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The Foods to Avoid to Lower Stroke Risk

“Stroke remains one of the most devastating of all neurological diseases,” killing about 5 million people a year worldwide, and is “the leading cause of permanent disability in the USA.” But the good news is that about 80 percent of stroke risk may be due to basic lifestyle factors: primarily, improving our diet, stopping smoking, and getting regular exercise.

The best way to stop smoking, evidently, is to have a heart attack. Certainly, once dead, you can’t smoke. Of those who survive a heart attack, strong, repeated advice from their doctor may persuade up to two-thirds to quit and never smoke again in any form as long as they live. “Yes, quitting smoking is very difficult. It doesn’t matter; it has to be done. If you were walking along the lakeshore and one of your grandchildren is drowning, it doesn’t take will power to go into the lake; it just has to be done.” It’s like a healthy diet: Some things just have to be done. Getting up at night to feed a baby can be difficult, too, but it’s not a matter of having willpower—some things in life just have to be done. After all, what we regularly eat every day is indeed a matter of life and death.

For stroke prevention, that means eating a more plant-based diet, like a traditional Mediterranean diet centered around whole grains, fruits, vegetables, lentils, beans, and nuts, as I discuss in my video Best Foods to Reduce Stroke Risk. A vegetarian or vegan diet may also work, but it must be accompanied by a regular, reliable source of vitamin B12, meaning B12-fortified foods or supplements. “Unfortunately, recommending taking B12 supplements may meet opposition among vegetarians because misconceptions regarding this nutrient are prevalent. Many individuals still hold on to the old myth that deficiency of this vitamin is rare and occurs only in a small proportion of vegans…Future studies with vegetarians should focus on identifying ways of convincing vegetarians to routinely take vitamin B12 supplements in order to prevent a deficiency.” The research is clear on that.

What is it about plant-based diets that make them beneficial for stroke prevention? In my video How to Prevent a Stroke, I talked about the role of fiber, which potentially leads to about a 1 percent drop in risk for every 1 gram of fiber ingested per day. Or, even better: A 12 percent drop in risk is associated with every extra 10 grams of fiber a day. In fact, fiber from whole grains is associated with a lower chance of dying not only from heart attack and stroke, but also cancer, diabetes, and respiratory diseases, as well as a lower risk of dying from infections or other causes––in other words, a lower risk of dying prematurely from all causes combined. Why? Perhaps because of the anti-inflammatory effects of fiber, which could explain how it could help across the board. Or, it could be that eating fiber means eating fewer pro-inflammatory foods. Those who eat more whole plant foods, which are where fiber is found, may be eating less processed and animal foods. In fact, the study immediately preceding the meta-analysis of fiber was a meta-analysis on meat, which looked at red meat and processed meat, and found about a 10 percent increased risk for stroke associated with each three and a half ounce daily portion, which is about the size of a deck of playing cards, or about 10 percent increased risk for every “half-deck” of processed meat.

Perhaps this occurs because of the heme iron—the blood and muscle iron—in meat, or because of “its pro-oxidative properties.” (No association was found between stroke and non-heme iron, which is the type of iron that predominates in plants.) Or, perhaps it’s because of some of the toxic pollutants like PCBs that can build up in animal fats. We’ve known, for example, that living next to a toxic waste dump might increase stroke risk, but only recently have we realized that dietary exposure even at so-called safe levels might increase stroke risk—and increase it by as much as eight or nine times for those with the highest levels of these pollutants in their bloodstream.

For more on how to reduce stroke risk with diet, see:

What does vitamin B12 have to do with stroke? Watch my video Vitamin B12 Necessary for Arterial Health to find out.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


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.

62 responses to “The Foods to Avoid to Lower Stroke Risk

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  1. I would love to hear your thoughts on the multiple studies linking B12 supplementation to the development of lung and other cancers (purportedly via the “feed the tumor” hypothesis).

    1. Griffin,

      Dr. Greger has a B-12 webinar coming up.

      We have discussed it within these comments a few times, but I will let a moderator or Tom do that part.

    2. Griffin,

      He did give a spoiler alert during a recent Q & A where he said to not worry about it because the people in the study had high blood levels from meat.

