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Vitamin B12: how much, how often?

This week NutritionFacts.org celebrates the upload of its 300th video. Though the site is officially only 9 days old, it launched “preloaded” with 288 videos taken from the last four years of my Latest in Clinical Nutrition DVD series. My primary motivation to move this body of work to the web was to make it freely available to everyone, a dream come true thanks to the Jesse & Julie Rasch Foundation. Another great benefit of this medium, though, is dialogue.

The daily new videos-of-the-day are just the beginning. The discussion begins below them in the comments section after every blog entry and video. Please feel free to ask any questions, offer any tips, make any requests, and share your experiences and expertise. So far I’ve been able to personally answer every question that’s been asked (or at least make an attempt!), and hope to keep that up as long as I can. You can also “like” the NutritionFacts.org facebook page and join in on the discussion there or on our twitter page.

Tomorrow is day 10 of my 365 day marathon to upload a new video every day, seven days a week, for at least the first year. So far, of all the posts, Vegan B12 deficiency: putting it into perspective was the most commented upon. The conversation there and under the corresponding video, centered on practical questions about how someone eating vegan — no meat, dairy, or eggs — can ensure a regular, reliable source of vitamin B12. Here are the recommendations I posted:

In my professional opinion, the easiest and most inexpensive way to get one’s B12 is to take at least 2,500 mcg (µg) of cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement (you can’t take too much–all you get is expensive pee).

Or, if you’d rather get into the habit of taking something daily (instead of once-a-week), I recommend at least 250mcg (I know the math doesn’t “add up” but that’s due to the vagaries of the B12 receptor system — I’ll record and upload a video showing how I arrived at these recommendations).

Or, if you’d rather get it from B12-fortified foods instead of supplements, I’d suggest three servings a day, each containing at least 25% of the “Daily Value” on its label (again, I’ll explain). Such foods can be as exotic as a certain type of “nutritional yeast” or as simple as a bowl of Cheerios.

In my 20 years eating a plant-based diet, I’ve personally found the once-a-week method to be the simplest . If you share with a bunch of friends it can cost as little as $2 a year — cheaper than Cheerios! :)

I am averse to even mentioning brand names (unless I’m being critical of their products, e.g. Alli®, Applebee’s®, Airborne® supplements, Burger King®, Centrum®, Chick-fil-A®, Chili’s®, Coca-Cola®, Dow Chemical®, Eggbeaters®, Flomax®, Herbalife®, Häagen-Dazs®, Juice Plus+®, KFC®, McDonald’s®, Lipitor®, Nutrasweet®, Pop Tarts®, Purevia®, Sugar Twin®, Splenda®, Sweet and Low®, Sweet One®, TGI Friday’s®, Truvia®, Vaseline®), but I’ll link to the $2/year one only because it was the cheapest I could find (please let me know if you can find a better deal and I’ll switch the link!). I certainly don’t endorse the other types of products they sell (such as fish oil, red yeast rice, spirulina, and weight loss pills). The supplement industry has a history of making misleading claims, much like the dairy industry, which I profile in today’s video-of-the-day on milk and mucus.

-Michael Greger, M.D.

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


68 responses to “Vitamin B12: how much, how often?

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  1. I am your new biggest fan! I purchased volumes 1 through 5 of the DVDs and just finished watching volume 1. (I watched them in reverse order.) While I think that everyone should watch all the DVDs because all the videos together paint a big picture that is compelling, it would be difficult to get people to take the time. So, this website fills a great role.

    I have already forwarded links to various videos to several friends and family. I have two friendly suggestions for this site:

    1) Key Words
    I can tell that you have made an effort to add lots of key words, but I think the effort needs to be more complete. I’ve only done a handful of searches and two of them came up with nothing – even though I know there are videos on these topics: Searches on “xylitol” and “red rice” both turned up nothing. Since I know that the videos exist, I was persistent and found the videos other ways. However, other people doing a search may thing that the videos do not exist. So, it would be worth it to get all the key words in place.

    2) Navigation
    Suppose I do a search on ‘breast cancer’. The results return 3 pages worth of videos. Say I click to go the second page worth of videos and then click on one of those videos to watch. When I hit the back button, I would expect to be taken back to that same second page of videos on the topic of breast cancer. Instead, I get taken back to page 1 every time. The site would be greatly improved if this could be fixed.

    Hope you find those suggestions helpful.

    I have lots of enthusiasm for this information! I am a 41 year old female who has been vegetarian for 16 years, but never for health reasons. I didn’t believe that health reasons exist. I did it solely for humanitarian reasons. And knew that to be true to my humanitarian goals, I would have to become vegan.

