Safest Source of B12

Safest Source of B12
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Since foods are effectively a package deal, what’s the best way to get vitamin B12 (cobalamin)?

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What’s the best way to get vitamin B12? Well, B12 is not made by plants; it’s not made by animals either. It’s made by certain bacteria, some of which line the guts of animals, of which people eat and drink. But that’s not the best source, because of the baggage that comes along with it.

Just like we can’t get the iron in beef without the saturated fat, the protein in pork without lard, the calcium in dairy without hormones; we can’t get the B12 in animals without also consuming stuff we don’t want—like cholesterol. For example, to get 47 micrograms of B12 from eggs, because the absorption is so low, we’d have to literally eat hundreds of scrambled eggs a day. 200 to 400 eggs a day! Do you know how much cholesterol that would be? If you got all your B12 from scrambled eggs, you’d consume 69,000 milligrams of cholesterol—practically your entire year’s worth every day.

So, yes, chickens harbor bacteria; the bacteria make B12; some of that B12 makes it into the chicken, and then into the egg—but so does the cholesterol. There has to be a better way!

Why don’t the bacteria in our colon make B12? They do, actually. It’s just too far downstream to be absorbed. In one of the less appetizing but more brilliant experiments in the field, a Dr. Callender delineated that human colon bacteria make large amounts of B12. Although the B12 is not absorbed through the colon, it is active. How do we know? She found some vegan volunteers with B12 deficiency, collected their stools for 24 hours, and then, you guessed it, bon appetit! And it worked! They were cured. Those are some hardcore vegans. There has to be a better way!

And thankfully, there is: fortified foods and supplements. Not only the safest, but also the most effective. In the U.S. Framingham Offspring Study, one in six meat-eaters between ages 26 to 83 were B12-deficient. The folks with the highest B12 levels weren’t the ones eating the most animal products, but the ones taking supplements, and eating the most fortified breakfast cereal.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is transcript contributed by Bruce A. Hamilton.

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What’s the best way to get vitamin B12? Well, B12 is not made by plants; it’s not made by animals either. It’s made by certain bacteria, some of which line the guts of animals, of which people eat and drink. But that’s not the best source, because of the baggage that comes along with it.

Just like we can’t get the iron in beef without the saturated fat, the protein in pork without lard, the calcium in dairy without hormones; we can’t get the B12 in animals without also consuming stuff we don’t want—like cholesterol. For example, to get 47 micrograms of B12 from eggs, because the absorption is so low, we’d have to literally eat hundreds of scrambled eggs a day. 200 to 400 eggs a day! Do you know how much cholesterol that would be? If you got all your B12 from scrambled eggs, you’d consume 69,000 milligrams of cholesterol—practically your entire year’s worth every day.

So, yes, chickens harbor bacteria; the bacteria make B12; some of that B12 makes it into the chicken, and then into the egg—but so does the cholesterol. There has to be a better way!

Why don’t the bacteria in our colon make B12? They do, actually. It’s just too far downstream to be absorbed. In one of the less appetizing but more brilliant experiments in the field, a Dr. Callender delineated that human colon bacteria make large amounts of B12. Although the B12 is not absorbed through the colon, it is active. How do we know? She found some vegan volunteers with B12 deficiency, collected their stools for 24 hours, and then, you guessed it, bon appetit! And it worked! They were cured. Those are some hardcore vegans. There has to be a better way!

And thankfully, there is: fortified foods and supplements. Not only the safest, but also the most effective. In the U.S. Framingham Offspring Study, one in six meat-eaters between ages 26 to 83 were B12-deficient. The folks with the highest B12 levels weren’t the ones eating the most animal products, but the ones taking supplements, and eating the most fortified breakfast cereal.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is transcript contributed by Bruce A. Hamilton.

Please consider volunteering to help out on the site.

Doctor's Note

I make a similar “baggage” argument about meat in my video Food Is a Package Deal, and about dairy in Plant vs. Cow Calcium. Next, I’m going to get into the nitty-gritty on how much one needs on a weekly basis, in Cheapest Source of Vitamin B12. And then I’ll cover daily dosing in Daily Source of Vitamin B12. Or, you can skip to Vitamin B12: How Much, How Often?

And for background, see my blog post: Vegan B12 Deficiency: Putting It into Perspective. For more on how many eggs would be required for other nutrients, see Egg Industry Blind Spot. And those with a thing for vegan bowel movement studies, see Bristol Stool ScaleBowels of the EarthFood Mass Transit; and Bowel Movement Frequency

For more context, check out my associated blog posts: How to Enhance Mineral AbsorptionPreventing and Treating Kidney Failure With DietStool Size and Breast Cancer Risk; and What Is the Healthiest Meat?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

199 responses to “Safest Source of B12

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  1. I make a similar “baggage” argument about meat in my video Food Is a Package Deal and about dairy in Plant vs. Cow Calcium. Tomorrow I’m going to get into the nitty-gritty on how much one needs on a weekly basis, and Wednesday’s video-of-the-day will cover daily dosing. Or you can skip to Vitamin B12: How Much, How Often? and for background, see my blog post Vegan B12 Deficiency: Putting It into Perspective. For more on how many eggs would be required for other nutrients, see Egg Industry Blind Spot. And those with a thing for vegan bowel movement studies, see Bristol Stool Scale, Bowels of the Earth, Food Mass Transit, and Bowel Movement Frequency. And there are videos on a thousand or so other topics so please feel free to dig in!

    1. Hi Doc,

      I’m sorry, but after watching this, it begs the question…

      where does fortified foods, or supplements get the B12 from??

      regards,

      1. Hunter – gatherer’s in Africa no problem with B12 which is from microorganisms in the soil Our food is too clean….eat roots and shoots no problem.

