Doctor's Note

Make sure you see the “prequel” to this video: Arteries of Vegans vs. Runners. I have dozens of videos on B12. For a quick cut-to-the-chase see my Q&A What is the best way to get vitamin B12? and for some context Vegan B12 deficiency: putting it into perspective. Vitamin B12 supplementation with fortified foods or supplements is critical on a plant-based diet. If you haven't yet, you can subscribe to my videos for free by clicking here.

To post comments or questions into our discussion board, first log into Disqus with your account or with one of the accepted social media logins. Click on Login to choose a login method. Click here for help.

  • BeetsBeansButts

    When I see a fellow vegetarian/vegan at the grocery store looking at TVP I usually ask them about omega 3s, Vitamin D, iodine, B12. (those are some nutrients of concern for vegans right?)

    There are easy ways to get these nutrients, but most vegetarians/vegans are not aware.

    We should really just put B12 in tap water.

    Thanks for making this video.

    • foo

      and take fluoride out of the water supply.

    • Mela Rossa

      Can you imagine how expensive it would be to put B12 in tap water?

      • Darryl

        A kilo of cyanocobalamin is about $2600. That’s enough B12 for 417 million doses at the RDA. Unfortunately, you need to get to get people to drink the tap water.

        • Mela Rossa

          Still a waste of money and the later part of B12 reacting with other molecules is also what I thought about.

      • I’m on my own well :)

      • george

        I read in a book (Davis and Melina, I think) that in the old days there was B12 in drinking water naturally because there were B12-producing bacteria living in water.

        • Ed Lincoln

          This is a very interesting notion. My home is a farm for the last 40 years and the hetotropic bacterial load is high.
          Please help me find research on this.

          • george

            Ed: This is the argument I remember reading: There were vegans, sometimes whole communities of vegans, 100, 200 or more years ago. How did they get vitamin B12, given that there were no B12 supplements? 1) from water because water was not chlorinated and had bacteria that produced B12. 2) from vegetables and fruits contaminated with soil, containing B12-producing bacteria (There was no running water then , so the produce was not squeaky clean. Please see the discussion under ”
            What is the best way to get vitamin B12?”

    • Marisa

      no one would want pink tap water. :P

    • HereHere

      I don’t understand why anyone would want to mass-medicate people through their water supply. In fact, I think it goes against informed consent, unless you consider having to buy expensive (but untested) bottled water acceptable.

      • Mathew

        Like when we added iodine to salt?
        “Worldwide, iodine deficiency affects two billion people and is the leading preventable cause of intellectual and developmental disabilities.[1][verification needed] According to public health experts, iodisation of salt may be the world’s simplest and most cost-effective measure available to improve health, only costing US$0.05 per person per year.[1] At the World Summit for Children in 1990, a goal was set to eliminate iodine deficiency by 2000. At that time, 25% of households consumed iodised salt, a proportion that increased to 66% by 2006.[1]”

    • drew

      what are the easy ways? Chlorella daily? wheat grass daily? I do not currently supplement b12!

      • dogulas

        Honestly, supplementing is the easy way. Because you know how much you’re getting. I take 2,500 mcg as a sublingual tablet once a week. Another kind of easy way (but less reliable) would be to eat B12 fortified breakfast cereals and other foods. Some things just have to be supplemented in our messed-up modern world.

      • corina zugravu

        No!!! Just add fortified foods and a good dose from a supplement!

    • Ruby

      Dark, leafy greens as a core diet. Algae.

  • Tobias Brown

    Combine this news with Michael Klaper’s report added to YouTube yesterday by Jeff Nelson titled “Are Failed Vegans Addicts?” where Klaper claims that “meat withdrawal” can cause depression. I’m a somewhat startled vegan. Now Dr Greger says that simply not having enough b12 can make our arteries as a bad as meat eaters. Wow. Maybe there should be a more rigorous protocol for those of us switching to vegan diet. I certainly found Dr Greger’s list of supplements to take and I do take B12.. but how do I know if they are working or not. Maybe blood testing should be a part of this? Maybe working with a certified vegan nutritionist should be part of this? Anyway. I will keep my nose to the grindstone trying to perfect my diet.

    • Ann

      Yep blood tests:) I do a yearly one. I was too low in B12, supplemented with a B12 spray, and after some months my B12 was great. I get it tested every time

      • Tobias Brown

        I asked my mainstream doctor to test my blood for all possible issues and he said no, except for the cholesterol test. And I was explicit with him that I’m eating vegan. Guess we have to take all of this into our own hands.

        So, I’ve considered the SpectraCell service… Which test’s are recommended? Are these services reliable? I’ve read mixed reviews about SC…

        • Ann

          I don’t know. Maybe get another doctor?

          Here in Belgium you can ask for whatever you like and they test it. I always give my doctor a list :p

          • barbarabrussels

            Hi Ann, I live in Belgium too. I order B12 tablets online from the Netherlands (Vitals – cherry flavoured), as I can’t seem to find them in any of the health food stores or pharmacies here – we haven’t really caught on with the vegan lifestyle here much, have we. Might I ask, where do you purchase your B12 spray? Thanks.

          • Ann

            I order it online :) No tabkets but a spray for under the tongue. There are 2 kinds I use :

          • BLVD

            Cyanocobalamin is not easily assimilated as your body has to remove the CIANIDE from the cobalamin. Methylcobalamin which is the form we need can be taken sublingually and for me that works whereas the other doesn’t. I buy it online, the NHS have never heard of it. I know I had the deficiency because I had macrocytosis (along with the symptoms) but my doc wanted to blame my ‘secret’ alcohol habit! He had also no idea that nitrous oxide depletes the body of B12, which I had been given for a broken bone manipulation. Also many other signs that they don’t know about. The test they do is totally unreliable as it only records your blood level, not the B12 that is at the cellular level. You need an ‘active’ test for that which is not available on the NHS except at St Thomas’s Hospital in London. If you want to read up on it get the book ‘Could it be B12?’ online.

          • Bat Marty

            same in Italy. We.. “communists” have some benefits ;-)

        • wendy

          If he is refusing to test you for B-12 and you have told him you are a vegan he’s incompetent and you need to find another doctor. On the way out the door you need to let him know that he engaging in medical malpractice

        • DH

          Get methylmalonic acid. It’s expensive but it’s the single best determinant of B12 deficiency – most specific and most sensitive.

          A B12 level is almost useless.

          Homocysteine is somewhat more useful, but could be elevated for reasons that have nothing to do with B12 deficiency.

          Hence, if you are concerned you are B12-deficient, you should test MMA.

        • V-Doc

          I’m a vegan family doc. Clearly your current doc does not understand a vegan’s needs. Unfortunately, most don’t. I agree with Ann – find another doc who understands you – the person. I screen all my veg/vegan patients for B12 and iron. But also counsel them on adequate intake of calcium, Vit. D, protein, Omega 3’s, iodine and zinc. As a vegan, all of these needs are easily met in a vegan diet , if done properly. The only supplement one might need is the B12, but even that is being supplemented in many veg foods. I have many veg/vegan patients who do great and are on no supplements of any kind.

          • Eve

            If you have your recommendations & suggested tests handy for Vegans could you email that to me, please?

          • I agree with V-Doc about the Vitamin B12 test. The tests I recommend for individual patients depends on their individual situation and what they are trying to accomplish. I believe it is good to get some baseline information for future comparison if symptoms develop or to allow for feedback as needed. I often recommend a complete blood count, liver “function” tests, electrolytes, kidney function, TSH, cholesterol panel, 12-hour fasting glucose and cholesterol panel (LDL,HDL, Triglycerides, Total Cholesterol), iron and Vitamin B12. Other tests can be added depending on history and goals. It is important to work with your physician(s) to ensure the proper testing. I know if is a challenge to find physicians who are knowledgeable about the best diet.

          • drew

            me as well,, along with a list of recommended supplements to take daily. i live in desert mountains and do not have access to a lot of seaweed veggies for iodine, but i do have amazon prime :)

          • Andrea

            Thank you for this informed comment, Dr. Tobias. Intimating that because someone is plant-based he or she needs B-12 vitamin pill supplementation for arterial health regardless of diet isn’t necessarily accurate. It is fairly easy and inexpensive to meet the requirement with fortified foods, which, by the way, is what is required for most omnivores to obtain their required B-12 without taking a pill.

          • Ann

            We need more doctors like you in the world!