    Last September I went to the VegFest conference in Portland. It changed my life. I finally got convinced that there really are health reasons to go not just vegetarian, but vegan. And at one of the talks, someone passed out your health recommendation sheet (or referenced it?) and that is how I found you on-line.

    I can’t thank you enough for your work. You make it painless for someone to educate themselves on real nutrition science. After seeing your videos, I have learned so much. I also have a bunch of questions and a small nit to pick, but I’ll post those under the appropriate videos.

    I don’t like to take people’s word for things. I want the science. THANK YOU for helping me to understand how to be healthy and for making it fun.




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  2. I have a third suggestion for this site: The ability to edit one’s own comment. While I know I can add another comment, I’d sure like the ability to fix a spelling mistake or add a sentence to the original comment. Just a thought.




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  3. I also thought I’d let you know that fingers can do the walking for us. I’m so used to typing “dot com” that several times while trying to reach this site, I typed NutritionFacts.com instead of .org. I was taken to a site that looks like it is about nutrition, but it is not you. It appears that the NutritionFacts.com address is already taken, but if you could buy the .com address up in the future so that both .com and .org come to here, I bet that would prevent people from going to the wrong site. Just another thought.




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  4. I read somewhere that taking antibiotics can reduce the B-12 in my system. Do I need to worry about this if I am taking supplemental B-12? I am currently on antibiotics for acne. Are there any other health concerns for a vegan (or anyone) taking antibiotics long-term?




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    1. Yes, there is. You will have to consistently supplement probiotics. This is very important. Antibiotics kill off all the bacteria in your gut so it is highly recommended you buy probiotics.




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  5. FROM WIKIPEDIA

    In a broad sense, B12 refers to a group of cobalt -containing vitamer compounds known as cobalamins: these include cyanocobalamin (an artifact formed from using activated charcoal , which always contains trace cyanide , to purify hydroxycobalamin), hydroxocobalamin (another medicinal form, produced by bacteria), and finally, the two naturally occurring cofactor forms of B12 in the human body:

    Anyone have any imput on the subject?




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  6. Hi I take the methyl lozenge form of B12 currently and it said to take 1000mcg/day, this seems like a lot. Should I really be taking that much to make sure I get what I need? Or maybe a couple times a week instead. Also do you recommend any certain suppliment brands for other things, like calcium etc, I’m weary about the extra ingredients. Thanks




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  7. Dr. Greger,
    Vegan Coach.com, citing you as a good source, recommends DEVA (company) vitamin B 12 supplements. Their product contains methylcobalamin, NOT cyanocobalamin, which you recommend on this site and which I’ve learned contains cyanide??  So, which is it? 

    And, I thought I was getting my source of vitamin B12 from soy milk. However, I’ve heard that heating soy milk which is done in pasteurization, after the vitamin B 12 is added, can eviscerate the vitaminn B 12.

    I need some expertise here, please,

    Joanne 




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  8. I like this blog and good information.
    Golf to head stateside in 2013: Autoweek TV. Also in this episode: Nissan recruits Consumer Reports test director.
    herbs-wholesale.com/brand/seventh-generation.html




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  9. On my package of vitamin B12 from Finland it’s written that 3 µg is daily dosage of B12, which is 300% of recommended daily dosage. And take no more than 1 tablet a day. Is it too small? On your site it is written: ‘I recommend at least 250mcg’ That’s strange.




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      1. If the daily dosage is 250 mcg, does it mean that I must take 250/3 = about 83 pills a day??? One pill is 3 mcg, like I said. I still can’t understand :((( 4-7 mcg and 250 mcg per day are such different numbers.




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        1. You need to get new b12 supplements! You can get some that are 250-500 mcg. If you choose to go your route of only 3 microgram supplements, you will have to take 3 a day 4-6 hours apart. Keep in mind, we absorb 1.5 micro grams plus 1% of the rest passively. After the initial 1.5 mcg absorption, we have to wait about 4-6 hours before we can resaturate our b12 receptors. The formula here is an example with a 500 mcg supplement.
          1.5 + .01(498.5) = 6.48 mcg, this falls into the 4-7 mcg per day range.

          It would be far less complicated to go that route, or simply take a 2500-5000 mcg dose once a week.




