you want to know more, read on.
Getting an adequate amount of B12
National recommendations for B12 intakes vary significantly from country to country. The US recommended intake is 2.4 micrograms a day for ordinary adults rising to 2.8 micrograms for nursing mothers. The German recommendation is 3 micrograms a day. Recommended intakes are usually based on 50% absorption, as this is typical for small amounts from foods. To meet the US and German recommendations you need to obtain sufficient B12 to absorb 1.5 micrograms per day on average. This amount should be sufficient to avoid even the initial signs of inadequate B12 intake, such as slightly elevated homocysteine and MMA levels, in most people. Even slightly elevated homocysteine is associated with increased risk of many health problems including heart disease in adults, preeclampsia during pregnancy and neural tube defects in babies.
Achieving an adequate B12 intake is easy and there are several methods to suit individual preferences. Absorption of B12 varies from about 50%, if about 1 microgram or less is consumed, to about 0.5% for doses of 1000 micrograms (1 milligram) or above. So the less frequently you consume B12, the higher the total amount needs to be to give the desired absorbed amount.
Frequent use of foods fortified with B12 so that about one microgram of B12 is consumed three times a day with a few hours in between will provide an adequate amount. Availability of fortified foods varies from country to country and amounts of B12 vary from brand to brand so ensuring an adequate B12 supply from fortified foods requires some label reading and thought to work out an adequate pattern to suit individual tastes and local products.
Vitamin B12 Liquid – Taking a B12 supplement containing ten micrograms or more daily provides a similar absorbed amount to consuming one microgram on three occasions through the day. This may be the most economical method as a single high potency tablet can be consumed bit by bit. 2000 micrograms of B12 consumed once a week would also provide an adequate intake. Any B12 supplement tablet should be chewed or allowed to dissolve in the mouth to enhance absorption. Tablets should be kept in an opaque container. As with any supplement, it is prudent not to take more than is required for maximum benefit, so intakes above 5000 micrograms per week should be avoided despite lack of evidence for toxicity from higher amounts.
All three options above should meet the needs of the vast majority of people with normal B12 metabolism. Individuals with impaired B12 absorption may find that the third method, 2000 micrograms once a week, works best as it does not rely on normal intrinsic factor in the gut. There are other, very rare, metabolic defects that require completely different approaches to meeting B12 requirements. If you have any reason to suspect a serious health problem seek medical advice promptly.
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