    2. Whatsup Doc? (sorry, the temptation was too big :)

      First of all I wanna tell you that I just started reading your book and already the first few pages are blowing my brains out, from fascination, sarcasticly dark humorous ambitions that could be found in a Monty Python movie – which are actually reality – to of course, the shown benefits and results. Bravo and thanks for that! And I don’t know if the answer to the question I’m about to ask will be answered in your book anyway, but still I feel like asking.

      So for my actual question/thought: About B12 – what about the B12 in Kombucha? What about B12 from nutritional yeast? What about B12 that some studies say is in Nori. And last but not least – ground water, spring water and living a “filthy” life – like picking your nose, eating fingernail residue after working in the garden, well and also eating the dirt in the garden. And eating with your hands, that you don’t sterilize like some mysophobic maniac.

      Thanks for your thoughts in advance, appreciate it!

      Namaste
      Sanjay

    1. No, it is water soluble so it easily exits our system. Similarly, vitamin c is water soluble. You can take way over the recommendations and be perfectly fine.

      1. What is the long-term data on this, and how are we to know that the immune system is not somehow being “freaked out” by this immediate intake of such large amounts of B12, even prior to ingestion? I’ve had horrible reactions to B12 supplements at times (have experiment with all the different forms, amounts, and methods of intake) and I know others who have had horrific experiences with B12 supplements as well. Some to the point of near heart-attack symptoms. I and others would like to make the B12 thing work great, but the reality is is that for some it makes things far worse. (A theory of mine is that some people with SIBO or borderline SIBO issues end up “feeding” their SIBO bacteria to be even “stronger”. But I do believe there are many other factors at play in causing some people to dread ever having to take B12 in supplement form, after experience the scary reactions.

        1. Are you sure you friends and yourself aren’t just finding yourselves caught in a web of hypochondria? If not, did you consider a smaller dosage? You do not have to eat a 2500 mcg supplement. You can take a daily supplement. Also, how often did you take it and what mcg level was it? These are all very important factors to your anecdote. I have actually heard of someone who broke out after beginning to supplement with B12. The breakouts stopped as soon as she quit taking them as frequently. One last thing, have you been checked for a potential allergy to anything in the supplements aside from the B12 itself?

          1. Seth, thank you for inquiring and your words. I’ve checked all bases, it seems. And bloodwork has
            been done as well. Frustrating. I treat this like science, to the best of my ability. I’m in no way the only
            one out there who can not tolerate B12 supplements in any way shape or form. It is what it is for now.
            But if you come across a legitimate source of completely natural vegan B12 (not man made/lab factory
            produced) , please let me know.

      2. Some people reported having got acne because they took too much (the amount of a month, every day! They didn’t read the package!)

        1. Acne is supposed to be because the body is finally able to rid itself of toxins (homocysteine and methylmalonic acid) once its B12 needs are met.

  2. I’m sure this question has been asked before, but it sounds like you can’t be healthy vegan without taking supplements. Is this really a healthy diet then? Shouldn’t we as humans be able to thrive on whole foods alone? I really enjoy your educational videos, Dr. Greger, but I struggle with the idea that we are designed to use supplements. I would love to hear your thoughts on this topic. Thanks!

    1. Vitamin B12 is a byproduct of bacteria, it was once found in our water supply, and on the plant foods we eat. Because we now chlorinate our water (to avoid getting sick from other bugs) and because we dont ground pick our vegetables from the wild without washing them, the only available source is now from animal products. This is of course an unnatural setting. Similarly, iodine is no longer found in plant foods. This is why the government iodized salt, to help Americans get adequate iodine intake. Similarly still, we do not expose ourselves to adequate sunlight, and the UV rays of today are much more potent then they once were in our evolutionary past so vitamin D must be supplemented for optimal health.

      Humans have changed their environment, so sometimes supplements are necessary to achieve optimal health.
      http://nutritionfacts.org/videos/vitamin-supplements-worth-taking/
      http://nutritionfacts.org/videos/vitamin-d-supplements-may-be-necessary/
      http://nutritionfacts.org/videos/avoiding-iodine-deficiency-2/

      1. Toxins: For some reason, I didn’t see your reply on screen and it didn’t come to my e-mail account until hours after I had written my reply. Your reply is so good, I would not have bothered if I had seen yours first.

          1. Regarding toxins, or is it Toxins, are you all aware that absolutely everything is a toxin if you have too much of it too fast? Google the term “water intoxication,” for example.

      2. Iodine is found naturally in foods that come from the sea – fish, shellfish, sea vegetables. Decades ago there was a very high incidence of goiter in populations that lived inland – in the midwest states like Ohio, Indiana Minnesota, etc where the farm belt exists. Goiter, it was eventually found, was due to a lack of iodine in the diet. This is why individuals living on the coasts of the country – those who ate seafoods – did not exhibit goiter. Midwesterners typically did not consume seafoods because of their far-from-the-sea locations. The reason that iodine was added to salt was so that those living inland would get it when they added salt to their foods. It was a simple, easy, and effective way to make sure that the population had sufficient iodine. Since iodine was added to salt the incidence of goiter has all but disappeared in this country. One can purchase salt that does not have iodine added if one chooses. A particularly high iodine content can be found in kelp, a sea vegetable.

    2. nsd: This is a good question and one that gets asked often. Dr. Greger may have an answer for you, but I wanted to share my thoughts too.

      I’m aware of two main supplements which Dr. Greger recommends, and they both make sense. Vitamin D is recommended for everyone, whether vegan or not, because we are no longer running around naked at the equator. It doesn’t really have that much to do with your diet.

      Vitamin B12 is needed because our modern society has artificially cleaned up bacteria in water and soil. The cleaning up of the bacteria is generally a good thing since we then avoid the bad bacteria. The problem is that with steralized water and soil, we then loose the good by-product of some bacteria, i.e.: B12. So, where do you get your B12? Well, you could get it from animal products, but that is frought with danger since whole foods are package deals. (See the multitue of videos on this site about the likely cancer and other disease promoting properties of animal products.) Or you can get your B12 from a safe and inexpensive supplement.

