B12 – Take it or Make it?- The Dirty Truth

In response to a colleague who was asking about B12 in vegans, I wrote this the other day and decided to basically share with you the unedited response.  The first half was written with them in mind… The second half was written with you in mind. You, the ones that are looking to be healthy now!

If you’re a nerd like me, you might love this… But if you just want the bottom line, skip to the part that says “B12 on a Vegan Diet”.  Enjoy!


The B12 “debates” are anemic at best (no pun intended).  I don’t say that because one side or the other is totally correct, but because it’s one of the areas of research that is SO lacking in research.  There just isn’t a lot of research out there on this topic specifically.  Of course, if you search “B12 and XYZ”, studies will come up…  But if you really want to have a great understanding about B12 in general and, more specifically, in vegans, you’d have to answer a lot of questions about:

  • Folate
  • Intrinsic factor
  • Tons of factors that impact absorption 
  • Human active B12 vs. B12 analogs 
  • Breast fed or not
  • Low HCl (common) makes B12 difficult to extract
  • Homocysteine levels
  • Serum blood used to be the gold standard for testing… It’s since been found to be inaccurate… Urine assays of MMA is the new standard
  • Eating feces. (Gross I know, but it’s a real thing, and it’s how many plant-eating animals such as the gorilla get their B12)
  • B12 tends to be heat sensitive so raw vs. cooked makes a difference (even on meat, which you don’t want to eat raw, so…)
  • Intake vs. absorption. (Vegans perhaps take in less but more often have better absorption which plays a role)
  • And finally, what type of vegan diet?  A whole food organic diet is different that a junk food based vegan diet.

All that said, the blog post below was something I wrote for my clients a few weeks ago.  For that reason, it is more general and less technical with the lay person in mind.  In short, although much more work needs to be done in regard to B12, supplementation is often a good option… but as is so commonly the case, improving the microbiome upgrades nearly every area of health, including the creation and bioavailability of B12.  My personal goal and philosophy is always to work WITH the body to help it do what it was created to do and then supplement from there as needed.

My hope for anyone who takes the time to read this is that it only furthers learning and helps us all to really think critically about what the evidence shows (versus what “we’ve heard”… Marketing and propaganda are a sorry replacement for full integrity research!).

B12 on a Vegan Diet

I never really liked meat at all and so going vegetarian was super easy once I learned I didn’t need it for protein.  I did like cheese so that was a bit tougher. I’ve been vegan for over 10 years now and I never feel deprived and have never felt better.  Veganism is not a religion for me and I’m not one of those “crazy” vegans who hates people who aren’t vegan… But according to countless hours of reading, classes, seminars and research, I really do believe that it’s the healthiest diet that we can consume for optimal wellness (major caveat, if done properly).

That said, I am referring here to an organic whole food vegan diet, NOT the standard American version of a vegan diet that won’t eat animal products but consumes lots of processed foods (fake meat, vegan donuts, cakes, bread, etc.).  This is a key point because those who eat whole foods are much healthier in every way as compared to the junk food vegans.

I am often asked about being vegan and all the various myths that ensue.  So what about B12?

There has been SO much misinformation around this specific nutrient and I’m not sure the blood tests are really that accurate.  Of course, you can supplement, which many people may need to do anyway (even non-vegan).  However, our body only needs about 1 microgram of B12 per day and it is relatively easy to get– or should I say, to make.   However, it can be challenging to absorb, depending on your digestive capacity.  Genetics also play a role.

B12 is one of 8 B vitamins and has an important role in cellular metabolism of every cell in the body.  It impacts DNA as well as the metabolism of lipids and proteins and aids in the production of red blood cells.  B12 heavily impacts the brain and nervous system.

If you are lacking in B12, common deficiency symptoms include:

  • Tired all the time
  • Loss of appetite
  • Constipation or diarrhea 
  • Pale skin
  • Vision loss
  • Nerve issues (numbness or tingling)
  • Depression and mood issues

It’s important to understand that B12 is bacteria derived.  This means that it’s not in meat but rather on meat.  It’s on plants as well, especially plants from good soil (not always easy to find).  B12 is more plentiful in meat because there’s more bacteria in dead animal flesh. (I’m not saying that for effect… It just makes sense that there would be more bacteria on something post-life.:)1  A big part of the challenge in our culture is that we have so sterilized everything (chlorine in water, hand sanitizers, bleach, etc.) that bacterial growth, even the beneficial kind, can be hindered.  This is perhaps part of why so many people have issues in their gut microbiome. (This often manifests in a wide range of digestive issues.  For more information on the microbiome, see my Dysbiosis blog here.)  B12 is created and absorbed by the large intestine and distributed throughout the body.2

To get your B12 from meat, by its very nature, you would also have to intake the cholesterol, saturated fats, hormones and many more things that come along with it.  And you don’t want all that.

