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B12 and Vitamin D Supplements

If you eat a plant-based diet, should you supplement with B12 and vitamin D? The answer may surprise you. This episode features audio from Are Supplements and Vitamins B12 and D Really Necessary on a Plant-Based Diet?. Visit the video page for the doctor’s notes related to this podcast.


If you eat a plant-based diet – you may wonder…Do we really need to take supplements like vitamin B12 and vitamin D? Let’s find out.

Hello, from Jonathan. How do you recommend navigating supplements: multi-vitamins, protein powders? I’m not sure what to trust given the lax regulation. 

Absolutely. Well, certainly the regulation is indeed lax. So, what protein powder to get? No protein powder! Why would anyone need protein power? You get protein the same way you get carbs, the same way you get fat––from whole foods, ideally whole plant foods. And no reason to take a multivitamin. There are some things that people may need supplements for.

For example, Vitamin D, if you’re getting inadequate sunshine. Vitamin B12, if you’re not eating Vitamin B12-fortified foods. So, how do you get supplements that aren’t contaminated with something, or actually have what they say they have? Probably the best way to do it is to get one that is USP certified; so, it’s a third-party certification entity that makes sure that whatever it says on the label is what is actually in the bottle. Doesn’t mean it’s good for you or anything. I mean, you can have USP certification of snake oil, but at least it would be actual snake oil at the dose that they say on the package. So, it’s kind of truth in advertising.

Okay, this is from Heidi. New to a plant-based (mostly fruit) diet. Okay. Do I need to take B12 supplements? 

Absolutely! Or eat Vitamin B12-fortified foods: one of those two. Critically important for anyone eating a plant-centered diet, even if you’re not…even if it’s not strictly plant-based; it’s critically important to do.

Okay, GABriel, or GabRIEL. What can cause tingling sensation in a whole food, plant-based diet, besides B12 deficiency? 

I presume you mean tingling sensation, kind of fingers and toes? That’s a sign of a peripheral…typically a sign of peripheral neuropathy. Why? So, let’s say you have a problem with your nerves. Why would it show up as tingling in your fingers and toes? Well, those are the longest nerves in your body. So, the nerve in your toe actually goes all the way up to your spinal cord – from your toe all the way up the spinal cord, one nerve! Like one long skinny, teeny, little string of spaghetti, but like almost microscopic – actually microscopic – all the way up. Isn’t that amazing? One…you know, you think of cells as being microscopic. This cell is like, you know, three feet long. So, you can imagine if there’s any problems with your nerves, those are the nerves that are going to really show it first, right? It’s the ones that are so long and vulnerable. And so, you get this kind of…that typical thing.

But it can be caused by all sorts of things. There’s all sorts of toxins: medications that can do it. And so, you just really need to go to a neurologist, and they go through the differential diagnosis––all the various things that can cause it. There are other nutritional deficiencies that can do it, and you just––some heavy metal toxicities can do it. Oh, there’s autoimmune diseases, all sorts of things; so, you’ve just got to get checked out.

We got Mechanikerkatze. Do I have any short-term effects…Oh, do you have short-term effects with insufficient B12 levels? 

Oh! So, I presume some kind of clinical effects. Do you actually feel differently in the short term from insufficient B12? You may not, which makes it so insidious. But you can start showing these sub-clinical issues in terms of rising homocysteine or something, which you really wouldn’t feel, but may have negative consequences. So, a regular, reliable source of Vitamin B12 is critically important. And so, for those eating plant-based diets, for example, I would recommend either sufficient Vitamin B12-fortified foods, or taking one 2,000 mcg B12 tablet once a week. Get all the B12 you need. Super cheap, safe, easy, convenient, and critically important.

Can you synthesize enough Vitamin D during the warm months to last you throughout winter?  Yes, in terms of enough Vitamin D to live. I mean, that’s the whole point is that during the summer months, you know, you’ve got high latitudes. You build up enough, and it’s stored in your fat, and you kind of live through the winter, and then you get more the next year. But do you have enough in your body for optimal health? That we don’t know the answer, and we suspect that it’s probably, probably dipped too low. And indeed, you see that, you know, that study, the Oxford study on vegans in the UK: high latitude. Vitamin D is perfect in the summer, dips too low during the winter months.

And so, it’s probably good when you’re getting insufficient sunshine to supplement your diet with Vitamin D, and I would recommend 2,000 International Units (IU) of Vitamin D3 a day for anyone getting insufficient sun. Doesn’t matter where you live. Even in the warmer months, if you’re inside all day, it doesn’t matter how much sun there is outside, you’re not going to make enough because it’s actually…it relies on cutaneous exposure without sunblock, without clothes.

What do we have next? This is from Stephanie. I don’t know if Vitamin D3 is okay for a whole food, plant-based [diet] because I read Vitamin D2 is vegan rather than Vitamin D3? 

Okay, there are vegan sources of both. Vitamin D2 is sourced predominately from fungi, from mushrooms. And Vitamin D3, which is sourced predominately from sheep’s wool, but is also from lichen, which is kind of an algae-based multi-cellular organism, but not an animal. So yeah, you can get vegan Vitamin D3. All D2 is vegan, but D3 is probably preferable, just because the studies showing increased longevity with Vitamin D supplementation were all done on Vitamin D3. And so, since that’s what the studies were done on, we don’t know if that necessarily translates to D2; so, I would just use D3 if you have a choice. And if it’s important for you to be vegan, you can get a vegan D3. No problem.

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