      Modern humans no longer live in our native habitat – the environment that we evolved in. Thus it makes perfect sense that finding the healthiest way to live would require adjustments.

      I strongly encourage you to check out the following links from this site. The video shows typical vitamin deficiences (that we know about) in average vegans vs omnivores. I think this is the perfect answer to your question. What is the easiest way to eat healthy? Whole plant foods – supplemented when needed to accommodate our unnatural modern life.
      http://nutritionfacts.org/videos/omnivore-vs-vegan-nutrient-deficiencies-2/
      also check out this blog post where I think that Dr. Greger has at least partially answered your question more directly:
      http://nutritionfacts.org/blog/2011/08/25/vegan-b12-deficiency-putting-it-into-perspective/

    3. I’ve never had B12 issues, even though I’ve always had a low dietary B12 intake, even when I was a lacto-ovo. I do eat fortified cereals every once in a while, though. About 95% of my food is organic and wild.

      Here’s my post about B12!
      http://www.facebook.com/photo.php?fbid=419853161377799&set=a.308248069204976.86189.100000593562775&type=3

      Many of us will never get B12 deficiency. Most of those that get B12 deficiency have absorption problems, which can be caused by many factors, including wrong diets, conditions like pernicious anemia, damaged gut, antibiotics and meds, etc.

      A human that lives a healthy lifestyle and eats a normal diet, does not get B12 deficincy. But most people live in an unnatural environment and eat wrong diets that are high in protein and fat, so it shouldn’t be surprising that they are at high risk of getting deficiencies.

      1. I’ve read from research gathered by Jeffrey Smith that Vitamin B-12 is now genetically engineered (recombinant DNA). And, I’ve noticed with most vitamins, that B-12, along with Vitamins C and E no longer work as supplements. So, I look for food sources, like sunflower seeds for vitamin E, a variety of raw fruits and veggies for vitamin C, and miso (not heated to high temperatures in cooking) for vitamin B-12.

        I do not want to eat GMO’s in fortified breakfast cereals, especially those where the owners of the companies have funded the Right to NOT know about GMO’s in Foods (and pharmaceuticals).

        1. You are already eating GMOs. Fortified foods have vitamins and minerals added. For example, common table salt is “iodized” to protect you from goiter. Some types of foods have folic acid added to them to help prevent spina bifida and related birth defects. Fortification just means a nutrition supplement has been added. We now have GMO potatoes that make a small amount of a precursor to Vitamin A inside the potato. This helps prevent blindness in many third-world countries.

          Nature is not inherently kind to us. That is why we have science. The ultimate purpose of science is to increase human longevity and comfort and give us enough control of our circumstances as to become like God.

    4. Yeah let’s ignore all the diseases that people suffer from as a direct result of consuming animal products (people who consume animal products take supplements, too by the way) and declare that eating according to the way our bodies were designed must not be healthy simply because we gotta take one tiny pill a day because WE ruined our environment that used to provide us with B-12 by natural means. Good one!

      1. You are surely educated enough to know that “natural” things are no safer than “synthetic” things. If all of the “natural” things are safe, then try a little “natural” poison ivy, or “natural” snake venom. If nature is so benign, try camping out. From the moment we are born, nature starts trying to kill us and recycle us. In the old days before modernity, nature was more successful at recycling us before our first birthday.

    5. Vegetarianism is an unnatural diet. When Benjamin Franklin went on one of his first Atlantic crossings, he had been experimenting with vegetarianism. One of the crew on his boat decided to cast a line and see if he could catch fish. The fishing was good, so the ship served fish that night Franklin had observed the cutting open of the fish and was shocked to see that their internals were filled with smaller fish. Franklin declared that, “if you can eat your smaller brothers, then I can eat you.” He gave up vegetarianism on the spot.

  3. A friend recently told me that the B12 I was taking as a supplement for vegan was a poor choice. I take tablet of cyanocobalamin with a meal and daily fortified soy milk and cereals. According to my friend, the superior way of getting B12 is with sublingual tablets. A quick research on the Net gave me 4 ways to get B12: injections, nasal spray, sublingual and swallowable tablets. All the sites claim to have the best product without citing any verifiable studies. AND they all happen to sell it… Is there a comparative study on the topic.

    1. Forget studies. The cyanocobalamin is the WORST B12 to take.. it is not “natural” and is actually antagonistic to good B12, hydro or methyl. I would bin it and do my research before I bought next time. The consensus of those not selling out (to cheap cyanocobalamin and high profits) is methyl is best. Sublingual seems nicer than hypo injections but if I was seriously deficient I would not mess about. Straight to the net to buy methlyl jabs in high doses.

  4. being a vegetarian, (still eat sardines, mackerel, anchovies) i have been concerned with getting enough B12 – eat Marmite every morning, which is supplemented with it 0.6 % RDA for 4 grams…which brands for B12 supp. are best ?

    1. Here are Dr. Greger’s recommendations for b12
      http://www.drgreger.org/latestrecommendations.pdf

      as well as the video series on b12
       http://nutritionfacts.org/video/vitamin-b12-recommendation-change/

      I would also strongly advise you to cut out all fish consumption because fish is the most polluted animal product one can consume. Although true that the fish you are eating are lower in contaminants then most others, you are sitll exposing your body to envoronmental toxins that will build up over time and can cause neurological and hormonal problems.

  5. The image of the cow with the bacteria graphic that comes flying out of the cow’s nether regions has me laughing every time.  Love it!

  6. Are there 2 types of B12? I have heard that the one type is not readily absorbed but the methylcobalamin is in a form that is readily absorbed. Is this true? Most of the the OTC suppliments contain the other form of the cobalamin. Is it worth taking these?

  7. Is the below comment true?

    “This argument is still hanging around, however, according to Dr Vetrano it was disproved by research over 20 years ago and is nothing more than an obsolete scientific theory.  Indeed, in a 1999 version of ‘Human Anatomy and Physiology’ by Marieb, it states quite clearly that we do indeed absorb vitamin B12 through our intestines.” (http://www.living-foods.com/articles/b12issue.html)

    1. Vetrano also claims that smallpox isn’t contagious. Stay away from the psudo- science quacks. B12 deficiency isn’t something to take a gamble on.