        • alysha

          I did a SpectaCell! I think it was the best thing I ever did. I found out I had 7 deficiencies and 8 borderline (all of which were caused by long standing b12 issues that take awhile to fix and others caused by my miscarriage and the intense stress afterwards.) I also did a hormone panel, adrenal, and thyroid panel as well. And was able to compare it with my blood serum thyroid panel and it was far more accurate. Remember, this is on a cellular level is it is going to show issues on a far deeper level. I actually think it helps you find problems long before they surface. They also show you how things connect, in that it may show you have low calcium, but that would be because maybe your Vit D is low as well. I just think it is super effective. And if you do research about blood serum tests, in almost all cases they say that blood serum is so unreliable, which I find to be very annoying. I found my own vegan, non-gmo high quality supplements to use vs. Thorne products (which they recommend) but, since incorporating some of their suggestions, I already feel better two weeks later.

        • Bat Marty

          It’s a shame in America, the land of freedom, you cannot have any blood test without I imagine paying lots of money..unless you suffer from a specific Italy (and Europe I think it’s the same) I can test whatever I want on my blood, and have it payed my the State (not everything but most of the tests), I just need a doctor’s request. And doctors do not follow any insurance rule, meaning that I can ask my doctor to prescribe me a round of check up tests and he’ll just do it. I think if Bernie Sander wins the elections maybe you guys could have a more less-tied-to-profit health system. I hope so, for you. Ciao :-)

      • Bat Marty

        but Greger also said that Vit B12 tests could give false positives…

    • BethanyB

      There’s a better test for B12 than using blood serum levels.
      Check out this video from February 2012:

    • drew

      where did you find this list?!! please post ! or email to me

    • alysha

      You have to get an MMA or a UMMA, standard serum blood tests are not accurate indications of how much b12 your cells or tissues are absorbing. Take it from someone who had a serious b12 deficiency AND lacks intrinsic factor (in that I lack the protein that breaks down b12 from food). It creates a whole host of problems so make sure you get it checked and take the sublingual routinely. :-) And blood serum b12 should never be below 600 although western doctors will tell you that 200 is fine, neurologists say differently. In Asia, below 600 is considered deficient!

  • lauren

    I can’t get more information on the first study, but each time I’ve seen the homeostasis model assessment, a higher score was not a good thing (as in MS risk and insulin resistance, for example). So are they indicating that lacto-veg’s had better beta cell functioning and insulin secretion or not?

  • Wegan

    And then there’s MTHFR.

    • Darryl

      There’s actually an interesting story relating MTHFR polymorphisms, 5-MTHF (active folate), and homocysteine, which I commented on here. Homocysteine looks to me like a coincident biomarker, with excess methionine and insufficient folate being the more direct causes of vascular dysfunction. Here is a key paper in unravelling the homocysteine story.

      • DH

        Unfortunately, folic acid supplementation appears to be a risk factor for colorectal and prostate cancer. Individual trials have documented this. In the case of colorectal cancer, it appears to be a tumor promoter rather than an initiator. After mandatory folic acid fortification of flour came into effect, there was a marked increase in colorectal cancer. In addition, although the latest meta-analysis from Oxford group does not demonstrate an increase in cancer from folic acid supplementation, a very critical editorial commented that the investigators may have missed an important time effect.
        References for all this available on request, but will need to dig them out.

        • Darryl

          The recent metaanalysis.

          Folate, as a methyl donor, both prevents unrepaired mutations and strand breaks in cancer initiation, and is a limiting nutrient for DNA duplication in cancer proliferation. And food folate is better, perhaps because its rate limited by homocysteine remethylation in becoming THF, whereas folic acid can progress directly to THF and purine/pyrimidine synthesis.

          If anyone needs a reminder that our evolutionary ancestors were heavy leaf eaters, consider that achieving the 400 μg RDA would have entailed eating 8-12 oz.of leafy greens. As modern agriculturalists, we also get significant amounts from legumes and whole grains, so need a bit less spinach between our teeth.

          Very high (therapeutic) doses of folate are still fascinating, as it may be the only peroxynitrite scavenger for which intracellular levels can be markedly increased. Peroxynitrite derived radicals are important in ischemia-reperfusion injury, and one animal study was remarkable, so someday we may see IV folinic acid routinely administered to stroke & heart attack patients in the ER, and patients undergoing scheduled major surgery.

      • Thanks for the link to the Circulation article… very interesting.

        • Darryl

          I’ve revised my opinion somewhat, as I’ve read more about the role of NADPH oxidases (NOX) in inflammation. Hcy does increase NOX production of superoxide, and that alone is a good reason to aim for lower levels.

    • Mary

      yes, so it would be nice if vegans (and everyone) knew to take Methyl B12 which is harder to find.

  • Laloofah

    I’m curious if you are using the term “vegetarian” and “vegan” interchangeably here, or if “vegetarian” is being accurately used to describe those who don’t eat flesh but do eat animal secretions such as eggs and dairy.

    • Skeptic

      In some studies which are referenced here, vegetarian is a catch-all word meaning anyone who doesn’t eat meat-but including fish. Some studies further break down vegetarians into lacto-ovo vegetarians, pesco vegetarians, and strict vegetarians or vegans.

      In my view, its an important issue since liberal vegetarianism generally yields health outcomes more like omnivores than like vegans. Its easy to miss the huge benefits of plant based diets by lumping vegans with vegetarians.

      I’ve never noticed a consistent usage of “vegetarianism” across studies published by different groups.

      • Laloofah

        I agree! It’s why I always wonder when the word “vegetarian” is used, especially.

  • Ann

    after 9 years of being practically vegan, I also got low in B12, too low.
    So I supplement with a spray , and that raised them up really good :) to the upper side of normal.
    A spray may not work for everyone, but it sure does work for me.

  • JoAnn Downey

    It IS vitally important to get B12 levels checked no matter what your diet is, but especially so for vegans. About 18 years ago when I was still eating meat, I found out that I had a B12 deficiency caused by pernicious anemia. So no matter how much B12 I ate or supplemented orally, nothing was getting absorbed. I’ve been giving myself a B12 injection monthly ever since. The sublingual route of administration works for some – it didn’t for me.

  • wendy

    Another issue that gets ignored, particularly with vegetarian and vegan women in their reproductive years is iron deficiency. I have to take iron supplements on my near-vegan diet or my ferritin levels bottom out and I end up with unrelenting brain fog and fatigue. You don’t need to be full blown hemoglobin deficient anemic to feel the effects of having low iron levels, low feritin is enough to screw up your enzyme systems and leave you feeling exhausted. You need iron to keep the the cyctrochrome C molecules in your mitochondria making ATP and to synthesize dopamine from tyrosine in your brain. My husband eats the same diet I do and he has buckets of energy, but I have to take supplements or I’m a zombie. Sorry if I sound perturbed, but I walked around feeling tired for a year needlessly. I got tested by my doctor for everything but feritin, finally did my own research, demanded a feritin test, got the results, and fixed my problem with supplements. It would have been really nice to have been forewarned about this possible issue by some of the advocates of this dietary approach.

    • DH

      Yep, that is one of the nutrients that needs attention on a vegan diet. Others include iodine, B12, calcium, protein, zinc, and possibly DHA. Jack Norris RD has a great site about these issues called It’s possible to get enough iron from food through non-heme sources though.

      • alysha

        Is getting Iodine from seaweed enough? I mean, isn’t iodine supplementation very dangerous?

        • Bruce Cropley

          Hi alysha. There are lots of great videos about iodine here – to find them, go to the top of the page. In the top left corner, there are 3 short horizontal bars. Click on these, then on the search box at the top, and enter “iodine” or “seaweed” :)

    • Thea

      wendy: Good for you for figuring it out instead of simply switching back to an unhealthy diet.

      Also, thanks for sharing your story. Hopefully it will help others as well.

    • Kathryn McMorrow

      I can relate. If a female has menorrhagia, as I had, and especially severe in perimenopause, I got anemic enough to develop regular attacks of chest pains (angina), in addition to depression, fatigue, and brain fog. I was informed I was anemic from a blood drive. I actually have to regularly ingest various natural appetite stimulants or I probably would not have the urge to consume enough healthy food. I tend to think, and other women I’ve talked with have agreed, that vitamin supplements help increase appetite

    • alysha

      This was my exact problem too and I was scared to death that it was my b12 deficiency rearing it’s ugly head even though I had just gotten my monthly shot and was taking a sublingual. As it turns out, after my miscarriage and 4 periods that followed my iron had dropped from 104 to 44!! I eat beans and nuts and all that good stuff, but for women, I think we just need a good whole foods based iron to keep it from bottoming out!

  • Thea

    I appreciate how Dr. Greger brings up B12 every year or so. It’s worth keeping this issue at the forefront of our brains.