      The study authors themselves said that it was only males who smoked who had the increase risk and Dr. Greger added in the meat part.

      I only was able to look at the abstract version, but I believe the author also said that there was no increase in non-smoking related lung cancers.

      If you go to the Q&A’s you can hear Dr. Greger plugging his webinar with the exact spoiler alert.

    3. What about the B12 supplements that are synthetic?! Surely that is not healthy to take longterm?
      Isn’t B12 made by bacteria in soil? Therefore, how do labs produce the supplements?

      1. Alani,

        Dr. Greger recommends cyano because that is the one that has the best test results.

        He is more worried about high homocysteine related to stroke and Alzheimer’s and the reality that people who have not supplemented have died and have had their spines rot out and develop conditions like MS.

        Fortified food contains cyano and there hasn’t been longterm studies where vegans and Whole Food Plant-Based people have health problems from supplementing B12 and the fact that fortified foods have cyano, it would probably have shown up by now.

        I have personally had Methyl fail but there are studies where if you are afraid of cyano, you can take a few different of the other versions and the combination worked fine.

        One study said to take 2 or 3 types if you are doing Methyl, Adesonyl and Hydroxo.

        Cyano works by itself.

        Methyl isn’t shelf-stable and it is easy to accidentally have it exposed to light or heat, plus you have to take more of it and it is easy to miss a dose. I got serious symptoms and I have interacted with a few other people who had the same problem when they just took Methyl.

        If you eat fortified nutritional yeast and drink fortified plant-milk, you probably could get away with just using Methyl but becareful because I switched off of the fortified plant foods and found out that Methyl wasn’t working.

        1. Thanks Deb! I appreciate your reply.
          I keep wondering if there isn’t a way (bear with me, this may sound ridiculous) to find organic B12 soil or something to just “sprinkle” on our food… instead of needing to take fortified foods and supplements.
          I eat mainly raw and do not do well on boxed plant milks. I do use nutritional yeast now and then.
          I’ll have to look up the symptoms for B12 deficiency because in my 20 years of not eating meat, I have not seen a decline in anything.

            1. ‘Reports of a new plant source of vitamin B12 are making the rounds on the internet. The plant in question is duckweed, an aquatic plant also known as water lentils. One company in Florida has announced that the duckweed grown in their ponds was found to contain vitamin B12 and that the B12 is also found in their commercial product Lentein.

              We want to advise a little caution before you ditch your B12 supplements.

              At this time, the B12 sourced from duckweed hasn’t been studied to determine if it has actual vitamin B12 activity. Without research showing that the vitamin B12 from duckweed can reverse deficiency, we can’t say anything about its value for humans. The company agrees that these tests are needed.’

          1. Alani,

            The thing is, for vegans, Dr. Greger in his stroke webinar said that they do have a higher risk of stroke even after correcting for the things in the study that were wrong.

            Stroke and Alzheimer’s/Parkinson’s are the 2 things people still have to worry about.

            We need to keep our Homocysteine levels at an optimal level and vegans who didn’t supplement B12 had the highest levels of Homocysteine and those who did supplement B12 had the lowest levels.

            As far as foods go, Mic The Vegan talked about Duckweed or something like that, but Dr. Greger already responded that it has to go through a very big process of testing to see even if it consistently produces B12 and if that B12 is effective at reversing Vitamin B12 deficiency.

            Cyano does reverse it. It has been tested and this really is such a big issue because of the stroke and neurological issues.

            Maybe someday Duckweed will be the best choice, but right now it has never been tested at all.

            1. Here are sentences to ponder because there is way more danger in being mildly deficient than in getting lung cancer – unless you are a meat-eating smoker.

              At least 14 studies have measured the vitamin B12 and homocysteine levels in vegetarians. The findings have been consistent: When vegetarians do not supplement their diets with vitamin B12 through fortified foods or supplements, their B12 levels drop over time and their homocysteine becomes elevated higher than omnivores, inversely related to their vitamin B12 levels (5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18). While this finding is stronger in vegans, it is also true of lacto-ovo vegetarians. In these studies, the average homocysteine levels of vegans were between 14 and 20 µmol/l compared to about 8 to 12 µmol/l for omnivores.

