Disclaimer: This information is for educational purposes only,
and does not replace individualized diagnosis and care.
Vegans and the Vitamin B12 Deficiency Myth
[Posted 23 October 2003; last updated 22 November 2008] It seems there's always at least one tired old myth making the rounds about vegetarianism. Twenty years ago when I switched, it was the "protein deficiency" myth. Now that the protein myth has been completely discredited (human breast milk is only 5% protein, and it is estimated that adult humans only need 2-3% protein in their daily diet), these days the vitamin B12 myth occasionally surfaces. Usually it's only preached in places like very old doctors' offices or talk radio shows dominated by heavy recommendations for drugs and dairy products, but the question still comes up. Of the thousands of people who visit this web site every month, a few always find me with the search string "vegans B12 deficiency".
Deficiencies at Large
A small number of people develop B12 deficiencies, most of them not vegans, just like people with deficiencies in every other type of vitamin and mineral. Ever heard a dieter say that his or her hair fell out while dieting? That's borderline scurvy, a Vitamin C deficiency. Any friends or relatives have white hair, wrinkles, maybe an aneurysm? That's copper deficiency. Know anyone with cystic fibrosis (CF)? His or her mother suffered a selenium deficiency before and/or during their pregnancy. Vitamin deficiencies are as common as bad health in general; in fact, they cause a good chunk of the bad health these days.
B12 Deficiency: A Lengthy Process
B12 (also called cobalamin due to its central cobalt atom) is a water-soluble vitamin with a very low recommended daily intake requirement, about 2-3 micrograms per day. That's MICROgrams, not milligrams. In addition to having extremely low intake requirements, Vitamin B12 is stored in the liver, kidneys, and muscle tissue, and most B12 (65-75%) is reabsorbed by the body instead of excreted. A deficiency could take from 5 to 20 years of inadequate intake to develop. The deficiency could be masked by adequate folic acid intake, as the two vitamins work together, but only temporarily. Eventually a B12 deficiency manifests as nerve damage and pernicious anemia, a very serious type of anemia where red blood cells are improperly formed and white blood cell count is low.
Bacteria: Myth vs. Reality
So how could anyone develop pernicious anemia when B12 intake requirements are so low, and when the liver stores so much that it takes years for a deficiency to develop? The reason touted for the B12 myth is that B12 is found primarily in animal foods. Very few plant foods provide good sources of B12, they say. In a way that's true, but only because the source of B12 is not plants OR animals; neither manufacture their own B12. In the B12 reality, Bacteria are the B12 producers on which both plants and animals rely. And in humans, that bacteria doesn't necessarily come from plants -- the mouth, upper intestine, and lower intestine all contain bacteria that produce B12. However, it's unknown if enough B12 to meet the daily requirement comes from internal sources of B12. More likely, they produce some, and the rest comes in with food and water consumed.
All of the Vitamin B12 in the world ultimately comes from bacteria. Neither plants nor animals can synthesize it. But plants can be contaminated with B12 when they come in contact with soil bacteria that produce it. Animal foods are rich in B12 only because animals eat foods that are contaminated with it or because bacteria living in an animal's intestines make it.
-- From The Vegetarian Way: Total Health for You and Your Family (1996), Virginia Messina, MPH, RD, & Mark Messina, PhD p. 102
Most people with B12 deficiencies and/or pernicious anemia are NOT vegans. Very few vegans have pernicious anemia. B12 deficiencies occur primarily when:
1.) Something is competing for your B12 (like parasites);
2.) Something is destroying your B12 (like cyanide in cigarettes); or
3.) Something is preventing the proper absorption of B12 (like inadequate production of intrinsic factor).
It's possible that vegans may be more susceptible to these three factors, as vegans don't consume huge quantities of B12 to counteract such problems (unless they use vitamin supplements). I assume it's also possible that any depletion of intestinal bacteria, for example from lengthy courses of antibiotics, might lead to a drop in B12 production, although I haven't yet found any other author mentioning this as a contributing factor. However, even with these factors present in vegans as well as the population at large, very few vegans develop B12 deficiencies. Most recent books I've found refer to parasites and intrinsic factor (IF) production problems as the common culprits.