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          1. Unfortunately, I couldn’t find any Vitamin B12 with that dosage. :( I think that is because the medical institutions in our country think that 3 micrograms is more than enough for a day (in pill form). I live in Europe, Estonia. That means I’m B12 deficient everyday :(( Maybe the soulution could be taking B12 fortified products? But they’re also not too rich in this vitamin.




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          2. Ok, I didn’t read carefully. As I understand, if I take 3 pills, which contain 3 micrograms of B12, with 4-6 hour intervals, that would suffice? 1,5 x 3 = about 4,5 micrograms




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  10. Greetings, thank you again for so many wonderful video’s and information. I just purchased B-12 energy patches
    made by http://www.Healthyhabitsweb.com .They are not inexpensive.( I have no affiliation with them at all). Mine come 8 patches to a package and they state each patch contains 0.4mcg of folic acid and 1000mcg of Methyl…B-12. Directions state using 1 or 2 patches every week–you attach one behind the ear or on the neck–, but how do you know which–1 or 2 a week?. Also, is a patch better absorbed than a pill, liquid or shot?.
    namaste’, rachel




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  11. I’ve adopted a whole-food, plant-based lifestyle for health and longevity. And, in an ideal world, I’d like to be as self-reliant as possible when it comes to nutrition (i.e. grow or buy locally produced and otherwise readily available foods). This goal is relatively easy to achieve almost anywhere on the planet except maybe the extreme high latitudes (north or south) and some deserts. (I don’t plan to go to human-made stations in space or under the sea!)

    That said, I’m curious to know what would be the least amount of meat or other animal product (or bacteria-rich soil!) that I would have to eat to ensure an adequate intake of vitamin B12? And would the related health risks of consuming these non-plants seriously compromise my goal of a healthy life, free of the diseases of affluence?

    Suppose, for example, that I moved to a country or region where manufactured vitamin B12 supplements were not reliably available, and I must obtain my B12 from local sources.* If I want to stay healthy and follow my chosen way of eating, I will be obligately dependent on an external (imported), manufactured supply of non-animal vitamin B12 (and probably D3 unless I’m in the tropics).

    The natural sources of B12 I’m aware of include animal meats and bacteria that live in the soil and elsewhere on animals. If these are indeed the only sources available, then I’ll have to consume some amount of these sources -daily, weekly, monthly or at some appropriate interval- in order to stay healthy. In other words, I’d have to compromise (or give up and go back home! .

    My question then is: what is the least amount of meat or other animal product (or bacteria-rich soil!) that I would have to eat to ensure an adequate intake of vitamin B12? And would the related health risks of consuming these non-plants seriously compromise my goal of a healthy life? I’m curious to know Dr. Greger’s and others’ thoughts on this.

    * another way to frame this would be that a person just didn’t want to be dependent on the supplements industry for the rest of their life…




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  12. Dr Michael Greger according to B12 vitamin , is there anyway to get the b12 from any natural source or raw food ? thank you
    kind regards




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  13. For me, 78 year old vegan plus some fish and B12 pill did not work. Blood test MCV above range, Hem below range feeling poorly. A month of liquid B12 under the tongue 500 mcg daily feeling better than last 9 months.




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  14. Dr. Greger,

    I was wondering if there have been any reports of any B12 supplement brands having misleading labels–i.e., not having as much B12 as they claim or even none at all. You discussed such a problem with other supplements, I think particularly herbal ones. Has this also been an issue with B12? I haven’t been supplementing (though I do eat some fortified food) but plan on starting now, due mostly to your recommendations. I would hate to buy a brand that didn’t actually have as much B12 as the label reported.

    Thanks for all the time you’ve put into all your work; it’s been extremely helpful!




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  15. Hi do you think it would be a good idea to crush a 1000mcg b-12 tablet and add it to the whole wheat bread we make at home? (a homemade fortified food) Or is it better to just take sublingual ?
    Thank you for your great work!




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  16. Hi.Is it better to take b12 on its own or as a B50complex twice a day or as a b100 once a day ? Is slow release good when you’re taking vitamin C later that day? thanks




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  17. I take a liquid multi-vitamin with 100mcg of b12 and it says that is %1660 daily value. Is this incorrect? Do I need to be taking 150 mcg more a day? Thank you.




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  18. Thank you so much for sharing your knowledge with all of us. It is your precious time and a service to human health.
    I have shared your site. It is very exciting to come and learn what is out there that we can choose to live a better life, not with pills (even so, those are beneficial,sometimes) but with the right foods. Mazel Tov




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  19. Can anyone suggest an online retailer (like nutrabulk) who sells and ships internationlly a similar B12 product that was mentioned in the above article. Please & Thanks =)




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  20. I’m happy with BulkSupplements.com for my B12 and D3. I ordered their B12 via Amazon, and then BS emailed me and offered a free second supplement. So I ordered their D3. Haven’t done the math for costs, but this 50g bag of B12 is a few hundred years worth. Now if I could only accurately measure such miniscule doses. I’ll try my powder scale, resolution 0.1 grain (6400 micrograms).