  • Wendy

    A common question I always get asked is “If we were all made to be vegans then why do we need to take B12” I don’t know how to answer that. Any help with responses to respond would be great.

    • Thea

      Wendy: This is a good question as it comes up a lot with people. The following is a reply I have given in the past to this same question. Hope it helps.


      How do you think elephants and other omnivores get their B12? Did you know that B12 comes from bacteria that lives in the lower intestine of animals, including humans? The B12 is too far down the digestive track to provide us with all that we need, but if you ate your own poop, you would get all of b12 you need. (We know this because they did an experiment on humans doing just that…)

      So, how did our ancient ancestors get their B12? Our super ancient ancestors ate small amounts of carrion and fish and maybe the odd egg when it could be found. But the vast majority of their diet was plants. (Dandelion greens are just so much easier to catch than deer…) So, how much of the B12 that they got came from dirty water and the soil attached to dirty plants vs the small amounts of animal product? We don’t know. What we do know is that the safest way to get our B12 *today* is from a supplement. I don’t recommend that anyone drink dirty water or eat meat. Who needs the cholera or cancer?

      Put another way: It is completely irrelevant how our ancestors got their B12. You can argue all day with people about what paleo people ate or not. It is irrelevant because we know that the body of scientific evidence tells us that the healthiest diet for people *today* is to eat a whole plant food diet with b12 supplement. People who eat a whole plant food diet with b12 supplement: live longer, and have *significantly* less risk of: major cancers such as breast, prostate and colorectal, type 2 diabetes (and possibly type 1), heart disease, stroke, autoimmune disorders such as arthritis, and more. People who switch to healthy eating find minor conditions clearing up: better skin, disappearing joint pain, and more. And whole food eating vegans are the ONLY population in America that on average have healthy body weights. Even a little cheating and that group’s average body mass goes above normal/healthy.

      Stressing about what our ancestors ate is not productive. Looking at what we KNOW is healthy for humans today makes the most sense.

      You might also want to check out Dr. Greger’s articles (here on on B12.

      • DH

        I noticed this week, on the one day when I had little choice but to eat something containing cheese (or else go hungry), I got severe joint pain. Otherwise I do not get it. Of course it could be something else that comes with the cheese such as processed starch – this was a pizza luncheon – but the association is interesting, as it was incredibly dramatic and I do not normally suffer from any arthritides (“arthritis” in plural). Next time, I’ll pack my own food.

        • Most likely your response was due to Neu5Gc.. see It is not uncommon in my clinical work as Medical Director for Meals for Health and the McDougall Whole Foods program to see patients who adapt a plant based diet see resolution of muscular skeletal aches after only a few days on their new diet. Of course for some autoimmune disorders there can be plant triggers as well. Taking food with you as you go out into the world is a good way to increase the likelihood of good health.

          • DH

            Fascinating. Thank you for referring me to that talk, which I just watched. My mother is trying to lose weight on a Weight Watcher’s Diet because of severe knee and hip pain and obesity. She keeps telling me that first she will worry about “how much” she eats then she will worry about “what” she eats. I’ve advised her repeatedly to go plant-based. I am trying not to be judgmental here but I have seen a pattern of recurrent and repetitive dietary failure in my mother. Eventually I am hoping she will give up this fad and come back to me for advice.

            Anyway, back to Neu5Gc. Were any of the patients in whom you saw resolution of MSK complaints after adopting a plant diet also taking statins? We see alot of myalgias in this community. In fact, I was one of them, before I stopped my statin. I know there is A LOT of statin skepticism but I believe they still play a role, particularly in people who already have atherosclerosis and/or in those who just won’t get with the program (which I often see as an intelligence issue, but I know that is wrong). So I am curious whether you ever saw a case of statin myalgia resolve after going on a plant-based diet (but retaining the statin).

            I used to think that supplying a lot of sterol precursors – in the form of dietary cholesterol – was the key to stopping my own statin myalgias. Then I figured out an easier solution – stop the statin and drop the cholesterol.

          • In one study of 14 patients on Statins with normal CPK levels and no muscle complaints their calf biopsies showed cellular damage in 10 of the 14. There is a place for statins but in my experience the cholesterol levels drop on average 30-40 points… I have seen one patient drop 110 points. At the McDougall program as well as Meals for Health most patients are not on statins. However for those on statins we wait for the end of the program to recheck there values before recommending to stop/reduce and/or change the medication. For folks who have documented arterial disease and clinical symptoms there is definitely a place for statins or other medications to control the level. You might find several of Dr. McDougall’s articles in his monthly newsletter of interest… Sept 2002: Cholesterol When and How to Treat, June 2003: Cleaning out your Arteries, and May 2007: Statins.
            Getting back to your mom… she needs to understand and practice the concept of calorie density. Order Jeff Novick’s DVD, Calorie Density: Eat More, Weigh Less and Live longer. Watch Doug Lisle’s You Tube video How to Lose Weight Without Losing your Mind. Jeff is the only person I know who has tied exercise levels to calorie densirty… very useful concept for me as a physician in counseling patients who want to lose fat.

          • DH

            I want to thank you for mentioning “How to Lose Weight Without Losing your Mind.” After your recommendation to someone else on this site to watch this video, I took the advice and did so; it then motivated me to purchase Lisle/Goldhamer’s book “The Pleasure Trap”, which was a real eyeopener. I didn’t know he had a DVD on Calorie Density – you are right that I will need to order that for my mother, although she does not have a computer home. She does however use the library and could watch a DVD there with headphones I’m sure.

    • Tom Goff

      I don’t think that we were “made” to be anything. Humans adapt as best they can to changing environmental conditions. We are partially adapted to eating meat but that doesn’t imply we should eat meat. The real question is what is the healthiest/optimal diet.
      Gorillas and other primarily herbivorous primates are not known to suffer B12 deficiencies (in the wild). They would presumably obtain sufficient B12 from unwashed vegetation. Another potential source is insects – consuming insects, even if not deliberate, is inevitable when consuming large amounts of vegetation. I understands that humans still possess the ebzymes necessary for digesting insects

  • JerryLA

    I’m 78, vegan male, fitness exercise. Last April I felt bad, dizzy, then remembered my blood test showed high MCV mean corpuscular volume and low hemoglobin. Those are earmarks of low B12. I’ve lost the enzyme to digest B12 pills and from food if any, Sub lingual under the tongue B12 dots fixed that problem in a couple weeks. The researchers that say we don’t need vitamins are doing a great disservice. No, I don’t take a multivitamin. BBC published results showing no gain. Actually synthetic Vitamin A and E are harmful. Why B12? It comes from micro organisms in the soil and my food is too clean. I’m logged in to your site. Why are you asking me to sign in with social media?

    • DH

      At least for men, there appears to be a small benefit from multivitamin supplementation, in terms of a 7-8% reduction in all cancers, as documented in the Physicians Health Study II randomized trial.

    • Kathryn McMorrow

      Go Jerry! Thanks for your informative contribution. You ROCK dude!

  • shel

    I would still like to know what food we are suppose to be getting B12 from in a natural diet, as nature would not deprive us, if we are not designed to be vegan. I always thought eggs would be a natural part of a gathering diet for man, yet they are slammed as being unhealthy. And yes, I am talking about organic eggs from home raised queen of the yard chicken.

    • Thea

      shel: In the “natural” world, we would be drinking unclean water and eating leafy greens and roots from dirty soil. We could get our B12 that way.

      But we don’t live in a natural world, and in this case, that’s a good thing. Good bye cholera!

      I think the following article from NutrtionFacts might help you put the B12 issue into perspective:

      Make sense?

      • DH

        Yes it makes total sense and is a brilliant and beautiful reminder. Of course, we could eat our own feces to get all the B12 we need, but that would likely make us very ill. We could drink out of mountain streams but then we might get beaver-fever (giardiasis) or god knows what else. We could eat dirty roots without cleaning them straight from animal feces-contaminated soil, but then we might get cryptosporidosis or microsporidium. In seeking to become free of these endemic parasites, we’ve lost the ability to get B12 from our natural environment – I consider this a zero price to pay. I consider myself blessed to live in an age when scientists can manufacture B12 as aseptic, sterile tablets, and thus I do not need to rely on animals, feces, mountain stream water or filthy roots for this essential nutrient.

        • Thea

          Amen! ;-)

  • t091582

    I would like to pose a question… I know this is opening up a whole different
    can of worms.. but here goes.. If being
    a vegan is the most kind eating style – not killing any animals.. why would the Lord cause vegans to die a
    terrible death by following a vegan diet from lack of B12?? Sure through modern nutrition science, man figured out that vegans need to supplement with B12, but if this is the way the Lord wanted us to live, why would he make B12 a necessary component for vegan survival? What about vegans of many years ago that did not know about B12??

