In light of the rapid population growth and increasing pressures on the global food supply, plant-based diets prove to be a potentially healthier and more sustainable option.
Vegans exclude animal-derived foods and products from their diet. Choosing veganism goes beyond dietary patterns and reflect a philosophy whose goal is preventing animal exploitation and cruelty, especially in food production.
In addition, going vegan is often motivated by the positive benefits of a vegan diet for health and the environment, making it an appealing choice for many individuals.
Vegan diets are associated with a reduced risk for cardiovascular diseases, as well as other degenerative disorders. There are a plenty of scientific evidence about the health benefits of a vegan diet, including weight loss.
A well-planned vegan diet offers a wealth of health advantages and can allow you to meet your daily value for essential nutrients. However, plant-based foods are often lacking in vitamin B12, so vegans need to incorporate fortified foods or oral supplements in their diet to meet their B12 needs.
Vitamin B12 deficiency is prevalent in vegans due to the exclusion of animal products in their diet. This article will discuss the different symptoms of vitamin B12 deficiency and how it is treated.
Key Takeaways
What Is Vitamin B12?
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that some foods naturally contain. It is added to some fortified foods, and comes in the form of dietary supplements or medications.
Vitamin B12 is essential in proper brain and nerve function, red blood cell formation, and DNA production. Vitamin B12 is also needed to synthesize amino acids so the body can make use of them.
The two active forms of vitamin B12 are methylcobalamin and 5-deoxyadenosylcobalamin, which means they are readily absorbed by the body. Other forms of vitamin B12 have to be converted into these two forms to become biologically active.
Vitamin B12 status is assessed through a blood test. Normal vitamin B12 levels usually vary between methods and laboratories, but an indicator of deficiency is when the serum or plasma values fall below 200 or 250 pg/mL.
The recommended dietary allowance (RDA) for vitamin B12 is 2.4 micrograms for adults. Pregnant and lactating women have higher needs at 2.6 micrograms and 2.8 micrograms respectively.
Can Veganism Cause Vitamin B12 Deficiency?
Those who follow a strict vegetarian or vegan diet are at risk of vitamin B12 deficiency because vitamin B12 is primarily found in animal foods and products. The risk factors for deficiency goes even higher for pregnant vegans who are on a strict vegan diet. Unless you take vitamin b12 supplements or obtain B12 from reliable plant based food sources, you are at risk of deficiency for the vitamin.
How Long Does It Take to Become Vitamin B12 Deficient as a Vegan?
One study has shown that short-term cessation of vitamin B12 supplementation is well-tolerated by vegans who have an adequate vitamin B12 status.
In the study, a healthy vegan man in his mid-30s stopped taking vitamin B12 supplements for a couple of weeks. A gradual decrease of vitamin B12 serum levels was observed during the fifth week, and supplements were introduced again on the 16th week mark.
The study found that an interruption of over 8 weeks could result in suboptimal vitamin B12 status that can eventually lead to a deficiency.
Other online sources state that vegans can develop vitamin B12 deficiency in two years after beginning a plant-based diet, but symptoms may take five years or more to manifest. This is because the body stores vitamin B12 in the liver, which can last for a long time without supplementation.
Who Are at Risk of Vitamin B12 Deficiency?
A person is likely to develop vitamin b12 deficiency anemia and other deficiency symptoms for one or more of the following risk factors:
- 1Older adults age 75 and above are at risk because their bodies don't absorb vitamin b12 as well as when they were younger.
- 2Those who suffer from digestive system disorders and autoimmune diseases, such as celiac disease, type 1 diabetes, thyroid disease, and Crohn's disease, experience difficulty absorbing vitamin B12.
- 3People who suffer from severe medical conditions, such as chronic pancreatic disease, inflammatory bowel disease, HIV, and ulcerative colitis
- 4Those who had stomach or intestinal surgery such as gastric bypass surgery or weight loss surgery
- 5Those who follow strict vegan or vegetarian diets, since vitamin B12 is mostly found in animal products.
- 6Those who take certain medications such as metformin, proton pump inhibitors (PPI), histamine H2 blockers, and oral contraceptives
- 7Heavy alcohol consumption or chronic alcoholism
- 8A family history of vitamin B12 deficiency
Vitamin B12 Deficiency Vegan: Symptoms
Vegans are three times more likely to become deficient in vitamin B12 after the age of 60. In addition, women of all ages on plant-based diets are also more likely to have a deficiency.
Vitamin B12 deficiency can cause a wide range of symptoms. These symptoms usually develop gradually over a period of time but can worsen if left untreated.
Vitamin B12 deficiency can also develop in anemia and nerve damage. Here, we list and explain the potential signs of vitamin B12 deficiency that you should watch for.
Vitamin B12 Deficiency Anemia
Vitamin B12 deficiency anemia occurs when a person doesn't get enough vitamin B12 in his or her diet or when the body has trouble absorbing the nutrient. This results in the body not producing enough healthy red blood cells.