  8. Yes, i too would like to know what type of B12 supp. to take….i just bought a “cyanocobalamine” one…is this good?
    (i did just end up in the hospital for a huge acute allergic reaction to something i ate or did recently….!)

  9. Hi, Im surprised no one mentioned nutritional yeast here?  I LOVE that stuff I use it most days in soups, on pasta etc.  As far as I am aware it is the only naturally occurring b12 food source that is also bio-available ( I believe that Dulce also contains b12 but it isnt bio-available due to chelation?)  Please feel free to correct me if I am wrong. :)  Thanks again for a great channel!

      1. I think Dr.Greger recommends sublingual supplementation. Many have B12 malabsorption so cannot adequately absorb B12 from any food type, including non-vegan. Sublingual supplementation by-passes the digestive system, entering straight into the blood stream. Remember also that all B12 tests are unreliable post-B12 supplementation / fortified foods, resulting in a falsely high level (showing any left over in the blood which hasn’t been taken up by the cells).

    1. I hope you realize that most, if not all, the people sited in that article are not credible sources in either the medical or scientific community. While they may be popular in raw food circles, they practice psufo-science and their ideas border on dangerous. If you want to develop b12 deficiency because you listened to Doug Graham, go ahead.

      1. Doug Graham has a Ph.D, and is well respected. It’s not pseudo-science. Helps if you know how to spell pseudo. I have read what many people have said about B12, from Dr. McDougall to pretty much every vegan nutritionist and doctor that is well known. And a lot have said that it depends on the person. And most people only get B12 problems in there 50s. When the body starts to break down. So I asked for evidence to show why B12 is not absorbed by the intestines. As for some people it is. Some it isn’t. It depends on the person as far as I am aware. If people take B12 all the time we wont evolve to make our own B12. So do what you think.

          1. Sorry I made a mistake, actually I was miss lead Doug has something similar to a Ph.D, but doesn’t actually have a relevant qualification to nutrition, but that doesn’t however disregard what he says. However lately I don’t agree with him on some topics, but some of what he says does make sense and is correct. He does have a lot of experience training athletes, so it’s not fair to disregard what he says just because he doesn’t have a Ph.D when he has a lot of experience. But Mistakes happen. I am human I make mistakes occasionally. This was 3 years ago. Please check the date.

            However what I said isn’t far from the truth, the body can adapt and some people have adapted to make their own B12 with out the need of supplements but that is rare. It is safer to take B12, but makes more sense to track b12 levels and make sure the levels of B12 don’t get too low. If they’re too low than it would be safer to take a B12 supplement. But it really depends on your body don’t assume that people are like you in studies, it’s best to work out how your body works. And it is possible to get the body to make more B12 than usually but it means eating higher amounts of nutritious food, and creating more bacteria.

            I could go on, but the above message was meant to be about keeping an open mind.

            1. Some thoughts:

              – The consistency of these studies should be taken to heart: http://www.veganhealth.org/b12/adults In study after study, vegans’ average b12 levels are lower than that of non-vegans, it gets lower over time, but normalizes with supplementation.

              – It’s true that there’s variation, and you may be on the high end of the bell curve. But why take a chance. At least get MMA and homocysteine levels checked, as measure of whether your body has enough usable b12.

              – Once you’re low in b12, you may already be putting yourself at risk. Prevention through a supplement is safe, easy, and fairly cheap.

            2. The body has only a limited capacity to adapt. If you stress one of us enough by taking away enough of a vital nutrient, we will die. Our offspring might have hope of being more functional in such a stressed environment. Everything seems to have an acceptable level of concentration, but too much will become deadly. Too much of ordinary carbon-based food will kill any of us with gross morbid obesity, what I call simply “carbon poisoning.” It seems realistic that, if you drank a half-gallon of olive oil every morning, you would eventually exceed some sort of threshold and die from it. It would be likewise for anything else considered to be a “health food.” Too much of a good thing is not, as Mae West said, “wonderful.” Too much of a good thing is a bad thing. Be moderate in all things. You should even be moderate about moderation. Maybe Barry Goldwater was right. “Moderation in the pursuit of liberty is no virtue.”

        1. Well, I also have a PhD. Having one doesn’t mean you know everything. It helps to have some data, if not a little humility, too.

      2. That wasn’t even Doug Graham’s article. In his video, Doug Graham did say to try a trial and error with supplements if with symptoms. Thank you to Stephen Lucker Kelly for this comment, “But Mistakes happen. I am human I make mistakes occasionally”. As far as I know, B12 deficiency wasn’t widely publicised (including by The Vegan Society?) until recent years.

    1. Nutritional yeast used to have low levels of Vitamin B-12, but has it been genetically modified (with recombinant DNA) like other sources?

    1. I never see any mention of sauerkraut in B12 discussions. But sauerkraut is full if bacteria that are known to produce B12. So surely it is an excellent source. And could potentially remove the need for supplements.

  10. Even Dr. Greger admits cyanocobalmin is not THE safest form of b12 for EVERYONE, and that’s the kind included in fortified foods and the cheaper supplements. The safest would be methylcobalamin, adenosylcobalamin & hydroxycobalamin, the first 2 of which are already in the bio-active form. It seems wise to ingest a sublingual version of one of those 3, in case there are any intestinal absorption issues. Can nutritionfacts verify this?

      1. Everywhere I look online it says that Methylcobalamin is the best b12 source because that is the form that the body absorbs whereas Cyanocobalamin needs to be converted to first hydroxocobalamin and then finally methylcobalamin, but then your recommendations are Cyanocobalamin. I’m a little confused. Could you help me clarify the difference and tell me which I should take? Thank you very much for your extensive work, I always find great help here.