    In other words, I would think that if the Lord wanted us to be vegans,
    either there would not be a need for us to have B12 for survival, or that it
    would be plentiful in common plants, so that we would never lack it… I would appreciate your thoughts about this… thank you.

    • Daniel Wagle

      The way I look at it is that many people had nutritional deficiencies before we knew about vitamins and minerals, whether they were omnivore, carnivore or herbivore. We still don’t completely know about all nutrients. The carnivores would have the most natural deficiencies of any of these three. Omnivores could develop Vitamin D deficiencies, because they aren’t a lot of natural food sources for this vitamin. They could also be living in a northern latitude. If a person is on a plant AND microorganism (algae, bacteria and fungi) diet, that is eating the right microorganisms, there should not be deficiencies. B12 is not produced by animals, but by bacteria. It is merely stored in animals but not plants. Some Paleo groupies say we need taurine and creatine, which are from animals, but the last time I checked, these are not listed as essential amino acids. By the way, I agree that Genesis 1:29-30 means that both humans and animals were ideally meant by God to be herbivores.

      • RappFan

        Genesis is a story, written in the context of its time, so I take 1:29-30 no differently than the advice of another time that said the best way to cleanse the blood was with leeches. Humans are the most adaptable species on the planet, which means they are meant to eat whatever will keep them alive at a given point in time. Sometimes this meant meat and other times it meant nuts and berries. In this country, most of us have a choice. Leave the bible out of it as it was written by men a long time ago (predominantly) who had an agenda (was God a carnivore since he ostensibly loved the smell of burnt lamb?).

        • Daniel Wagle

          You can believe or disbelieve whatever you want. I was just saying what people can believe if they have faith perspective- and that it was a basis for being Vegan, but there is also a basis in the Bible for not being Vegan as well. I wasn’t saying that persons who aren’t religious should be, or should base their views on the Bible. One difference I have with conservative religious people is that I think the Bible contains multiple perspectives, not just one. Even if there are texts which state that God loves the smell of burnt lamb, there are many other texts in the Bible which question animal sacrifice, such as in Hosea, which states, “I desire mercy and not sacrifice.” You must interpret texts which support animal sacrifice in light of the day and age in which it was written. In that day and age, virtually every culture practiced animal sacrifice, but at least there are many texts in the Bible which question this practice.

    • DH

      I think you have to separate the theological from the scientific here. Otherwise we are back to the Scopes monkey trial and the persecution that led to. It’s ok to have a theological faith or theological perspective, but you should not confuse this with hard science. In other words, what you are espousing is some form of theological determinism – you infer that God wanted us to be omnivores – you infer that God causes vegans to die a terrible death form lack of B12. Let us stick to the straight science and leave theological views aside. Only from science or ethics can one make reasoned moral opinions.

      • Daniel Wagle

        I agree that we must separate theological from scientific. However, in many ways, humanists often seem closer to what I think is the true biblical view than are fundamentalists. Humanists are often Vegans, but that is also the Biblical view of Genesis 1:29-30. The social stance of the Bible is basically liberal, just like in humanism. Humanism merely rejects the supernatural parts of the Bible. Fundamentalists often reject the ethical teachings of scripture, such as the pacifism of Jesus and the Veganism of the creation stories, as well as the emphasis on social justice in the Hebrew Prophets. But the question, what are people meant to be? or do? is more of a philosophical/theological issue that can’t always be answered by science, which doesn’t mean a person must believe in God.

        • DH

          The bible also recommended whipping slaves (not to mention having slaves), stoning adulterers and killing magicians. In the modern buffet approach, we select those parts our culture finds acceptable and not those we find unacceptable. Basing something on a document written over 2000 years ago is absurd.

          The Buddha’s teachings are similar. There are discourses where The Buddha says the perfect kind of wife (or at least one of the perfect kinds) is a female subservient slave. Obviously, that matches the culture of that time, but not now. We evolve, we move on, we progress.

          Yes there are questions that can’t be answered by science. Sometimes they require a deep understanding of ethics and moral philosophy, but I wouldn’t say “God” or “Bible” will give you that answer every single time. From a strictly utilitarian perspective, a plant-based diet is the best because 1) it minimizes the suffering of the most number of sentient creatures, 2) minimizes future ecological harms such as global warming and widespread antibiotic exposure, and 3) it’s adequate to promote lifelong health. 4) In the factory farm system, workers are often undocumented and very poorly treated, with extremely high rates of occupational injury.

          In the long run PBD does the least amount of damage to the greatest number of individuals. I didn’t need the bible or any scripture to reason that one out. I hope that doesn’t offend people.

          • Daniel Wagle

            I guess I am a perfect candidate for having your point of view, given that I am a gay male and people quote scripture all the time against us. I cannot be ordained in my own United Methodist denomination because of this. Many of our opponents say I am going to burn in hell forever. I guess what I am saying is that saying that the Bible always agrees with fundamentalists gives fundamentalists too much credibility. I refuse to believe their point of view is “biblical.” Maybe it does say to stone adulterers, but remember Jesus saying “he who is without sin cast the first stone” about stoning a woman caught in adultery.? Scripture must be interpreted in “context,” esp historical, something that fundamentalists do not do. There is not one instance where a woman was actually stoned for adultery, even in the Old Testament. It probably refers more to Israel the nation, being the bride of Yahweh and that they would be punished by being invaded by neighboring countries, such as Babylon and Assyria for flouting their covenant with God. The Bible, as well as science can be quoted on all sides of issues. It does, for instance, give a basis for Veganism, but it doesn’t absolutely require it , either. There are even texts that seem to go along with Atheism. The book of Ecclesiastes 9:5 states, “For the living know that they are to die, but the dead no longer know anything.” There is very little emphasis on an afterlife in the Hebrew Bible and this book seems to deny it. The book of Esther was almost not included in the canon because it hardly ever mentions the name of God. Job, in the book of Job said many things about God that would offend many people. So, all in all, you are ok, but please don’t concede the Bible to hatemongers.

          • DH

            I agree with 100% of what you’ve written. You have greater knowledge of the Old and New Testament than I will likely ever have. I have just been reading a book called “Buddhism without beliefs” which argues for a kind of secular agnostic Buddhism (at least for “Buddhists”). I was raised in an Orthodox Jewish household but long ago fell into atheism and more recently Buddhism. But I still readily admit that there are Buddhist scriptures that speak only to the time and culture in which they were written (5th century B.C. in the Gangetic basin), and appear at best to be quaintly anachronistic. But perhaps there are even positive interpretations of these in the commentaries. One should not try to explain away things written 2500 or 2000 or 1800 years ago by using similes and metaphors – some things are truly abhorrent (though would only have appeared that way to the most progressive of beings of that time).

            A point I should have made earlier, but failed to, is that the questions initially posed (like: “Why would the Lord cause vegans to die a terrible death by following a vegan diet from lack of B12??”) presuppose the existence of the Lord AND that everything in the world is God-directed (such as B12 deficiency in vegans). It is impossible to answer this question unless you believe in an omniscient, omnipotent, omnipresent God of the Bible. Assuming you live in the U.S.A., you are in one of the most religious countries in the world, and a beacon for fundamentalists of all stripes. I only point this out because it conditions the worldviews of many of those who live there.

            My view on the whole thing is that belief in God is therapeutic for those who can claim faith, but the question is largely irrelevant to others, like me, who do not get any benefit from such faith despite having tried. It is not a question of proof but rather a question of relevance. And to disbelieve in the existence of God is to be as absolutist and lacking in evidence for that claim as to believe in the existence of God. It is an honest and open question to me, but pretty much tangential to my own belief system, which I hope is more empirically derived (the 4 noble truths, for example). And any belief system should ultimately be tested according to the effects it has on other people, on one’s self, and on one’s actions in the world.

          • t091582

            thank you for your expanded comments. After I posed the question and re-read it, I should have said something like.. “if you don’t believe in God then this question does not apply to you”.

