B12 update

I’ve been doing some research into vegan B12 options, and as always, it sinks in how little we really know, how much more we have to learn, and the uncertainties of it all. I can tell you what science has worked out so far, but remember that everything is always changing as new evidence comes to light. Science is, and always will be, an incomplete art: we cannot know what we don’t know, or where the blind spots in our vision are, and without this understanding, we are always going to be seeing only part of the big picture.

Can we get it from plants?

You cannot rely on fermented foods, mushrooms, sprouts, seaweeds, spirulina, raw plant foods for B12. With every single one of these supposed sources of B12, it has been established that either the B12 quantity is non-existant, too low and/or the B12 is actually an analog that just looks like B12. When you give these foods to people as their only source on B12, they become deficient. In some instances, the deficiencies actually happen faster, because the B12 analog is interfering with the action of true B12. Also, if you are deficient in true B12 while also consuming lots of analog B12, your serum or plasma B12 levels can appear normal in tests, even though you are deficient. In other words, the B12 analogs can hide deficiencies, giving us a false sense of security.

Chlorella and Aphanizomenon flos-asquae (AFA) have some true B12, but we haven’t had enough research done yet to know if we could truly rely on these as our sole source of B12. Initial research has given mixed results.

 Do we really need to supplement?

You will probably come across plenty of very convincing sources telling you that you don’t need supplemental B12, for one reason or another, and history may well prove them right, but the risk involved with taking a B12 supplement seems way less than the risk of not taking them, and this is coming from a naturopath who doesn’t like taking supplements unnecessarily.

It can take anywhere from months to (in extreme cases) up to 20 years to develop a deficiency if you aren’t supplementing, because some of us are very efficient B12 recyclers, able to keep reusing the B12 we already have stored in the body. The problem is, B12 deficiency isn’t somewhere you want to arrive at and then fix up in hindsight; it’s far safer to avoid deficiency in the first place because deficiency consequences can be severe and irreversible. Early symptoms such as weakness, fatigue and mood changes, can be overlooked because they can be so easily attributed to some other cause.

B12 deficiency can cause megaloblastic anemia (fatigue, weakness, decreased stamina, shortness of breath, palpitations and skin pallor) but sometimes this condition can be masked in people with a rich folate diet because dietary folate can hide B12 deficiency symptoms. Meanwhile, the B12 deficiency can be causing damage to the nerve cells, spinal cord and brain, with symptoms such a confusion, depression, irritability, mood changes, insomnia and an inability to concentrate.

Physical changes can include tingling and numbness in fingers, arms, legs, defiiculty with balance, lack of sensation, and eventual paralysis. Gastrointestinal deficiency signs can include a sore tongue, reduced appetite, indigestion and diarrhea. Deficiencies in pregnancy may be linked with neural tube defects, and the babies of breastfeeding B12 deficient mothers can develop serious and permanent damage to the nervous system.

Another thing that happens with B12 deficiency is that your homocysteine levels can skyrocket. Homocysteine is a natural amino acid in humans, but high levels are linked with poor bone health and artherosclerotic plague build-up and damage to the arterial walls, which can eventually lead to heart attack, stroke, depression and possibly dementia. B12 works with B6 and folate to convert homocystiene into cysteine and methionine, two amino acids your body can use for building protein. These three nutrients are often used to treat elevated homocysteine, but research results have been inconsistent. What has been proven effective though, is supplementing DHA (a long-chain omega-3 fatty acid) to reduce elevated homocycteine levels in people who are DHA deficient. There appears to be a link between elevated homocysteine and low omega-3 status.

The phrase ‘we can produce B12 in our own gut’ is an argument often used to suggest we don’t need supplements at all: yes, we do produce B12 in our bowels, just as do other animals…. But the production site is lower down in the digestive system beneath the part of the bowel we absorb it from. This would be like trying to drink from a garden hose when the end of the hose is stuck in the neighbours yard and the fence is covered in barbed wire: it just won’t work. You may also have heard that B12 is present higher in the gastrointestinal tract upstream from the absorption site (such as the mouth), but the quantities produced are too low to prevent deficiency.

 Supplementing B12

You can access some B12 from fortified foods, where B12 (ie supplemental B12) has been added to commercial foods during the production process (eg nutritional yeast) but dosage strength varies from product to product, brand to brand and batch to batch… and you would need to be taking it multiple times a day (eg use it as a spread or sprinkle) to ensure reasonable intake. Even then, most professionals advise backing this up with an actual supplement from time to time.

We only absorb a very small fraction of what we consume, when it comes to B12. For example, if you take 250 mcg, your receptors will only take in about 1.5 mcg and won’t be able to absorb anything more until 4-6 hours have passed. So the less frequently you take B12, the higher the dose you will need.

Most sources recommend using one or more of the following approaches:

A) Daily intake of at least 25 mcg. Maximum recommended upper limit for daily use is 250 mcg for adults up to the age of 65, and 1000 mcg for seniors.

B) Take 2000 – 2500 mcg twice a week, either sublingually or swallowed (either is fine, it doesn’t have to be sublingual absorption– ie ‘under the tongue’ absorption).

C) Consume three servings or B12 fortified foods per day, with each serving providing at least 2 mcg of B12. Fortified foods may include nondairy drinks, vegan meat substitutes, breakfast cereals or nutritional yeast.

Cynocobalamin, methylcobabalamin or….?

The head positively spins, when we think about all the different forms of B12!

Cyanocobalimin is the most commonly used form of B12 in supplements. It’s a synthetic form of B12 that is converted by the liver into a more active form. It has the most proven effectiveness so far and the most research backing. It appears to be non-toxic when used in amounts as recommended, but we don’t really know the long-term effects of large doses (eg 1000 mcg per day). Just because something is relatively safe for you in a low to moderate dose, doesn’t mean it will keep being safe for you in a high dose. More isn’t always better.

You might hear some talk of the cyanide portion being an issue, but cyanide is found all through nature and is fine in small doses. 1 level tablespoon of flaxseeds contain 30 times as much cyanide as a 2,500 mcg cyanocobalamine supplement. Once absorbed, our body removes and detoxifies the cyanide, then it turns the cobalamine into methylcobalamine.

If you are a smoker or you have kidney problems, cynocobalamin might not be so effective for you, so try using methylcobalamin instead. We don’t have a lot of scientific research available to really pin down accurate dosaging guidelines for methylcobalamine (partly because its so much more unstable than cyanocobalamin), but it’s possible users may require as much as 1000 mcg daily.

Yes, there are other forms of B12, but again, the testing on safety with these is inadequate. We simply don’t know enough, yet, about the impact of supplementing various different forms of B12, but I know other practitioners may feel differently to me.


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