  11. The human brain continues to shrink as it gets older. Vegans tend to have the fastest rates of brain shrinkage because they tend to be deficient in vitamin B12. Even people who eat plenty of meat every day have moderately fast rates of brain shrinkage, although not nearly as fast as vegans. People who swallow 1,000 mcg of vitamin B12 daily from pills have the slowest rates of brain shrinkage:
    http://www.webmd.com/healthy-aging/news/20110926/low-vitamin-b12-may-speed-brain-shrinkage http://www.ox.ac.uk/media/news_stories/2010/100909.html
    http://www.ncbi.nlm.nih.gov/pubmed/18779510
    http://www.ncbi.nlm.nih.gov/pubmed/19116332
    http://www.ncbi.nlm.nih.gov/pubmed/17991650
    http://www.ncbi.nlm.nih.gov/pubmed/21947532
    http://www.ncbi.nlm.nih.gov/pubmed/20648045
    http://www.ncbi.nlm.nih.gov/pubmed/17972439
    http://www.ncbi.nlm.nih.gov/pubmed/20187536
    http://www.ncbi.nlm.nih.gov/pubmed/19817650
    http://www.ncbi.nlm.nih.gov/pubmed/16177198
    http://www.ncbi.nlm.nih.gov/pubmed/12936959
    http://www.ncbi.nlm.nih.gov/pubmed/9637947
    http://www.youtube.com/watch?v=sSFQy_cLvLU
    http://brainposts.blogspot.com/2010/09/vitamin-b-and-brain-atrophy-in.html
    CONCLUSION: Even people who eat lots of meat every day should swallow 1,000 mcg of vitamin B12 daily from pills. At present, there is no evidence that swallowing more than 1,000 mcg of vitamin B12 daily will slow the rate of brain shrinkage any better than swallowing exactly 1,000 mcg of vitamin B12 daily, which is a very safe dosage.

    1. I could not find the full text of th article referenced, but the study referencing it does say this “In one of the less appetizing but more brilliant experiments in the field of vitamin b12 metabolism in the 50’s, Sheila Callender (7) in England delineated that human colon bacteria makes large amounts of vitamin B-12. Although the bacterial vitamin B-12 is not absorbed through the colon, it is active for humans. Callendar studied vegan volunteers who had B-12 deficiency disease characterized by classes megaloblastic anemia. She collected 24-h stools, made water extracts of them, and fed the extracts to the patients, thereby curing their vitamin B-12 deficiency.”

      http://ajcn.nutrition.org/content/48/3/852.full.pdf

  12. Hi there, in you video you are speaking about getting 47micrograms a day of B12 through eggs, yet, the recommended minimum intake is about 3 micrograms, and an optimal intake would be around 5-15 micrograms.

    Then you speak about the cholesterol of eggs, but you deny the same argument you make for B12 to the cholesterol, namely that the absorbtion rate of the egg’s cholesterol’s very low, at the very least, highly individual.

    1. Please continue watching the b12 series, Dr. Greger explains all of the b12 issues throughout them. Also, I know of no evidence showing that we do not absorb the cholesterol in eggs. Can you share some evidence?

    1. Because animals eat dirty food with poop on it. The B12 is in the poop and the dirt. They absorb it and it gets into them. Just like if you ate the flesh of a human, there would be B12 in their muscles, which they absorbed from whatever source they got it from (fortified breakfast cereals, flesh of other animals, supplements, whatever).

  13. Dr. Greger – Many thanks for your website and all the effort behind it. It is truly appreciated. I have three young children (ages 6, 4 and 2) and have moved my family to a primarily plant based diet over the last two years. While I fully believe it is a superior diet to the traditional American diet, I am often concerned my children (and husband and I) may be missing critical vitamins and/or nutrients. I only recently learned of your website and have been pouring through information. Does your current position on B12 align with the posts I’ve found from 2-4 years ago? In short, I believe your recommendation is to supplement with B12 or eat B12 fortified cereals, etc.

    I have no medical, nutrition or dietary related background nor formal training in the area and merely utilize the internet for information, which can be incredibly contradictory. My primary goal is to ensure I am providing my family the optimal diet for optimal health. After reading a few of the B12 posts, I’m terrified I may be doing my family harm by currently not supplementing.

    Thanks in advance for your reply.

  14. Dear Mister Greger, I’m really concerned about my health. Despite I use your daily dozen my health is not what I expected. I think I have a vitamin B12 resorption problem and now I try to take it sublingual. But, I saw i n a other video of you that artificial vitamins, like vitamin c, help nothing. (compared to the vitamin c in a apple for example). So the issue that toiling me is, is any vitamin B12 what is not from a bacteria, helpful for me?
    What kind of difference consist between artificial vitamin c and artificial vitamin B 12?

  15. Michael Greger M.D. I’d like your thoughts regarding the following issues, especially the first one:

    – B12 supplementation would play a role in advanced cancer development(1)(2)
    – B12 would be involved in acne(3)

    Also, you said that B12 is produced in our colon, that this form of B12 is assimilable by our organism but can not be because it’s in our colon. How is that possible there would be this bacteria only in our colon and not in our stomach or our small(?) intestine which would make it assimilable by our body.

    [1]: http://www.jpsmjournal.com/article/S0885-3924(00)00169-X/fulltext “Elevated Serum Vitamin B12 Levels Associated With CRP as a Predictive Factor of Mortality in Palliative”
    [2]: http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(197709)40:3%3C1348::AID-CNCR2820400352%3E3.0.CO;2-Q/abstract “Serum vitamin B12 and transcobalamin abnormalities in patients with cancer”
    [3]: http://stm.sciencemag.org/content/7/293/293ra103 “Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis”

  16. Hello Doctor Greger, I know you recommend vegetarians/vegans to take some B12 supplements. I’m wondering what you think about the studies which showed an increased cancer risks linked to taking B12 supplements. Do you still think it’s better to take supplements than being B12 insufficient? Thanks!