          • Daniel Wagle

            I am curious, would you still consider yourself to be Jewish? I know that a person can still be considered a Jew, even if they are atheist, as long as they have a Jewish mother. Judaism is not as much based on belief as Christianity is. However, I don’t think the New Testament necessarily excludes non believers from heaven, as fundamentalists often claim. Belief does make a person Christian, even though works are the back door to heaven. Works also show that we are Christian according to the letter of James. Matthew 25:31-46 speaks of the ta ethne or gentiles, that is non-Christians, non Jews being judged on works, and some going to heaven on the basis of works apart from faith. Jews will go to heaven because they are still the chosen people, as Paul stated in Romans 11. We might have gotten off track from discussing Veganism, but Romans 14 is one place that Paul validates Christians not eating meat, presumably on the basis of Genesis 1:29. Christians don’t divide animals into clean and unclean as in Leviticus 11, but as I understand, Jews didn’t expect gentiles to keep the kosher laws, only not to strangle animals and eat them alive. Genesis 9 allows the consumption of all animals, except for the blood,none being unclean. The blood was where the “soul” of the animal was. However, eating meat in Genesis 9 was allowed as a concession. Genesis 1:29 or to eat only plants is an option for Christians, because it is not based on whether an animal is clean or not, but rather that animals have “souls,” or an intrinsic worth and value based on being sentient. The Hebrew Bible states that animals have souls, if you read it in Hebrew and the New Testament reaffirms this in the book of Revelation.

          • DH

            Ethnically I remain Jewish, but certainly not religiously. I haven’t stepped into a synagogue in 6 or more years, and even then only reluctantly. Any belief I have is empirically tested in terms of whether it is producing benefit or harm for myself or others (that is one of the beautiful things about Buddhism — very little faith is required — and the scriptures repeatedly stress the importance of testing out key concepts for yourself). I don’t think much about reincarnation, just as I don’t think much about God. But it is said that if one can develop very advanced states of being (ethically, wisdom-wise and in meditation), deep knowledge of things like reincarnation and past lives may be possible. Anyway, I am nowhere near there.

            Your perspective is fascinating. I could have sworn that I was told by rabbis when I was a youth that animals do not have souls, only human beings do. I probably asked something like “Why don’t we take our animals to pray with us to synagogue?”, since I loved my dog at that time. I was told that the soul of a Jew does not exist in an animal. This is counter to what you are mentioning, but I am not completely convinced either way. In any case, I don’t believe in the concept of a soul anymore. I don’t even believe in the concept of the self – I think it’s just a psychosocial abstraction which can be useful in social and linguistic dealings but is actually very harmful when you look deeply into the trouble in the world. In fact, the lack of existence of a soul or self is a key foundation of Buddhism, and it can be verified in deep states of meditation or simply introspection. A thought is a thought, a feeling is a feeling, a body is a body, a perception is a perception, consciousness/mind state is consciousness/mind state but nowhere can a fixed, permanent, abiding, reliable self or soul be find in any of these aggregates. Perhaps this discussion is better suited for or somewhere else though….

          • Daniel Wagle

            Probably the word NEPHESH in Hebrew, which is often translated as “life or soul” does not necessarily mean a soul that lives eternally, although that could be a later interpretation. I go to an Orthodox Rabbi for counseling (at a mostly Christian counseling center at that!) and he said that Jews don’t believe animals have an eternal soul, but an extended meaning could mean that. Nephesh according to Driver and Briggs means “soul, life, living being, desire, emotion, passion, that which breathes, the inner being of man.” The Greek word is psyche, and the latin word is anima, from which of course we get the word “animal.” I would understand it as “sentience,” “life force,” and that animals have feelings and thoughts. I would think it would mean that animals have a certain value, that should at least make us hesitate to eat them- certainly because they can feel pain and fear are two reasons not to eat them. In Genesis 9:4 we are told not to eat the blood of the animal, because that is where the soul lies or “nephesh dam” resides. Dam means blood. The Greek word is aima, where we get the word hematology. ” Living creatures,” such as in Genesis 1:20,24 and 30 is really a translation of “nephesh.” That may be one reason that we are to eat only plants in Genesis 1:29. Revelation 8:9 speaks of “creatures of the sea that had souls (psyche)” in the original Greek- so this idea is reaffirmed in the New Testament. Realizing that animals have souls is one thing that moved me more towards the Vegetarian and Vegan diet. So both Christians and Jews should believe that animals have souls and should at least seriously consider being Vegan. Also, many Unitarians would share your agnosticism and interest in Buddhism, and many would be Vegan/Vegetarian.

          • DH

            Daniel, you know more than me about the religion of my birth origins.

            The bottom line for me — Through what I eat, I do not harm as many animals as would a meat-eater. You are right that whether one calls it sentience or soul, it is still causing harm, particularly under the factory farm system from which 99.9% of “animal products” are derived. I just didn’t know about any of this until I became a Buddhist.

            Anyway, what do these terms really mean? I believe we are all human beings, regardless of these rather senseless designations (‘Gentile’, ‘Jew’, ‘Chosen One’, ‘Buddhist’). In the case of the term ‘Buddhist’, the word is only 200 years old. It was coined by French Catholic missionaries who went to Indo-China (Vietnam, Laos, etc) and noticed numerous temples with statues of the Buddha there. The local people in villages there did not consider themselves to be “Buddhists”. They were simply practicing a culture and spirituality they had been practicing for generations, without interruption; they were certainly not engaging in idol worship, as the Buddha was only ever considered a human being (reverence is different than idolatry). Anyway, we are all just human beings, either we act ethically or we do not, so let’s leave spiritual designations aside.

            Actually, I am skeptical about the doctrine of rebirth, multiple realms of divine beings, karmic transmission through past and future lives — these questions really have nothing to do with ethical practice, nothing to do with science, nothing to do with morality. I am unable to come up with a ‘yes’ or ‘no’ to any of them – at best, I call them irrelevant. Even if rebirth or an afterlife were proven, it would still leave one with the ethical question of how best to live in this very world (answer: with kindness for others).

            Finally, while I am disinclined to believe that anyone – human or animal – has a soul, I fundamentally respect your views on this. It is not the lack of scientific evidence to support or negate the notion of soul that troubles me. Far from it, I don’t think that question can ever be addressed by modern scientific approaches. Rather, it’s my own reflection and meditation and the fact that nothing that I have ever tested empirically has led me to believe there is a stable, enduring soul (or even self). A core of the Buddha’s teaching is that the belief in the soul or self causes great harm – in that way, he went radically against the established vedic religions of his time (at considerable personal risk). Anatta (= no soul) is a fundamental mark of existence, at least according to the Buddhist way of seeing things.

            By the way, there is also a belief that Jesus travelled to India and knew about the Buddhist teachings. There is some evidence that Buddha knew about ancient Greek teachings such as those of Herodotus. He certainly knew about Greek slave colonies like Bactria. And finally, one of the remarkable things is that there is a role for faith in a system like Buddhism, but it is considered more akin to ‘confidence’ than ‘believing without evidence’. You need confidence in any set of teachings before you can progress along the path. My last point – the end of the path in Buddhism is awakening, which is defined as complete freedom of the mind from the compulsions of craving.

          • t091582

            thanks again Daniel. I guess I was looking for a nice easy answer but as in life, there are many unanswered questions.. Mark

          • t091582

            thank you so much Daniel, that was an awesome answer. Mark

        • Darryl

          Religious historiography discussions are fraught, but I wanted to share:

          Was Jesus a Vegetarian? by Kamran Pasha

          • Daniel Wagle

            This was good, but I don’t think Paul ever said in Romans 14 that persons who eat only vegetables *should* eat meat. He respected it on the basis of Genesis 1:29- he said we should not despise the Vegans. The ones who eat meat in Romans 14 follow Genesis 9:3. Both Genesis 1:29 and Genesis 9:3 were options for gentiles, according to Jewish law. Which means either eating meat or not eating meat at all were the options Paul thought Christians had. Paul rejected Leviticus 11 for Christians, where some animals are clean to be eaten and some are not to be eaten because of being “unclean.” In Jewish law, distinguishing between clean and unclean animals for consumption were laws only for Jews and not for Gentiles. although Muslims now follow something similar to Leviticus 11. Gentiles were expected to at least to keep Genesis 9:3-4, which means animals could not be eaten alive and couldn’t be strangled. Complete Veganism was an option for all of mankind, Jews and gentiles alike- and Paul no where disputes that. There is also no evidence whatsoever that Paul endorsed the animal sacrifice system in the temple- Christ’s sacrifice ended this. Paul’s view of what parts of the law were binding on *gentile* converts to Christianity was perfectly compatible with what Judaism expects of gentiles to be righteous, such as in the seven laws of Noah. It is interesting that Jeremiah 7:22 disputes that there was ever a command to conduct animal sacrifice, such as in the book of Leviticus, much of what Jesus did in the temple was foreshadowed by much of Jeremiah 7, such as in verse 11, where the temple is called a “den of thieves,”: which is repeated in Luke 19:46.