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  21. Dr. Greger hello! I have a question concerning B12. I work a lot and I have a very busy schedule during all the week sometimes with lots of pressure in the office so I take B12 by 8ml per day which consist in: B12=17.5µg, b6=6.3mg, b1=4.4mg, niacin=16mg,L-glutamin=100mg,L-lysin=10mg and L-serin=42mg.
    After the first day and the second day of use which I feel calm and I have my daily routine, in the third day I feel Sleepy and Fatigue. But i make a very good sleep and I feel very calm (especially when I have pressure, I am able to logic calmly).
    So the effect on my nervous system is managed better (I am happy with that) but Is it normal to feel tired and to be sleepy since in the afternoon?
    I can’t wait to go to bed and I make a very good sleep…I make a very calm sleep but when I wake up in the morning I feel like tired for 1-2 hours (may be because I sleep every day by only 6 hours and I have a busy daily schedule?)

    I have had exactly the same effect also when I took other B complex one year ago (but at that time may be I slept less every day by 4-5 hours)???




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  22. What if I take a 1,000 microgram B12 cynocobalamin tablet orally 3 times each week? Is my taking it orally, rather than chewing it or taking it sublingually, going to leave me at risk for deficiency?




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  23. I know that you get B12 in animal products. Some people have been talking about not washing plant produce etc. to obtain B12, but that is not normally possible with fruit and vegetables obtained from the greengrocer.

    I’ve been looking at a study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042564/) and it appears that there is B12 in some non-animal sources such as dried purple laver BUT the B12 levels are not consistent.

    This source has B12 in apricots as 58.5ug/100g (http://link.springer.com/article/10.1007/s12161-011-9349-3, http://link.springer.com/article/10.1007/s12161-011-9349-3#/page-1)

    This source B12 in okra – from ND – 91.2ug/100g (http://www.hindawi.com/journals/jchem/2014/831357/) but it did not state if it distinguished between B12 and pseudo-B12

    Bottom line, I was wondering if there is any way that a vegan can get (enough) B12 WITHOUT having to use supplements?




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  24. Dr. Greger, the link to the B12 is no longer valid. They do sell big bottles of B12, so it may just need to be updated. Thank you for all you and your staff do!




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  25. Thank you so much, Dr. GREGER.
    You have changed my diet. Given me hope. Congratulations on all the great work you have done and shared.
    Amazing! Your fan, Marcia




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  26. Accordingly with Dr. Edward Group III, DC, NP, DACBN, DCBCN, DABFM is the founder and CEO of Global Healing Center, cyanocobalamin is not good for you. Is it true? Is there enough scientific evidence for this assertion?




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  27. Hi, i’ve been taking 5000 mcg of b12 a day for a while now. Just accidentally bought the 500 mcg dissolvable tablets instead. Is it potentially dangerous to cut back so dramatically? I would have to take so many of them to get to 5000 mcg a day…




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    1. Justmakingsure, it’s not dangerous to cut back abruptly. Unless you were severely deficient 5000mcg a day was likely way more than you needed anyway. Because b12 is a water soluble vitamin you just urinate out any excess you body doesn’t use so it doesn’t harm you to take too much it just makes your urine a little more expensive. In any case you could cut back to 1000 (two 500mcg tablets) a day and most likely be just fine at least until you finish up what you just bought.




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  28. Dr. Greger

    You recommend 250 mcg and my bottle says to take one lozenge daily but it’s 1000mcg. Is it safe to take one daily as indicated? What about for my 10 year old son?




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  29. Due to Crohns disease/surgeries I don’t absorb B12. I had taken injections for 40+ yrs and now become allergic to the cobalt. I am trying sublingualB12. My doctors don’t seems to know how much to take for maintenance. So far I am doing 1000mcg of Methylcobalamin daily and chose a brand that contains only two fillers. Is 1000mcg/daily too much, too little? I don’t know. Would you give me your opinion? Thank you




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  30. I want to become vegan, and I’m convinced that this is much healthier for humans, but it surprises me that if humans are supposed to not be omnivores, why do we need a supplement to give us something that is dangerous to not get enough of?