  17. “There is a better way” to get B12 from a whole food plant source – Jackfruit seeds!
    http://edayan.net/profiles/blogs/health-benefits-of-jack-fruit-seeds
    “According to Purdue University, the fresh seeds are considered to be a high starch, low calcium and iron food but a good source of both vitamin B1 and vitamin B12.”
    Please investigate and let us know – Jackfruit itself is fast becoming a popular western culture vegan meat substitute. I developed many recipes and from boiled delicious jackfruit seeds which taste like sweet chestnuts and mix them into salads or make a hummus with it. Its quite popular in India where jackfruits come from. I don’t have B12 deficiency as far as I know being vegan for 19 years, eating jackfruit seeds for 5. Never had B12 supplements. Love to hear from any experts out there, including Dr. Greger

  18. *New question:
    According to recent studies, too much B12 causes acne. Having experienced the deficiency and supplementing with various B12, I’ve found it to be true. Never had a spot in my life until now, I can’t help but wonder. Is there a connection?
    The B12 in question here is the Cyanocobalamin VITAMIN B12 (cobalamin, C63H88N14O14P)Cyanocobalamin ~ Alias: Cyano-5,6-dimethylbenzimidazole-cobalamin ; Vitamin B12 Product name: Vitamin B12 feed cyanocobalamin.
    Methylcobalamin is my preferred B12.

    1. I found that rumen physiology gives a few hints — a kneeding process, free of oxygen, with acidity kept sufficiently low with bicarbonate. And Cobalt occurs more in green leafies than in anything else. Sounds like something we could mimic in a fermentation process hosting B12 producing bacteria… spinach beer, anyone? :-D

  19. I am wondering if it makes a difference to take vitamin B12 without food. It says on the label to take it with a meal. Does it make a difference? Thank you.

  20. would it not be acceptable to have small amounts of lean beef for B12, as long as we are mostly plant based diet? is the harm mostly in the excessive meat eating.

  21. What about children? My daughter is 2,5 years old. Is it safe to take a supplement of B12? Please share with me a text which verifies your aspect (for typical reasons). Thank you in advance! :)

  22. I’ve been “seasoning” my veggies with a yeast product high in the B-vitamins. It’s the only one that keeps me from falling asleep after a meal. Monsanto has genetically engineered most yeasts on which cobalamin is grown, from what I’ve read. At any rate, it does not work for me.

    I tried upping the amount of B-12 in a natural and once organic source of B12, but was told by the staff of another online physician that there was also phosphorous in the mix and that I should not increase the phosphorous. Why? If it is natural and organically grown, what’s the harm. Also, which other source would you –anyone recommend?

  23. I have a question for any of the moderators or Dr. Greger about seaweed and B12. My research indicates that many seaweeds contain B12 analogues which inihibit the absorption of the real vitamin B12. However, Dr. Greger has made numerous recommendations to develop a taste for seaweed as it is a great source of iodine, an essential chemical all vegans need to be aware of. So my question is how much does seaweed interfere with the absorption of the real B12? Should we be seeking an alternative source of iodine?

    Another question I have is what does the team think of the chemicals used to create the pills which contain the B12? There are quite a few if you just take a look at any bottle. (Magnesium Stearate, Mannitol, Crospovidone, etc, etc) Although one might only take 1 small pill every week, it’s still something to consider. I haven’t found a single pill that didn’t contain at least 3 other ingredients.

    Thanks!

    1. Hi, Jamie. I am Christine, a NF volunteer moderator. I am not sure what the sources are for the research you have done. There is a lot of misinformation out there about vitamin B12. You might be interested in this research article.
      http://www.mdpi.com/2072-6643/6/5/1861 I don’t think that inhibition of vitamin B12 absorption by seaweed consumption is a serious concern. In fact, nori may be a good source of vitamin B12, as the linked article suggests.
      To answer your second question, you probably won’t find a B12 supplement without other ingredients, because something has to be used to form it into a pill that will then dissolve after you take it. Magnesium stearate is not harmful, and is, in fact, a form of an essential mineral. Mannitol, is also not harmful, and may be helpful for some conditions. Crospovidone makes the pills dissolve, and is considered an intert ingredient. It appears that, unless you inhale it, or crush tablets for intravenous injection, these ingredients are not known to have toxicity as they are commonly used. I hope that helps!

  24. If only about 1.5 mcg is absorbed at a time through IF pathway; why do people always stress the B12 content of some animal products being higher than others? Why should it matter at that point as long as it has at least 1.5 mcg since that’s all that will be absorbed anyways, correct?

    1. Hi, thanks for your question!
      So according to the National Institute of Health Fact sheet on B12, 56% of 1 mcg dose of B12 can be absorbed. Over this amount, the % of absorption drops as you said because of the amount of intrinsic factor available. However the total RDA for B12 is 1.8 mcg for adults. Therefore, as you mentioned, the total amount in one food / meal may be less important than the total amount consumed in the whole day.

  25. I am a fan and supporter of both Dr. Greger and Dr. McDougall.

    Dr. McDougall’s recent newsletter https://www.drmcdougall.com/misc/2017nl/apr/170400.htm
    recommends three other formulations of B-12, including methylcobalimine, over the cyanocobalamine that Dr. Greger consistently and repeated recommends. Both seem have studies supporting their positions.

    Dr. Greger, please address Dr. McDougall’s article, and give specific reasons for backing the cyanocobalimine.

  26. Hi,

    I have been vegan for over a year and for a few months I have been experiencing what looks like symptoms of B12 deficiency: tiredness, muscle pain, dizziness, general weakness feeling, difficulties to breathe after climbing stairs etc. I am unable to exercise more than twice a week while I used to exercise pretty much every day… I got blood tests done and they did detect larger than normal red cells, but my GP told me it looked ok. Still I have started taking B12 supplements, in the form of chewable tablets (1000mcg daily, Solgar ones).
    My question is how long will it take for the supplements to “refill” my B12 levels and for me to feel normal again? Please give me an indication as my GP is not well informed on this subject and my condition is getting gradually worse, no I am starting to worry.