    • I will leave the existence of god argument to the philosophers. My wife and daughter are both philosophy professors. I would like to stick with science and be clear on terminology. Herbivore, Omnivore and Carnivore are descriptions of biologic systems. For instance bears are usually omnivores but there are also polar bears (i.e. carnivores) and panda bears (i.e. herbivores). Our design through evolution is as a hind gut fermenting herbivores. Our adaptations relative to the great apes are increased amylase genes and increased volume of our small intestines to help absorb glucose from starches. Of course we can choose to eat a variety of foods. These choices can be labeled vegan, several types of vegetarian, or carnists. The term, Carnism, was coined by Melanie Joy. I believe you would find her presentation, Carnism: The Psychology of Eating Meat, which she gave at the McDougall Advanced Study weekend in 2012 interesting. . We can eat a variety of foods but anytime we eat foods that violate our biological design we raise the risk of poor health outcomes. Of course the introduction of tools which can be used for hunting and agriculture has exposed us to foods we weren’t designed to eat especially in the quantities that we consume them. Of course you have to factor in advertising and misinformation tied to lack of knowledge or commercial interests. Back to Vitamin B12 which was the only vitamin except Vitamin D (which is actually a hormone) that we don’t get directly from our food. Since we were exposed to many bacteria before modern public health and food processing technologies we didn’t need to take a supplement. Now we have to make sure that we have an adequate intake. At least my thoughts…

      • DH

        “Back to Vitamin B12 which was the only vitamin except Vitamin D (which is actually a hormone) that we don’t get directly from our food.”

        I would add iodine and DHA to that list. Well yes you could get iodine from eating sea vegetables (and now from widespread iodination of table salt), but in areas where soil iodine levels are very low, and that are inland, cretinism/congenital hypothyroidism becomes very prevalent. In addition, DHA is only found in oily marine fish, and vegans typically have very low levels unless they supplement, because rates of biotransformation from preformed ALA are low and unreliable.

        • Marcella Smith RN, MSN NE-BC

          Wrong. I’ve been a veggie for 27 yrs now, I have always supplemented with Chia and Flax and always have a satisfactory Omega 3 ALA, EPA, and DHA. Humans do convert the ALA to the EPA and DHA omega-3 fatty acids just fine, just not like a fish. I actually don’t know any vegan who is selfaware that has a low Omega 3 set, so I don’t know who the ‘typical’ vegan you have been talking to who is low, nor the prejudiced writer’s materials you are reading, a backwards, over the shoulder look at the data and puff you have those pooooooorrrr sickly yet long living healthy vegans going without again, haha, my goodness, but where do they get their protein????

          • DH

            Your story is very interesting, and I assume you’ve checked your DHA levels. Fish don’t actually make DHA, rather they consume algae or smaller fish which eat algae, and it’s the algae that make DHA. The fish take advantage of this, particularly cold-water fish as DHA remains in liquid form at cold temperatures.

            More importantly, for a summary on low DHA in vegans see: (written by an evidence-based nutritionist). I have personally reviewed the literature and largely he is correct.

            Note that there are dramatic differences between individuals and even within individuals (pregnant, non-pregnant and by age) in the rate of manufacture of DHA from EPA. Just because *you* don’t have a problem with making DHA, doesn’t mean that everyone is fine with just consuming plant-derived ALA alone. I am not 100% convinced on the necessity of DHA for human health, but I am hedging my bets on this one and thus if I get dementia in 30 or 40 years, I will be able to say it certainly wasn’t from lack of DHA.

        • I would agree with adding iodine to the list with the note that if you are consuming iodized salt you are most likely not going to have a problem. If symptoms or concerns are present testing the urine can help sort out the problem. A general population recommendation for DHA supplementation is less clear to me. I am aware of Dr. Greger’s recommendation. However consuming isolated nutrients has to be done cautiously as the unanticipated adverse consequences when dealing with interventions in adaptive or complex systems seem to be the rule rather than the exception. Read Dr. Campbell’s new book Whole for more information or some of Donella Meadow’s work outside of medicine.

          • DH

            The only misgiving I can ever envision about veganism is the possibility of multiple micronutrient deficiencies. I have lately been experiencing angular stomatitis and do not normally get this condition. At first it responded well to increasing beta carotene-rich foods like carrots (there turns out to be a 4-fold increase in angular stomatitis in people with vitamin A deficiency). Several months later, it came back with a vengeance, and I reluctantly treated it with a B100 complex. That seemed to work well for a while but it has now returned. I am thinking it could be a zinc or iron deficiency.

            The only other time in my life that I ever had angular stomatitis was when I was a summer research student living in a dorm in Toronto and essentially consuming only spaghetti and tomato sauce for dinner every day (and probably wheat-based stuff for breakfast and lunch). That was a riproaring but transient case about 20 years ago.

            After carefully reading the literature, I’ve decided that at a minimum I need to supplement with B12, iodine (in the form of low dose kelp), DHA and vitamin D. After tracking my dietary profile, I noticed I was getting low on some of the B vitamin intake, and thus the decision to go with a B complex instead of B12. Now I’m wondering if I should experiment with adding low dose zinc. My diet is largely whole foods based, but I do eat a little less carbs than everyone else (if only because I once had severe premature onset metabolic syndrome – about 50 lbs ago!). Anyway, with that degree of micronutrient supplementation, I question the adequacy of my diet. There are also genetic-diet interactions that we are only beginning to appreciate – for example, specific people may be highly prone to specific vitamin deficiencies. On the advice of a vegan nutritionist, the only vitamin I tell my patients they need when starting to go plant-based is B12, to keep things simple at that point (I then add vitamins later). But I am beginning to wonder, at least about my own diet, whether a diet that requires my degree of micronutrient supplementation is that healthy. I also drink fortified almond milk – only about 1/2 cup per day though – and do consume nutritional yeast.

          • Liz

            You might try topical miconazole for the angular stomatitis. I know this just addresses the symptoms rather than the cause, but it does work for me. It may provide relief while you attempt to figure out what is causing the problem.

          • DGH

            Thanks for that suggestion. Is that over the counter? I am sure my AS is due to a B vitamin issue, as it usually responds to B complex therapy. However, I have no isolated which one it is, so I usually end up having to go on the whole ‘horse’ pill..

          • Liz

            Yes, it’s an OTC anti fungal cream, available at any drugstore and not too expensive either.

      • t091582

        Thank you Don! I will watch the video when I get a chance!
        regards, Mark

    • Marcella Smith RN, MSN NE-BC

      If we were still living in God’s natural world we would be getting our B12 from the microbes on the plants we eat. That is how God created our perfect world. Then ecoli and other pathogens came along and we had to clean our food’s B12 poopin’ microbes down the sink drain. God gave us what we needed, we screwed it up.
      Take Vit D, why would everyone who does not work outside need to take Vit D supplements? Shouldn’t God have fixed that? Well He did, we were designed to be outside wondering thru the grain fields and pulling apples and berries for food. But we don’t, we sit behind computers in the dark, hence we need supplementation or get all sorts of bone disease and cancers.

      • As Dr. Greger has pointed out the amount of sunlight necessary to achieve adequate levels of Vit D is not that great depending on latitude see videos on Vit D for reasoning. For patients who are in nursing homes or other situations where they can’t get sun supplementation makes sense. Supplementation doesn’t help replace the positive effects of sun light on our nitrous oxide system. I think you would be interested in the TED talk: Richard Weller: Could the Sun be good for our heart of interest. I urge caution in using a fat soluble vitamin like Vit D when you can adjust your life to get adequate sunlight.

  • paul

    So, eat a little tiny amount of meat or fish twice a week and the problem is solved.

    • Marcella Smith RN, MSN NE-BC

      Gross, that is like me asking you to eat a little tiny amount of dog feces twice a week, does that help you relate?
      Besides, flesheaters run low B12 also, you should have yours checked :) . 20% of flesheaters over 60 are deficient

      • Veganrunner

        Marcella I just laughed so hard. Thank you!

        • Coacervate

          In a way it is laughable but the comment is just a measure of how complete the brainwashing is. Fight the Machine.

  • burghgrl

    IN recent testing, I learned that my b-12 level was a “high”. This, after a year of consuming a goodly amount of nutritional yeast (I’m only a few years vegan) on a regular basis. I was told, this was a great source. Apparently, it was true. Previously, the levels were “low”. Go figure..

    • Coacervate

      Thats great news. I was told yeast is NOT a good source of b-12.

      Hopefully one of the “Team” would pipe up on this?

      Just wondering, did you also start eating fresh veg straight out of the garden or garden market?

      • Darryl

        Yeast doesn’t naturally produce B12, but in many brands of nutritional yeast its added to the growth medium.