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    1. Hello Victor,

      I am a volunteer moderator who helps Dr. Greger answer questions on NutritionFacts. I am a whole foods plant based dietitian nutritionist based in Scottsdale, Arizona. You ask an interesting question. I can only assume that you are thinking that the need for Vitamin B12 suggests that biologically we are “supposed” to be (genetically) eating meat?
      I don’t know a ton about cavemen, and how much meat they ate. I do remember from my biology and anatomy classes that human growth and development was evolutionarily advanced when our ancestors started sucking the marrow out of animal bones (great source of essential fatty acids). I’m not sure that this means that I should be sucking animal bones to get my EFA’s since there are many rich plant based sources of nourishment of fatty acids. With B12, Cobalamin, commonly referred to
      as vitamin B12, is the only nutrient not directly available from plants. This is because vitamin B12 is synthesized by microorganisms, bacteria, fungi, and algae,
      but not by plants or animals. Animals consume these microorganisms along with their food, which is why this vitamin can be found in their meat, organs, and
      byproducts (eggs and dairy). When we go back to our ancestral roots, we suspect that humans were not always able to eat a large source of B12 (in the occasional mastadon that was hunted and eaten) so that could explain the storage component of B12. But, since it was widely available in an unsanitized, “natural” environment, as we were eating bugs and grubs we could attain consistent amounts of B12.

      As you can see from my rambling reply, it cannot be scientifically known if humans are “supposed” to be vegan or not. Targeting one micronutritent as an argument either for or against this position is a tough sell. Instead, I can look at the myriad scientific reasons why a vegan diet offers superior health benefits in our modern world and supplement once or twice a week with sublingual B12. I prefer that approach.

      Thanks for being part of our community!

      Lisa Schmidt, MS, CN
      Mindful Benefits
      plantbaseddocs.com




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      1. Thank you for your great reply. I guess it makes sense since some percent of the diet of monkeys are insects. Should the plant-based diet, if done without supplements, also consist of a bit of insects (just once a week maybe) if we only consider the health aspect and not any moral, environmental or social aspects? And if so, how much would we need to eat to get the amount of B12 we need?




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        1. Okay, Victor, YUCK! You are beyond my scope of stomach comfort here. I know in some parts of the world insects are part of a normal diet, but for this squeamish girl, I prefer a squirt a week of B12 drops. You might check out Crick Nutrition for their take on the scientific benefits of eating insects. They claim “more B12 than salmon or beef!”

          This is not an endorsement of their product, rather, an invitation for those so inclined to not supplement cheaply and simply with B12 to investigate insect sources.
          Yum Yum!!




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          1. “They claim “more B12 than salmon or beef!””

            Then it makes even more sense! Thank you for your help. I don’t think I will actually eat insects, it just help me rationalise a vegan diet to know that the B12 deficiency is not because eating meat is unnatural – just that we probably used to eat bugs.

            Are there any other deficiencies commonly found in vegetarians, I should know about?

            http://articles.mercola.com/sites/articles/archive/2015/08/03/vegetarian-vegan-nutrient-deficiencies.aspx mentions a bunch: B12, creatine, “protein” – questionable since doctors never find deficiencies in protein!, carnosine, taurine, vitamin D3, heme-iron, DHA omega 3 and sulfur. I don’t really trust this supposedly very trusted site, but I want to build muscle and become stronger while having a vegan diet, and I want to be sure that I am getting what I need. Are any of these some I should worry about?




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            1. Victor,

              I love Dr Greger and Nutritionfacts because it is 100% independent, existing only because of Dr Greger’s passion and donations of time and money from community members and moderators such as myself. I used to be a fan of Dr Mercola until I learned about the bias in science due to researchers competing financial interests. Dr. Greger has a great video on this you may enjoy. Dr. Mercola sells “health formulas” (eg. not food) so I wonder how this affects his information??

              In my practice as a clinical dietitian nutritionist, I have NEVER seen a case of protein malnutrition, except for severely anorexic clients (I’ve sadly had a few of those). Everybody else, not so much.

              For vegan muscle, please see Robertcheeke.net. He has been a competitive vegan body builder for over 25 years, and he is the son of a dairy farmer in Oregon! What a great guy. I asked Robert and two other colleagues to speak to a plant based course I teach at Arizona State University and he is amazing. Great information, highly credible experience.

              You don’t have to eat animals to get big! You might have to eat bugs, ha ha. Keep us posted!!

              Best of luck to you and thank you for being part of our community.

              Regards,
              Lisa




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