              In contrast, a 1998 study of vegans receiving 500 µg/day of vitamin B12 for 2 months showed them to have homocysteine levels below 5 µmol/l (5). A 1999 study showed vegans who averaged 5.6 µg/day of B12 to have homocysteine levels of 7.9 µmol/l, slightly lower than the omnivores (6).

              1. They had a sentence that even just being “mildly deficient” affects the homocysteine levels.

                That increases your risk of stroke and neurological problems, plus if you get really low, you could rot your spine or just plain die.

        2. Alani,

          And if it is the cyanide in cyano that you are afraid of, flaxseed has something like 5000 times more and all fruits and vegetables and water have it and our body is pretty good at flushing it out.

          If you look at Dr. Greger’s flaxseed/cyanide video he shows how much flaxseed you would have to eat to get cyanide poisoning and it is a whole lot.

          Nobody ever has gone to the hospital for cyanide poisoning from cyanocobalamin and they do keep track.

          Honestly, very few people end up with cyanide poisoning even from bitter apricot kernels even with cancer patients taking a lot of them. Though with those people really can go over the limit.

          It is harder to do it with flaxseeds and cyano B12 has 5000 times less.

          1. Thanks Deb.
            The Cyanide is not my sole issue – I’m interested in B12 as a whole – especially understanding the difference between natural bacteria-made and synthetic.

            I’ll look into more info.
            Thank you x

            1. In “The China Study”, T. Colin Campbell says that there is growing evidence that plants grown in healthy soils take up B12. Sounds like you eat a very healthy WFPB diet so this may explain where you are getting B12. Also, if you aren’t eating processed, hypersanitized food there is probably some healthy soil bacteria on the food you’re eating. I grow a lot of my own organic food and don’t supplement. Never had a problem. I do drink a little unsweet Silk soy milk every day which is fortified.

              1. Blair,

                But what is the source of B12 that plants take up? I’ve read about its uptake when B12 is added to the growth medium, eg I’ve also read that even the feed for food animals is now supplemented with B12, presumably because otherwise these animals aren’t eating enough of it. And I’m guessing that all this B12 is laboratory synthesized.

                To my mind, that’s no different that taking a supplement myself. I feel the same way about fortified food (which I don’t eat): why not skip the “middle man,” as it were, and just take the supplement myself. That way, I know how much I’m getting.

            2. Alani,

              Check out Wikipedia for starters; it states: “Cyanocobalamin is commercially prepared by bacterial fermentation. Fermentation by a variety of microorganisms yields a mixture of methylcobalamin, hydroxocobalamin and adenosylcobalamin. These compounds are converted to cyanocobalamin by addition of potassium cyanide in the presence of sodium nitrite and heat. Since multiple species of Propionibacterium produce no exotoxins or endotoxins and have been granted GRAS status (generally regarded as safe) by the United States Food and Drug Administration, they are the preferred bacterial fermentation organisms for vitamin B12 production.[21]”

              So it sounds as though the B12 is made by bacteria in fermenters, then converted to the cyanocobalamin in the production facility.

              Here’s an interesting tidbit: “ Vitamin B12 becomes inactive due to microwaving or other forms of heating.[30]” ( ). Is that true for animal products? It does sound as though, if it is fed to plants which we then eat, it could be inactivated by cooking them.

              And now this: “A particular drawback of testing vitamin B12 levels is that the current widely used blood test only measures the total amount of vitamin B12 in your blood.

              This means it measures forms of vitamin B12 that are “active” and can be used by your body, as well as the “inactive” forms, which cannot.

              If a significant amount of the vitamin B12 in your blood is inactive, a blood test may show that you have normal B12 levels, even though your body cannot use much of it.”

              If Dr. Greger mentioned this in his videos, then it went in one ear and out the other. But perhaps that’s why he recommends an MMA test for B12? “ Better than getting a serum B12 level drawn, though, which most doctors do, a methylmalonic acid level is a superior test for B12 deficiency, which can be blood or urine. You can just pee in a cup for it.”. (But there’s an even better test, apparently; check out the video or transcript.)

              1. Dr J.

                That is interesting.

                The other day, I was reading The Vegan Society pages. I think it was The Vegan Society.