        With B12: Bob’s Red Mill, Bragg’s, Foods Alive, Frontier, Now Foods, Red Star, Twinlab

        No B12: Hoosier Hill Farm, KAL, Whole Foods bulk bin

        So check the label on your nooch.

        • Jed L

          Darryl, I had Whole Foods confirm with me that their nutritional yeast is grown using synthetic vitamins. They do not add any (fortify) vitamins after the yeast is grown, yet this process allows a sort-of loophole for them to claim their product has not been fortified. It is my current understanding that ALL nutritional yeasts on the market in the USA are grown with synthetic vitamins. Some companies go a step further and add more synthetic vitamins after the growth cycle. What concerns me is the synthetic vitamin effect/residue …. ingesting anything grown with synthetics seems to raise concerns for me.

          Any thoughts?

      • burghgrl

        I do consume a good deal of produce, yes. My garden is in it’s first full year, so it wasnt the place of origin mostly. The market…absolutely. I’m fortunate to be able to buy nut. yeast in bulk, at the earth origins outlet here.

        • Coacervate

          I wish there was a way to determine how much B12 we get from our gardens. I make my own compost and make sure it is well rotted before using. I usually give greens a casual rinse but a lot of stuff goes right down the hatch as is. I’m hoping that I’m getting some good B-12 rich dirt in there too. 1 microgram is all but microscopic. I wonder how many grams of bugs you need to eat to get your B-12 hit. No pin worms…erm..yet…that I know of.

  • JohnC

    I am trying to find a non-gmo source of b-12 and not having much luck.

  • Mela Rossa

    Not every Vegan develops a B12 deficiency after 5 years without supplements or fortified foods.

    Some of us are ahead of our time and know exactly how we produce our own B12 with bacteria.

    • Toxins

      Our bacteria do produce b12, but it is so low in the large intestines that we are unable to absorb it. The reason one can last 5 years with no deficiency is that b12 is constantly recirculated. Be warned, it is difficult to reach normal levels once depleted and it would be unwise to get to that point. Dr. Greger has an entire series on b12 examining all aspects of this vitamin.

      • Mela Rossa

        It isn’t hard for me to reach high levels of B12 since I know exactly how humans produce the vitamin with bacteria and absorb it.

        You’re making a lot of assumptions about what everyone knows. Just because you experts are lost sheeps, it doesn’t mean everyone on this planet is like you.

        • Toxins

          Mela, I am not an “expert”. I simply study the science which you have failed to do. I am not giving you any information that is not already well known in the scientific community. You cannot will your body to produces its own b12 and absorb it, it does not work like that. Again, I encourage you to research this site as it gathers the scientific data to support the claims made here.

          • Mela Rossa

            YOU have failed to study the science and YOU are missing valuable pieces of the science.

            I am an expert on B12.

            I leave you in your ignorance.

          • Toxins

            If you are en expert then please share your studies. Anecdotal opinions are quite unreliable.

          • Mela Rossa

            At this point. Figure it out yourself and lets see how “smart” you are.

          • Toxins

            I already have figured it out, and I figured it out using studies and evidence not youtube videos.

  • Ronald Chavin

    However, swallowing pills that contain vitamin B6 and/or folic acid will lower our blood levels of homocysteine but will not lower our risk of developing cardiovascular diseases:

  • artcomm

    Vitamin B12 is everywhere nowadays. Most cereals (whole wheat and other brands) contain all the vitamin B12 needed daily in about 40 / 50 grams of the cereal. However, there are a lot of supplements that provide really 10 times what one needs of vitamin B12 daily. And, yes, it’s true; just a little cheating is enough to lose control of your weight. Vegans are the group of people who better keep lower weights, especially if they don’t ever cheat. In Mexico, all cookies, some beverages and other stuff with no animal products in them have plenty of vitamin B12. They sell something called “Polvorones” which will provide 100% of your daily B12 in about 6 to 8 pieces. In the States most cookies (like the vegan Oreo) lack this vitamin B12 and I can’t see why. Fortunately, I have tested great (and feel great) ever since I became a 100% vegan 2.5 years ago. I will NEVER EVER go back! And I don’t cheat.

  • peterz54

    What Homocysteine level is too high?
    Over the last 15 months, the period in which I became a serious about eliminating all animal products in my diet, my homocysteine level has gone from 6 to 9 to 11 umol/L . I have been taking a low dose multi which seemed to have more than enough B12. I have not been tested for B12. So, at what level of homocysteine, if it continues upward, should I increase B12?

  • christinatanios

    Hi Dr. Greger! I love your site and think that you provide so much
    wonderful information. I have been taking vitamin code’s raw b-complex and am wondering if
    you or someone else can recommend another brand? I want to make sure
    that I am getting enough vitamin b12 from a reliable source; the information on the back of the box says that 2 capsules contain 133 mcg of vitamin b12, which is supposedly 2217% of our daily value. I also bought Deva’s vegan sublingual b12, but then I noticed that it came with a California proposition 65 warning, so that’s no good. Any tips will be greatly appreciated. Thank you!

    • JacquieRN

      Hi this is not Dr. Greger but I am helping him a bit. Did you see this?

      • christinatanios

        I did, thank you. I think I will try Dr. Fuhrman’s women’s daily formula + d3; it has Vitamin B12 (as methylcobalamin) and 2 capsules contain 40 mcg, which is 667% of our daily value. Even though it’s not cyanocobalamin, it should work just fine, right? Here is a link to the product: Thank you for your help!

        • JacquieRN

          Dr Fuhrman and McDougall (2007 both are fine with methylcobalamin.
          Dr. Greger Feb 2013: “We don’t have as much data (in terms of proper dosing and efficacy) on preventing/reversing B12 deficiency in vegans with any other form that cyanocobalamin. Until there is I’m less comfortable recommending it.”

          • christinatanios

            That’s right; I do remember Dr. Greger saying this. Well, do you have a brand that you would recommend? Otherwise, I may just have to go with Dr. Fuhrman’s or keep searching for something better. Thanks again for all your help.

    • I would just take Vitamin B12 sublingual once a week, daily or make sure you are consuming adequate B12 in foods such as soy and almond milk or nutritional yeast. The video that JacquieRN suggested is one of a series in Feb 2012 that Dr. Greger did. You will avoid all the problems associated with some of the isolated ingredients in multivitamins… you will also save money. The proof is in the pudding so to speak… get a Vitamin B12 check to see how you are doing. You can also get other blood tests recommended by your physician.

      • christinatanios

        Thanks, Don. I am a Holistic Health Coach and have asked my peers what Vitamin B12 supplements they take as well; I’m just gathering as much information as possible. I’d love to have a product line that I can trust and refer my clients to as well. I have had my Vitamin B12 levels checked and have also had blood tests done and everything is normal! I do cook with nutritional yeast and I also add it to my salads. I’m not a huge fan of fortified foods such as soy and almond milk, which is why I prefer an alternative way to supplement. Thanks for your help.

  • MikeNewland

    I’ve been eating low fat plant based for three years with a small portion of fish or chicken a couple ot times a week but no dairy. Quite common?
    I assumed that in conjunction with B12 fortified soya milk that provided a sufficient supply of B12. It appears not. Frightening!
    I also read that omnivores have a store of B12 sufficient for several years so another reason not to worry for a while – I thought.
    I’ve added 100 micrograms a day of B12 in tablet form.
    Comment would be welcome.

    • Toxins

      Your diet sounds far healthier then the Standard American diet so I am sure the occasional meat is not doing you great harm as long as it truly is occasional. Another important aspect of your diet is to include as many whole, unrefined, low sodium plant foods as possible. In terms of B12, you need much more then 100 mcg. There is no harm from overdoing the b12 so don’t think you will be at risk for overdose. Dr. Greger recommends 250-500 a day or 2,500-5,000 a week.

      • MikeNewland

        Thank you.
        I only eat plants and grains which are unrefined and nothing with added sugar.
        I’ll double up my B12. It’s cheap as chips! I’ve added 10g of flaxseed a day and iodised salt as well recently. I’ve been taking 10 mcg of D3 a day for three years. Not a sunny climate in England.
        So much to learn. Dr Greger keeps me busy.

  • lait

    could there be a situation of an over does?

  • sylvia

    Is there a difference to take 5000 mcg of B12 every 5 days instead of
    1000 mcg everyday ? (I’m quite lazy to take everyday and also tend to

  • veganforlife

    What is the preferred level of homocysteine?

  • Amir

    Can you give recommendations for methylcobalamin supplementation for children?

  • shay dawidowicz

    There is no evidence in this video or any of the
    other sources I’ve checked that vegetarians and vegans are at increased
    risk of any health problem, including problems associated with
    deficiency of vitamin B12.