Intrinsic factor is needed by the body to enable it to absorb vitamin B12. Without it, a type of vitamin b12 deficiency anemia called pernicious anemia can occur.
The inability to produce intrinsic factor in the stomach is due to several issues, including chronic gastritis, autoimmune diseases, or surgery to remove all or part of the stomach and the end of the small intestines.
It is important to note that vitamin b12 deficiency anemia goes hand in hand with folate deficiency anemia; so vegans need to take their folic acid intake in consideration when supplementing.
Neurological Symptoms
In severe cases of vitamin B12 deficiency, the brain and spinal cord could be affected by what's called subacute combined degeneration. This is a progressive degeneration of the spinal cord due to vitamin b12 deficiency.
Basically, the nerve fibers that control movement and sensations are damaged due to the deficiency, leading to symptoms such as weakness, tingling and numbness. The person suffering the deficiency may also experience irritability, drowsiness and confusion.
Psychological Problems
The occurrence of psychiatric symptoms due to vitamin b12 deficiency have been studied for decades. Symptoms include confusion and memory impairment, depression, hallucinations, and acute psychotic states. Other symptoms include paranoid delusions, anxiety insomnia, and manic states.
In elderly patients with Alzheimer's disease, mental changes associated with vitamin B12 deficiency include delirium and cognitive decline. This is why maintaining high vitamin b12 blood levels in the elderly is recommended.
People experiencing psychological symptoms related to vitamin B12 deficiency should consider testing for the deficiency. Vitamin b12 supplementation is required for patients suffering from the aforementioned symptoms.
Bear in mind that supplements can't replace standard treatment methods for psychological problems such as antidepressants and therapy.
Fatigue and Pallor
A lack of vitamin b12 can lead to anemia, presenting symptoms that often include fatigue and pallor. The symptoms of exhaustion and fatigue are more pronounced when you suffer vitamin b12 deficiency.
This is primarily due to the body's inability to produce healthy red blood cells that transport oxygen effectively. Aside from fatigue and pallor, other symptoms of vitamin b12 deficiency include the following:
- 1Shortness of Breath
- 2Dizziness
- 3Weight Loss
- 4Lack of Appetite
- 5Sore Tongue & Mouth
- 6Yellowish Skin
What Is the Best Vitamin B12 Deficiency Treatment?
Diagnosing vitamin B12 deficiency can be challenging because some people are asymptomatic or have symptoms that are similar to other nutritional deficiencies.
The best way to diagnose vitamin b12 deficiency is through a routine blood test, which include a complete blood count (CBC) and a test that measures vitamin B12 serum levels. A person is diagnosed with vitamin B12 deficiency if the vitamin B12 level in their blood is below 150 per mL.
Physical exams and a review of the patient's medical history is also done. In some cases, a bone marrow biopsy or an assessment of homocysteine levels are also conducted if the results of initial tests are unclear.
The type of treatment for vitamin b12 deficiency depends on the underlying cause of the deficiency and whether it's causing neurological symptoms. Patients whose deficiency are due to reversible causes will be treated until the deficiency resolves. However, the treatment is longer and possibly indefinite if the cause of the deficiency is irreversible.
Another way to treat vitamin b12 deficiency is by making significant dietary changes. Incorporating more vegan sources of vitamin B12 as well as supplements in your diet can help treat the deficiency and prevent it in the future.
Final Thoughts
Vegans are more at risk for vitamin b12 deficiency than the general population. Vitamin b12 deficiency can happen if your diet doesn't include foods rich in vitamin B12, or if you're not supplementing your intake. This can lead to a wide range of symptoms including neurological and psychological symptoms, as well as anemia. The good news is, it is possible to meet your dietary requirements for vitamin b12 by consuming fortified foods and by taking oral vitamin B12 supplements.
Frequently Asked Questions
The quickest way to treat a vitamin B12 deficiency is usually through vitamin B12 shots administered by a healthcare provider. Vitamin B12 injections result in the rapid replenishment of B12 in the body, especially for severe cases of deficiency, where neurological symptoms are present.
Vitamin B12 injections are often administered every other day for a series of weeks until symptoms have resolved. Note that the treatment plan depends on how severe the deficiency is and its underlying cause. Otherwise, oral supplements may be prescribed.
If you are deficient in vitamin B12 or think that you are not getting enough, the first thing to do is to make dietary changes. Incorporating vitamin B-12 rich plant based foods, such as fortified foods, breads, cereals and nutritional yeast, as well as taking oral vitamin B12 supplements can help you meet your dietary intake and prevent future deficiencies.
Vegans can obtain vitamin B12 from fortified foods such as plant-based milks, nutritional yeast, breakfast cereals, meat substitutes, and vegan spreads and margarines. Another way to meet your vegan vitamin B12 requirements is to take B12 supplements in the form of tablets, sprays or lozenges. Vitamin B12 injections may be administered once a week for those who prefer their B12 supplementation in the form of shots.
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