1. Competition (Parasites)
Hulda Clark, the famous research scientist who uses radio resonance in vivo to determine microorganisms involved in cancer, AIDS, and other diseases, finds the parasite Ascaris (a worm-like parasite) is usually involved in cases of pernicious anemia:
"Each red blood cell is shaped like a doughnut without the hole. This fits a lot more oxygen, O2, than round balls would. Yet, if there isn't enough vitamin B12, the dimple isn't put into them to make them doughnut shaped. This reduces the body's oxygen supply and the disorder is called "pernicious" anemia. The changed shape of the red blood cells is reflected in a bigger volume called mean cell volume (MCV). The correct volume for red blood cells is about 90 cubic microns. Many elderly persons have a MCV over 100!
"I have seen pernicious anemia to be associated with Ascaris infestation. Kill Ascaris on a frequency generator (408 KHz) or zap. The source of Ascaris is usually a pet, owned in the past. Once infected, the tiny worms do not leave your body on their own. The infestation may date back to childhood. What a relief for the bone marrow whose job it is to make red blood cells to have enough vitamin B12 again! What does Ascaris do with your B12? B12 is a beautiful rose colored vitamin. Some worms are actually pink from absorbing your B12! Giving B12 shots is the current clinical treatment for B12 deficiency. Killing Ascaris twice a week by zapping and taking B12 lozenges is a better solution."
-- From The Cure for All Diseases (1995), Hulda Clark, PhD, ND, p. 285
One thing to note about Hulda Clark is that she is NOT an advocate for vegetarianism (although she does concede that meat carries far more parasites and bacteria than vegetable matter). If Clark thought veganism was involved in pernicious anemia, or that people need to eat meat products to avoid it, she would have said so.
Another cause of B12 deficiency could be destruction of the Vitamin due to dietary or environmental factors. For example, smoking, high protein diets, alcohol consumption, chlorinated water (disruption by chloroform), and diarrhea may deplete B12.
[Special note: I've noticed that several critiques of this article online complain that I don't mention mercury detox as a B12 consumer. This is a good criticism, and much more information on mercury health issues can be found at MercuryPoisoned.com.]
3. Absorption Problems
Other than parasites, the most common cause of B12 deficiency is absorption problems. In order to properly absorb B12, the stomach produces a special "intrinsic factor" that, with adequate calcium, promotes the absorption of B12 in the small intestine. Intrinsic factor production problems are often related to stomach problems in the elderly.
The Cautious Path
So what's a vegan to do for B12? Less rinsing of fruits and vegetables is a bad idea. Bacterial food poisoning is much less common with vegetables than meat, but it can still occur with vegetables. The body might produce enough B12 from its own bacteria and naturally-occuring bacteria on food (rinsing doesn't remove all of it), but I like to play it safe. Personally, I believe in vitamin supplementation for a number of reasons. In their book Rare Earths, Forbidden Cures, Joel Wallach, DVM, ND and Ma Lan, MD, MS cover the uneven distribution of minerals in the earth's crust. Wallach and Lan believe that mineral supplementation is absolutely necessary, as even pristine farmland usually doesn't contain all the needed minerals.
I take an occasional multi-vitamin -- a GOOD multi-vitamin that's bought at a health food store or mail-ordered, with plenty of colloidal or chelated minerals. Although I'm not the best at taking pills (sometimes I don't take my vitamins more than a few times a month), I eat a lot of organic fruits, vegetables, legumes, nuts, etc. Not all vegans make the effort to eat healthy. Vegans who eat a lot of processed, nutrient-poor foods and take no vitamins put themselves at risk for a number of deficiency diseases.
One of these days, I want to start a "Pam the Lab Rat" series, where I describe alternative medicine I've tried on myself and how it worked for me, like the Hulda Clark-style Zapper (an excellent device). In the meantime, I'll cover how my limited vitamins and good diet work out for me in relation to any B12 deficiency:
I didn't go completely vegan until early 1997. Until that time, for years all I'd eat in the way of animal products was "a little cream in my coffee". It's now 2003, 6 years later, and my only health problems are leftovers from physical accidents -- a trip-and-fall, and two auto accidents (1998 and 2002). In 1999, a physician treating me for the 1998 auto accident couldn't believe that some of my neurological symptoms weren't caused by a B12 deficiency. Somehow she believed that all vegans had B12 deficiencies. So she ordered a full, very expensive liver panel on me. The readings all came back perfect, of course. Then several months later, a chiropractor fixed up 100% of my symptoms in question with chiropractic adjustments, and with only a few visits! That's the problem with traditional doctors -- they know almost nothing about nutrition. (A vegan's been in an auto accident, therefore her injuries must be from vegetarianism? What kind of logic is that?) From what's been written about medical education, sometimes MDs might be offered an *optional* class on nutrition in medical school, but they often don't attend, because that's a lowly nutritionist's job...