    Everything Greger says in this video is that they have taken and tested
    specific vegetarians with a deficiency of B12, and found problems
    related with B12 deficiency. What is that mean? Nothing. They could have
    test non-vegetarians as well.
    It does not prove that the lack of B12 in their organism is a result of
    consumption or non-consumption of animal food products – by the way
    vegetarians usually consume animal products (by eating more eggs and milk) not less
    than meat eaters; it does not prove that vegetarians or vegans are at
    increased risk of vitamin B12 deficiency.

    Actually, eating meat increases the risk of B12 deficiency in various
    ways, for example causing absorption disorder (which is frequently the
    cause of B12 deficiency, according the researches I’ve checked – lack of
    consumption is only a hypothesis and B12 deficiency common among meat
    eaters); also, animal products contain big amount of Methionine which
    requires B12 in order to break it down, therefore heavy animal consumers
    might develop B12 deficiency. In fact this explanation clarifies the
    data Greger introduces in his video much better than the accusation
    towards the veganism: he is talking about bad influence of Homocistein
    which can be caused by B12 deficiency. Homocistein is a stage in the
    process of Methionine breakdown. If deficiency of B12 is playing a part
    the Methionine would not continue breaking down and would stay harmful Homocistein. That is to say, the problem is over-consumption of
    Methionine and the solution to this problem is reduction in consumption
    of Methionine – reduction of animal food products. Recommendation for
    steady supplement consumption is a symptomatic and superficial way of
    treatment, as recommending diabetics using synthetic insulin regularly –
    instead of telling them to lower the fat in their diet.

  • Ruby

    Y’know, I have a really hard toime listening to info that compares vegetarians to meat eaters and finds them similar or the same. as a quick anecdote, when I stopped meat (after a short stint after an entire adult life as an essential vagan) and wanted to stop grains (don’t not digest well, never have, and stopping gluten did not help at all in the long run) I had an opportunity to integrate raw goat milk, frsh from that day, into my diet. In one month I was noticably slower and retarded energy; 3 months of this and I was almost comatosed of any vital energy. And the last month I cut way back. It took a whole 3 more months to unload from that toxicity; ears draining, night sweats, lethargy, for 3 months. . . . on a diet of warmed/raw soups with high green content, algae as always(even during raw dairy) and miso. . . .THUS when I hera these studies that diferentiate between dairy eaters and meat eaters. . . I’m stunned than anyone is stunned the affects are the same in essence. Unless the study is of vegans. . . . doesn’t seem any point, or much, to me. . . . Shrug.

  • Ruby

    One other important point, especially with all this talk of B12 deficiency and other deficiency concerns og vegans . . . .It’s is wholly possible and may even be . . . maybe not predominant but, a vegan can have a piss poor nutritionless diet of frensh fries, cookies, bread, pasta, candy, sugar etc ad nausium. I’d like to hear more chatter from vegans about core diet enhansemsnts and at least a bit less about all this suplimentation, or at least mention dark green leafies and algaes in tandum, and supliments as aid till you change your habits and test until you find a good dietary homeostasis. . . All the talk of corporate made pills and treated water bothers me ever so much, but even more chafing in the absense of diet solutions.. . .Really.

  • Guest

    Hi Dr. Greger! I’ve been taking MegaFood’s vegan b12 tablets and I am wondering if they are sufficient? I know that you recommend cobalamin and say that it can be found for as little as $2/year, but I have yet to find this (does anyone know where I can find this?). I stopped taking other vitamin b12 supplements because they had mannitol and other ingredients that I don’t want to consume. MegaFood’s b12 supplement comes from S. cerevisiae and I’m wondering if this yeast is another trusted source of vitamin b12? Thanks in advance for your help!

  • Calvin Leman

    I drink well water and add B12 to my green drink that I have each day. I speculate the I am getting the B12 I need.

  • JenVeg

    How do we explain the long-lived blue zone populations? From what I understand, they have only small amounts of animal foods in the diet, that I would think would not supply the recommended amounts of B12, yet they seem to live well into old age. The B12 amounts that they consume would tend to indicate that they would have blood vessel epithelial cell damage, but their longevity would suggest otherwise. Could there be some other cofactor involved to make this small amount of B12 sufficient? Thanks.

    • Thea

      JenVeg: I have some speculation on the matter – though no data to back it up. Note the following quote from a blog post on

      “Our herbivore primate cousins get all they need ingesting bugs, dirt, and feces, and we may once have gotten all we needed by drinking out of mountain streams or well water. But now we chlorinate our water supply to kill off any bugs. So we don’t get a lot of B12 in our water anymore, but we don’t get a lot of cholera either—that’s a good thing!”


      I’m thinking that those blue zone populations were getting thier B12 from non-chlorinated water and unwashed vegetables, etc. In other words, they were probably not just getting their b12 from the little bits of animal products that they ate. But having said that, you may also note that we only need tiny amounts of B12 each day to stay healthy. So, I’m not sure the underlying assumption behind your question is valid. Something to think about anyway.

  • Dr Health Flex

    Here is the challenge with majority of B-12 supplementation and even B-9. Cheap synthetic versions -cyanocobalamin and Folic acid are actually harmful as they rob from the much needed methyl groups. The synthetics go through a 5 step methylation process to be converted to bioavailable form.In addition millions od Americans suffer from a genetic error MTHFR that drops out the methylation process leaving the toxic cyanide and unusable B-9 to be again sent to the liver and it is often stored there becoming potentially carcinogenic . The UK and most of the EU have banned these substances

  • Hermes Liberty

    B12 Patches: any value compared to oral, nasal gel, sprays, sublingual? I enquired of a company selling the transdermal (gimmick?) and they couldn’t point me to any scientific studies – just ‘10,000s of people worldwide are happy with’ the two forms they sell – hydroxy- and methyl cobalamin.

    • Joseph Gonzales R.D.

      Not sure about sprays and gels. The cheapest way to get B12 is shown here. Keep asking the companies that is always nice to have that communication.

  • Wade Patton

    Wait, how do we measure the miniscule dosage from powder form where 1/32t is 80,000mcg? By my calculations per MG’s recommendation of 2,500 mcg per week that’s 32 weekly doses in a single 1/32 of a teaspoon. I’m thinking a toothpick might be the best “scoop” for such small measures (where accuracy is far from critical). So for now I just dumped some into my palm, dumped it back into the container and licked the residue off my hand. Wow, did some more math, to wit: this 50g package has enough for 384 years of weekly doses (if measured accurately). I suppose I should share.

    • Wade Patton

      Here’s what I propose I do: add a filler to well-measured amount of the b12 I have such that the dosing can be more easily measured-by volume. Question, what is a good filler for such purpose. Thanks.

  • Danilo Martins Rocha

    My only intake of B12 comes from a toothpaste that has B12 added to it. Is this an efficient and sufficient way of getting B12?

    • Joseph Gonzales R.D.

      Hi Danilo. I have never even heard of B12 toothpaste! I am unsure it’s reliability. Check out Dr. Greger’s Doctor’s Note under the video about the best way to get B12!

      Thanks for your comment,

  • Surfer2u2015

    Dr. Greger touched on insect consumption as a source of B12. Early humans likely ate insects as a low risk, high reward, nutrient dense staple in their diets. The myth of early humans sitting around eating animal parts all the time needs correcting. Hunting larger game was a high risk, low reward/return in human energy expenditure endeavor; and injury prone on top of that with no medical facilities. So humans being what they are would most logically go for the low risk, high return on investment of time with respect to food sources, and avoid injuries at the same time. Now looking at insects, they are packed with calories, fat, and fiber (yummy exoskeletons, etc.; but ooooh gross, right? Hotdogs anyone?), fat soluble vitamins, and of course B vitamins including B12. I am amazed at the consumption of insects in early human history as being a continuing blindspot with the whole paleo crowd and confused vegans as to sources of nutrients. I’m sure by writing this I will get all sorts of funny comments back. So let the chiding commence!

  • John Mooter

    I am vegan. My B12 levels have been above normal for a decade.

    • danieltb

      I forget where I heard it, but (according to what I’d heard) chlorophyll is supposed to enable recycling of B12; if you’re getting plenty of chlorophyll, it might be part of the reason why.

  • frankfv8

    if U do not have the entire B complex b12 is null and void

  • danieltb

    At 12:46 – 12:56 of Mike Adams says cyanocobalamin is “toxic” to the body. Would you agree with that? I know that once I started taking cheap B12 supplements recommended by Dr. Greger my face started breaking out with acne.