Root vegetables tend to be some of the better sources as they are grown directly in the ground/soil.  Nutritional yeast (although tougher to find good quality) is a great source too because it’s rich in protein and other B vitamins along with B12.  I love green smoothies with dark leafy greens as they offer B12 but also a broad spectrum of phytochemicals, other vitamins and minerals (especially iron) and are well absorbed for most people.3  Algae is another powerful source.  Although it can be harder to find good quality, I love algae because it also has DHA. (My favorite sources of B12 are DHA Caps, DHA+D, DHA+E EPA/DHA Softgels, EPA/DHA Marine Liquid and Spirulina Manna.)  

But here’s the bigger takeaway:  In a generally healthy body, you can get the B12 that you need easily from what is being naturally made in the mouth, teeth, gums and nasopharynx.4  Vegans and vegetarians have a healthier, more robust and diverse microbiome.5  This makes them more efficient at creating the B12 that they need.  If you aren’t so healthy, then supplementing is critical.

Although more study is needed, there is much verification that a vegan diet is optimal for health; however, a small amount of supplementation may be helpful.6  If you are on a vegan diet or just suspect that your B12 is low, it can be helpful to supplement aggressively for a few weeks WHILE you are building your microbiome.  After which, you can supplement less often.  The key, though, is to build the microbiome with a whole food, plant diet so that you aren’t relying completely on supplementation.  With alternative health care you can turn your body into a B12 making machine.

If you feel you need to supplement, try: B12, Spirulina Manna, DHA Caps (additional forms of DHA include DHA+D, DHA+E, EPA/DHA Marine Softgels and EPA/DHA Marine Liquid), Nutritional Flakes, Max B or Phyto Methylate.

Do I take B12?

So what do I do personally?  I get this question a lot.  I love and also don’t love this question…  I love it because I am an open book and am always willing to share my holistic health journey with you.  I don’t promote things that are contrary to how I personally live.  But I don’t like the question for another reason. Too many people take what I do as a dogmatic prescription because of my standing as a holistic doctor/ naturopathic practitioner  for what they should do.  If you weigh the same as me, eat the same as me, have a similar exercise routine as me, have the same stress levels as me, live like me, etc., this is perhaps a good route for you to take… But if you don’t, your needs will differ greatly.  That said, I eat Nutritional Yeast 3-4 times/week (making sure the quality tests on to all 4 polarities, aka cell resonate), mostly because I like the taste… I take DHA daily, but more for the plant source omega 3s…  And yes, I do take ¼ teaspoon of nanized B12… 

But PLEASE HEAR THIS: Those are supplements and if you have been following me for any amount of time, you know that I believe supplements are just that– they should SUPPLEMENT a healthy lifestyle.  The more important factors to note in my naturopathic health routine, is that I drink over 100 ounces of water daily, eat dark leafy greens daily, consume ½ cup or more of fermented vegetables daily, exercise daily, haven’t had processed food (at all) in over 10 years, etc.  All of that is the foundation on which the supplements become more effective.  I don’t say any of that to impress you but rather to impress upon you the fact that my foundation, although not perfect, is solid. My body has good raw materials to work with.  I take cell resonate supplements every day and have for years and I recommend them to clients as well.  But I never want to mislead anyone to believe that any supplement can out-do the work of living a health promoting lifestyle which is about way more than just food or exercise.  Sleep, purpose, thoughts and stress reduction all play a role.  

Another point to mention is that as I have done micronutrient testing for the past couple of years for myself and clients, I find b12 to be commonly low regardless of meat-eating vs plant based.  It’s ideal to get tested…for more information on that, click here.

If you are having health challenges that don’t add up, that you can’t figure out, or that you have tried EVERYTHING to fix to no avail, it may be time to get help with a naturopathic consultation.  I would LOVE to support you on your path to optimal health.  Don’t wait, get healthy now!

Reference List:

1. Cousens G. Consious Eating. North Atlantic Books; 2000.

2. Yoshii K, Hosomi K, Sawane K, Kunisawa J. Metabolism of dietary and microbial vitamin b family in the regulation of host immunity. Front Nutr. 2019. doi:10.3389/fnut.2019.00048

3. Posen JS. Iron and vegetarian diets. Med J Aust. 2013. doi:10.5694/mja11.11494

4. Thrash A. A Discussion of Vitamin B12. https://www.ucheepines.org/a-discussion-of-vitamin-b12/. Accessed May 30, 2020.

5. Tomova A, Bukovsky I, Rembert E, et al. The effects of vegetarian and vegan diets on gut microbiota. Front Nutr. 2019. doi:10.3389/fnut.2019.00047

6. Lederer AK, Hannibal L, Hettich M, et al. Vitamin b12 status upon short-term intervention with a vegan diet—a randomized controlled trial in healthy participants. Nutrients. 2019. doi:10.3390/nu11112815

Nothing said or implied in this post is intended to treat, cure, diagnose or prevent any disease.  It does not take the place of a qualified health care practitioner and is intended for educational purposes only.

Dr. LeAnn Fritz, PhD

Dr. LeAnn is a practitioner, coach, speaker, consultant, and the founder of New Hope Health. She is also the author of The Quantum Weight Loss Blueprint, and Get Healthy Now. She is laser-focused on practical, evidence-based practices to empower her clients to get real results that last. She sets the bar when it comes to radiant health that will change every area of your life forevermore.

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