                They said that if people eat things like algae, they can have false positives of B12 testing and they recommended going straight to Homocysteine. I am not agreeing or disagreeing, but they were saying that people can test fine if you eat certain things without being fine.

                I say it because Veg Source Jeff Nelson has been supplementing for 20 years and now tests high and he is going to stop taking it and will be testing and Ryan from Happy Healthy Vegan is considering the same thing, but both of them are testing high on the B12 test. Actually, both of them test high so they are analyzing the “risk of being high” or not and Ryan eats fortified foods anyway, so his is more a formality.

                It is becoming an issue because so many people are becoming afraid of supplementing and they probably should ALSO be afraid of not supplementing and, yes, Dr. Greger did give the MMA as better blood test.

                It is hard to keep track of all of the logic for everything.

                1. I tested high in B12. Then heard that the high level could be inaccurate because of supplementing. Don’t supplement for 10 days then test for a more accurate blood level.. I didn’t supplement for 3 weeks then tested and was no longer high.

                2. Deb, you repeatedly misquoting/misunderstanding Jeff Nelson’s (vegsource) personal issue with B12.

                  Jeff Nelson had his B12 tested last year, and it was found to be high… Since that time he has TEMPORARILY stopped taking the large b12 supplements, and continuing to monitor levels. He also uses soy milk ie some fortified products if I am not mistaken. He emphasizes the importance of b12 supplements especially for vegans! See the video description. I feel it’s important to be accurate and not generate excitement where there is no cause.
                  When was the last time you were tested?

                  Like Jeff, I was tested and my levels found to be high, (high normal) and at the suggestion of my doctor, I temporarily stopped taking supplements for a while. I will be retested. I do take iron with a small amount of b12, and use fortified plant milk. It’s important to be tested imo.

    4. I am not aware of multiple studies linking B12 supplementation with cancer. There are multiple studies linking high B12 levels with some cancers but it seems likely that those cancers may cause high blood B12 levels (rather than vice versa)…………………

      ‘The underlying pathogenesis leading to high Cbl levels is poorly elucidated, with a few exceptions (6,10,11). It is not thought to involve increased Cbl intake because intestinal absorption capacity is saturable (31) and high physiological consumption does not increase plasma Cbl levels substantially.
      We therefore conclude that the mechanisms resulting in high Cbl levels may be related to malignant pathogenesis. Our recent study showed that levels of the circulating Cbl binding protein haptocorrin were high in patients with high plasma Cbl levels (3). Moreover, cancer was associated with high Cbl and high haptocorrin levels. This protein originates from a variety of tissues, but its physiological function remains unknown (32). It is elevated in patients with some cancer types (6,10,11) and has been suggested as a marker for disease progression (6,10). Thus, haptocorrin may be a candidate factor to include in future studies of the possible pathogenic mechanisms leading to high Cbl levels in cancer patients, in particular for the novel associations demonstrated in this study.’

      As far as I know the only study linking high dose B12 supplements to increased cancer risk, found an association with lung cancer and then only in male smokers. The was no association found in male nonsmokers or in female smokers (or female nonsmokers for that matter).

  2. “Centered around” is an oxymoron.
    For better grammar, please use “centered on” or “revolved around” instead of “centered around.”

    1. The title of the post is “foods to avoid……” while the accompanying photo shows vegetables and fruits (tomatoes). That is an unfortunate combination.

    2. I for one, appreciate it when strangers correct mistakes I make. How can we grow and learn if people don’t point us in the right direction?

    3. RB

      I understand that Dr Greger and the team welcome feedback from from visitors who identify errors of various kinds.

      They don’t seem too keen on personal abuse though. Can’t you just play nicely with the rest of us children?

    1. Meat and dairy and eggs contain all of the animal proteins and immune cells that the donor had in their body. They arouse our own immune system when we consume them, causing systemic inflammation.

      Inflammation is the cause of ALL non-infectious chronic disease.

      1. Lic

        Unfortunately, cranks and internet marketers with doctorates are still cranks and internet marketers

        The claims that grass-fed meat and grass-fed dairy are healthful seems to be entirely a product of wishful thinking and successful marketing. People’s ability to dream up inventive reasons why grass-fed meat etc should be healthy seems endless. However, actual evidence in the form of reduced death rates, cancer rates and CVD event rates is conspicuously lacking from all the hype.