    Many thanks
    Louna

    1. Louna,

      May I suggest that you have your physician run the appropriate test, which is the methylmalonic acid testing, not the serum B12 test which is not reflective of tissue stores of the vitamin ? You might also look for additional issues which are common with macrocytosis, the large red blood cells.

      There should be a much more comprehensive work up to determine the cause. The above quoted article should be a starting point. As a note DON’T get alarmed by the many potentials that seem life threatening….. what I have found commonly is the need for both folate (active forms) and B-12 along with digestive changes which could include enzymes which gets most folks back on track to normal RBC size.

      The intramuscular or subcutaneous injection of b-12 (one of the 3 forms) can make major differences and should be done much more than once per week, to see a difference. The old info and claims for adequate b-12 levels from a once per week shots have been seen to be less than adequate. Dr. Gaby’s observation and some subsequent publications have verified this info.

      You can also do some testing that reflects the nutrient’s effect on your cells, not just a level in your body by using Spectracell labs evaluation.

      Trust this helps put you on the path towards better health,

      Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

      1. Thank you for your help.

        The supplement started having effect around a week ago and I feel much better since then! It has given me a bit of acne but I much prefer this than feeling weak..! I had asked my doctor to do the MMA test, but he said they cannot do it (I am in the UK).

        Thanks
        Louna

  27. Hi Louna,

    I am a volunteer for Dr. Greger. I am sorry about your current situation.

    However, it may not be a vitamin B12 deficiency. Your vitamin B12 stores are typically enough to last for several years. Your physician should be able to do a B12 test to determine if your levels are sufficient or not. You should also be notifying your physician of the symptoms you have been experiencing.

    If it actually is a B12 deficiency, taking 1,000 mcg daily should start to clear symptoms up after a week or 2, assuming your absorption is sufficient. If absorption of vitamin B12 is not very good, an intramuscular injection can be useful.

    Wish you all the best!

    1. All tests are potentially unreliable. See this info shared at B12deficiency.info
      UK NEQAS for Haematinic Assays
      False normal B12 results and the risk of neurological damage, B12 Alert
      http://archive.is/hbPHE
      “In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord. We recommend storing serum for further analysis including MMA, or holotranscobalamin and intrinsic factor antibody analysis, and treating the patient immediately with parenteral B12 treatment.”
      The British National Formulary states that where there are neurological symptoms, B12 injections should be given every other day until no further symptoms, then weekly, then every two months for life.
      Doctors avoid following the guidelines though, especially when B12 is in range, even when only just, despite the vast range and info above, plus info that the patient should be treated with B12 according to symptoms, not result.

  28. How do animals make b12? Are they able to synthesize b12 in their gut because they ate something from a b12-rich soil or do they create it themselves? Where does that bacteria come from that helps make b12 in their gut?

  29. So in doing some reading research on B12 I found statements on the Mayo Clinic website that say:
    “Vitamin B12 may interact with agents for bone loss, cancer, gout (colchicine), high blood pressure (angiotensin-converting enzyme inhibitors), and for stomach and intestine disorders (H2 blockers, proton pump inhibitors), agents that affect blood products, agents that affect the nervous system, alcohol, Alzheimer’s agents, antibiotics (neomycin), anti-seizure agents, aspirin, bile acid sequestrants, birth control pills, cardiovascular agents, chloramphenicol, metformin, nicotine, nitrous oxide, para-aminosalicylic acid, stimulants, and zidovudine.”

    Another statement that is concerning to me is this:For vitamin B12 deficiency caused by long-term PPI therapy
    I don’t know that I’ve ever been tested for B12 deficiency.

    I have been eating WFPB for 13 weeks now! YAY Have lost 23 pounds! Again YAY!
    Dr says I need to wait 3 more months to have more blood work since I had it 2 weeks before I started this way of eating.
    I take Nexium (PPI) for Hiatal Hernia and Losartan 50mg for BP and a statin for high cholestorol (which I have cut in half)
    So, my question for you is this. I have been taking a B 12 supplement of 1000 mcg every morning. Should I cut back on the B12 or
    wait until I have more blood work done? I know the facts say you can’t overdose on B12 but Mayo seems to say there can be problems
    if combined with these other meds causing changes in potassium and red blood cells. I would hate to find out that my
    healthy eating is causing other problems. I won’t see the Dr until the 6 months are up so……..

  30. Another outstanding piece on Alzheimers and B vitamin supplementation. Following the recent release of studies showing the incidence of lung cancer in people taking B supplements, would love to hear your thoughts on the safety of B supplements for Vegans. Thank you!

  31. I can’t answer as to if Dr. G will be making a video on this or not, but here’s a few things to consider. In the referenced study, it was only men taking more than an average of 55 ug/day that saw the increase in cancer risk and did not occur in those taking a multivitamin or other sources which typically have much less B12. These differences are somewhat suspicious, making me think that we’re dealing with some lurking variable or statistical anomaly, but lets set that aside for now since its an unknown. Your B12 requirement as far as we know is about 2.4 ug per day if you’re the average adult, and you can only absorb about 10 ug provided your gastric mucosa is healthy with functional intrinsic factor. So if you take 10 ug/day, you’re going to be well under the 55 ug mean “risky” intake. You can get this by purchasing liquid B12 supplement and diluting it. As an example, I’ve seen the liquid sold as 30 drops = 1000 ug. So just take 1 drop and dilute it in a big glass pitcher to whatever dose you like down around 10 ug/day. That should solve the problem until the next study comes out…and if you’re concerned about your B12 level, then get it tested….feeling “off” can be due to millions of different issues. Simply taking B12 and feeling better could also just be the placebo effect. Be objective and evidence-based: get tested.