Here are a few functions of Vitamin B12: proper formation of red blood cells, manufacture of DNA, formation of fatty insulation surrounding nerve cells, detoxification of cyanide from cigarettes and food, cancer prevention, nervous system health, proper growth, prevention of PMS, posture and balance, memory and concentration, proper cell division, sperm production and motility.
Some B12 deficiency symptoms: pernicious anemia, diarrhea, fatigue, nerve damage, depression, PMS, heart disease, trembling, low sperm count or poor sperm motility, and a sore red tongue.
The above functions and symptoms of B12 are only partial lists. If you suspect you may have a B12 deficiency, it's best to consult both reference materials and your doctor, as doctors are often poor sources on nutritional deficiencies. A doctor, however, can determine whether your symptoms are actually a B12 deficiency or a different disorder.
Over the years, fewer than a dozen people have written to me, convinced that their pernicious anemia (or a loved one's) was due to being vegan. This was either something that their doctor had told them, or an idea they had formed on their own. I always ask the same question -- did your/her doctor test for PARASITES? So far, the answer has always been "no." I don't want to tell people who they should see for a doctor, or call anyone's doctor a quack. But if your doctor diagnoses pernicious anemia and doesn't even test for parasites, then he or she is unfamiliar with the number one cause of pernicious anemia according to the literature in his or her own field. That's reason enough to seek a second opinion. Furthermore, I belong to several very large vegetarian/vegan groups, and so far have only met one person with pernicious anemia (and no, her doctor DIDN'T test for parasites or even mention them).
Personally, I've been a vegetarian for more than 20 years, and vegan for more than ten. I have never been diagnosed with pernicious anemia, and only one doctor even tested for it (due to dizziness after an auto accident -- the results came back normal, of course). I don't mean to be rude, but the facts were clear -- that particular doctor wasn't very good, and wasn't my doctor for long. I had dizziness after an auto accident, with many other accident-related symptoms, and she thought dizziness was due to B-12 deficiency? It was tragic, so much time being wasted by this nonsense while I suffered and was unable to work. Months later, a chiropractor re-ordered my neck x-rays and the radiologist found a healed (by that time) neck fracture. That's right, a neck fracture can cause dizziness.
Although I've never had pernicious anemia, it should be noted that I cleanse for parasites at least once every two years (although this didn't start until the year 2001, and I was fine until then, too). I use either a Clark zapper (see clark.pamrotella.com) or an herbal parasite cleanse from Hulda Clark's book "The Cure for All Diseases." So parasites aren't going to be eating my B-12, at least not for long! However, I don't mean to imply that parasite cleanses are absolutely necessary to prevent pernicious anemia. Many vegans never cleanse for parasites, and never have such extreme B-12 deficiency. It's really up to individuals to monitor their own health, and make decisions based on their own personal situation.
Hulda Regehr Clark, PhD, ND. The Cure for All Diseases. Chula Vista, California: New Century Press, 1995.
Virginia Messina, MPH, RD, & Mark Messina, PhD. The Vegetarian Way New York: Three Rivers Press, 1996.
Denise Mortimore. The Complete Illustrated Guide to Vitamins and Minerals. London: Element [imprint of Harper Collins Publishers], 2001.
Rachel's Environmental & Health Weekly. Dangers Of Chlorinated Water; RACHEL'S ENVIRONMENT & HEALTH NEWS. Annapolis, MD: Environmental Research Foundation. Published on Gary Null's web site at http://www.garynull.com/Documents/erf/dangers_of_chlorinated_water.htm
Nicola Reavley. The New Encyclopedia of Vitamins, Minerals, Supplements, & Herbs. New York: M. Evans and Company, Inc. (Bookman Press), 1998.
Joel D. Wallach, DVM, ND, and Ma Lan, MD, MS. Rare Earths, Forbidden Cures. Bonita, California: Double Happiness Publishing Co., 1994.