        There is no evidence for example that people eating-grass fed meat have better health outcomes than people eating conventional alternatives. Let alone people who eat no meat at all. Such products may have a better lipid profile than their conventional alternatives but that is only a small part of the total equation. Meat, grass fed or not, still contains saturated fat, cholesterol, haem iron, IGF-! and NeuG5c for example. And carnitine
        All of these increase risk for chronic disease and they are found in both grass fed and corn fed meat.

        And if we look at countries where all the beef is grass-fed with no added hormones or steroids etc, Like Uruguay, we find for example that the more of this stuff that people eat, the higher their rates of cancer.

    2. Hello Lic,

      Grass-fed meat is certainly better than conventionally raised meat, but that does not mean it’s overall healthy. Dr. Greger actually has a video comparing wild meat to conventional beef and found that, while it was less inflammatory, it was still inflammatory:

      The same would go for dairy. They likely contain higher levels of omega-3 fatty acids, and less saturated fat, but are still not a health food.

      I hope this helps,
      Dr. Matt

  3. I opened the blog and got a scare: The title says: Foods to avoid to lower risk…. and the picture shows vegetables and greens. I thought I would have to survive on water from now on. LOL. The title should be: Food to eat to lower risk….

  4. I do like the concept of, no matter if it is hard, some things “just have to be done.” Indeed, saving a drowning child or feeding the baby at 3:00 am have to be done. But living longer and healthier … for many, that is a trade-off. Like the people who hate to exercise, they say, “yes, I may live three years longer, but I’ll have to spend those three years exercising.” As Margaret Mead wrote, it is harder to get people to change their diet than to change their religion.

    1. The issue with nutrition is not simply living longer, but rather enjoying good health during the years we are allotted.

      Millions of people suffer with health issues of one description or another for the majority of their lives. Of what joy is a long life to them?

  5. Hi Doc!

    So the question that’s outstanding in my simple mind is this; “Where do I get Vitimin B12?”

    Yes, I know it can be acquired from eating meat. How is it that we have this vitamin B12 requirement in our bodies to live, and there doesn’t appear to be any consumable plant to acquire this vitamin. What on earth did our ancestors of long ago do to acquire the required Vitimin B12.

    I know I can go to a “Health food & Suppliment” retailer or look online and find tons of vitamin B12 supplements. But the question is, which are indeed the real deal and not full of other contimanents or not even contain any of the advertised vitamin B12.

    Just because a manufacturer receives the coveted USP stamp doesn’t mean doesn’t mean they continue to produce that product to meet USP specifications.

    So, the question is, where do we acquire vitamin B12?



    1. B12 is apparently made in the soil by bacteria and in our gut.
      The reason why one can obtain it from meat is because animals graze and come into contact with soil daily… whereas we do not. And our food is now grown in treated soil.

      I’m still waiting for a response Dr Greger about B12 being made by bacteria and how it is replicated in a lab to be healthy aka fortified food.

    2. They didn’t eat hypersanitized food and ultra processed food. There was soil bacteria on the food they ate and the water they drank. Today, even factory farmed animals are fed B12 supplements because they aren’t eating natural food.

      Also, in “The China Study”, T. Colin Campbell says that there is growing evidence that plants grown in healthy soils take up B12.

    3. We have a requirement for B12 and plants can provide it since they have B12 bacteria on them. However, nowadays we routinely wash them off. Eating raw plants in the wild also necessarily involves (inadvertently) eating small amounts of insects and insect eggs which are also another source of B12.

      As for a good source, you could join Consumerlabs which has tested .many B12 brands. From memory they approved a fair number but i can only recall one – Amazon’s Elements Berry B12

    1. Hi Marvin, Dr. Greger will be doing a webinar in April on pandemics in general, based on his previous work. We’ll be sending the info out in a few emails coming up. Are you subscribed to the newsletter?

  6. “Because MTHFR impacts the process of methylation, it is also recommended to take a methylated (and more usable) form of B12, known as methylcobalamin, rather than the more commonly available cyanocobalamin form. B12 absorption is essential for good mental health, and is also compromised by the MTHFR mutation and the other factors listed above.”

    The above is a quote from Psychology Today. MTHFR may also create a problem with folic acid. A serious issue for expectant mothers with MTHFR.


    1. Glenn,

      Yes, people can test for that. There is a danger from over-methylating, too.

      And Methyl isn’t shelf-stable and doesn’t always work so don’t just rely on it, but if you need a methyl donor then add that in, but the PubMed articles that I read tested combinations Methyl plus Adenosyl or with Hydroxo rather than just Methyl.

      One scientist said that Methyl was incomplete because your body also needs Adenosyl. I can’t remember which things he mentioned but it seems like myelin sheath was one.

  7. The Chinese are treating Coronavirus with intravenous Vitamin C because it cannot be absorbed in sufficient quantity by the intestines. (All viruses can be killed with ascorbic acid in sufficient concentration.)

    UNLESS you take it in “liposomal” form. Microscopic fatty spheres encapsulate the stuff until it passes through the intestinal wall, greatly increasing the possible blood level.

    Ebay is where I bought mine.

    1. Navy,
      Thanks! I like that it is third-party tested and that it is made in the USA despite not having heard of that particular brand name

  8. What I worry about with the Vegan community is that there is more fear of supplementing than expressing the reality of how vegans test. I do understand that both Ryan and Jeff did communicate that they did supplement for years and that their numbers are high, but whether they mean to or not, they are starting a process of “experimenting in not supplementing” and they are the voices so many young people are listening to. I am looking forward to Dr. Greger’s webinar, but people are deathly afraid of cancer and not afraid of stroke and homocysteine and I guess my question that I would like Dr. Greger to have an answer for during the B12 webinar would be: Statistically how high is the risk for cancer versus stroke and Alzheimer’s for vegans and by that I am meaning Whole Food Plant-Based but I only would have the Adventists to look at and I don’t know offhand if they supplement or not.

  9. Or maybe it is that they aren’t afraid of anything other than toxins getting into their clean diet somehow.

    Because they have a diet that is like Iron Man’s suit so nothing bad will ever happen unless they take something not clean enough.

    That was the original movement’s philosophy and this one could go in that direction, too.

    I say it because I watched an interview with Dr. McDougall about B12 again and he just felt like he shouldn’t have to supplement and that is probably “What protected our prehistoric ancestors?” as if humans were all so healthy.

  10. I ended u writing to Ryan directly and I will contact Mic next.

    There have been 14 studies on vegans and people are speculating anecdotally in ways that will lead people away from supplementing.

  11. Thanks for the excellent information. Do you have any advice on how to strengthen immunity for Covid 19? I have a heart condition, at risk for stroke, and asthma. I have followed your work on those topics and have seen good results. However, any guidance you provide on immunity would be appreciated.

    1. Hi Tim,

      Dr. Greger will be doing a webinar on this in early April, actually. Are you subscribed to the email newsletter? It will be announced in the next couple of days. In the meantime, we have lot of videos on immunity: Hope that helps!

      1. Thanks Kate, I am on your email list. Will the webinar be available to view after the event. Most of the past webinars have been during work hours. I have been unable to attend as a result. Thanks again for the link.

  12. I understand that Nutritional Yeast and various fermented vegetarian foods used around the world for thousands of years are excellent sources for B12 vitamins. Is this correct?

  13. Hi, Gordon A Pettipas! You are one of many to raise this question. It was once widely thought that no harm could come from excess vitamin B-12 intake, to the point that the Institutes of Medicine of the National Academies of Science, who set the nutrition guidelines, did not set an upper limit for it, stating, correctly, that there was no evidence for toxicity. It now appears that, as with most things, too much vitamin B-12 may be almost as harmful as too little. Vitamin B-12 is critically important for neurological function, and has an impact on cardiovascular health, as well. It is not made by either plants or animals, but by bacteria that were once abundant in soil and water. Modern water treatment and agricultural practices, while preventing deadly waterborne diseases, have largely wiped out these bacteria. As a result, it is now common practice for vitamin B-12 supplements to be given to animals raised for food. Vegans are far more likely to consume too little vitamin B-12 than too much, which can cause permanent neurological damage over time. The key is to take enough, but not too much. You can find everything on this site related to vitamin B-12 here: I hope that helps!

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