    Dr. Ben

    1. All B12 tests are unreliable, especially if supplementing for four months beforehand.
      http://archive.is/hbPHE
      UK NEQAS for Haematinic Assays
      18 February 2014
      B12 ALERT

      False normal B12 results and the risk of neurological damage (Please click for details)
      “In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord. We recommend storing serum for further analysis including MMA, or holotranscobalamin and intrinsic factor antibody analysis, and treating the patient immediately with parenteral B12 treatment.”

  32. Dear dr. Greger,
    would you mind to suggest me which brands of vit B12 do you prefer between these two (the only two available here in Italy at a decent price in the form of cyanocobalamin and containing at least 1000 mcg per each pill) ? For example (click on the images to see the labels in English), in the first case that costs only slightly less, is it a problem that has dextrose or cellulose ?

    https://http://www.amazon.it/gp/product/B071Z2VVW1/ref=ox_sc_sfl_title_1?ie=UTF8&psc=1&smid=A2NG8XQ47A7MHH
    http://http://www.amazon.it/gp/product/B01C131TCQ/ref=ox_sc_act_title_1?smid=A36G11MJ4NGU0S&psc=1

    And is it a problem to get 2 pills and half all at once to get that 2500 mcg of vit b12 per week ?

    Thanks in advance !

  33. a.prestifilippo,

    The small amount of dextrose and/or cellulose is not an issue. They are simply some of the less expensive ways to make a pill and if that’s the limits to your access….so be it.

    I would highly suggest that you consider the methyl form assuming it’s available, as opposed to the cyano based B12, as the over time there is no issue with cobalt levels. As a water soluble vitamin the dose and toxicity is very low. You can lab check your methylation pathways along with methyl malonic acid to determine the optimal dose, if your concerned with getting a certain dosage and response.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

    1. Thanks SO MUCH for your quick response!

      But I’m confused about your advice on methylcobalamin, I’ ve understood that dr. Greger’s thought was that the best form (most researched, most stable, most economic, safest, etc…) of B12 is the cyanocobalamin one…
      https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/ https://nutritionfacts.org/questions/which-type-of-b12-is-best/ There is even an audio excerpt here (at about min 2:30) may you comment it ?

      1. If it’ s so, I still don’t understand why dr. Kadish (unlike dr. Greger) recommends methyl rather cyano-cobalamin form…

        1. Aprestifilippo,

          I recommend the methyl form as we are using B12 for the long haul and often times in the injectable format. With the oral form the cyano many be a better cost and absorption media, so not to be discarded just keep in mind the route. I’ll be more specific with my answers, thanks for the question.

          To further the thought process, why not use the preferential format since the body normally will methylate the cyano for to make it active, a step now known to be problematic for may patients, especially my cohort of ASD kids and adults. Yes a higher dose, due to the absorption difference is in order….. my take on the options.

          Dr. Alan Kadish moderator for Dr. Greger http://www.CenterofHealth.com

          1. Thanks SO MUCH dr. Kadish, I already bought the cyano form of B12 supplement, but pretty interested to know all the details about the issue…thank you again

  34. Dr. Michael Klaper says that some sea vegetables such as Dulse Seaweed have B12 analogues (pseudovitamin B12) that block the action of active B12. Therefore should not be consumed on or close to the day that you’re taking your B12 supplements.

    He says that Pseudovitamin B12 occupies the receptor sites on your nerve cells so real B12 can’t get in. I’m just wondering what Dr. Greger’s and his team’s take on this is as I have not heard him mention this before.

    Dr. Klaper mentions this in YouTube video https://youtu.be/IvlaQJImt9w?t=43m3s

    1. Hi Owaysis, thanks for your comment. I think Dr Kepler indicates a good issue that he mentions if you consume the sea vegetables then space it out and not take the B12 vitamin at the same time. That is a good point and I think the studies he points out are published in Scientific journals.Dr Greger also points out fortified foods and supplements not only the safest, but also the most effective way to go about it.
      Safest Source of B12

      1. Hi spring03, thank you for your quick reply. I’m taking two 500 mcg supplements of B12 (Cyanocobalamin) a day for two days. Then leaving three days inbetween taking the B12 and 1 tsp of Dulse Flake Seaweed a day for three days. Does this sound an okay way to separate my iodine source from my B12 supplement?

        Also do you know if would be okay to take 5 x 500 mcg B12 supplement tablets in one dose, once a week. The bottle states one or two 500 mcg tables once daily.

        Thanks.

    2. Just curious, is it the same for other kind of algae (that I eat) like chlorella, wakame or kombu – regarding the pseudo vitamin B12 ? If it’s so, I’ll consider too to space their assumptions out…

      1. Hi a.prestifilippo. Yes most sea vegetables like Wakame have this pseudo B12. I’m eating Dulse. Everything you need to know on this pseudo B12 is in the YouTube video link below at 43 minutes. I’d watch the full video too as it’s extremely informative. A must watch video. The link bellow will start 43 minutes in. All the Iodine information starts at 26 minutes.

        Dr. Michael Klaper – https://youtu.be/IvlaQJImt9w?t=43m3s

        1. Thanks so much, yes, I already watch dr. Klaper’s video througly, really, really interesting – by the way, he almost trashed me when I decided to follow his advice to do a 3 days watter fasting (I’m at the third day of those 3 days…) !

            1. Obviously I was joking… it’s simply that 3 days of fasting are not that easy, particurally if you do them for the first time

      2. Hi, a.prestifilippo@gmail.com. You might be interested in this, and this. According to the research I have found, wakame has more B12 analogues, while nori has more B12 and, interestingly, less iodine. This abstract states that chlorella includes methylcobalamin among its constituents. I will access the full-text next time I am at the National Library of Medicine, so that I may learn more. Meanwhile, I hope that helps!

        1. Thank you, any thoughts about algae kelp/kombu ?
          I know that dr. Greger didn’t incourage people to get it because it contains too much iodine, but I get one with 1000 mcg of I per gram and carefully measure it (less than one gram per meal, a few times per week), it should be ideal to be spaced out to get those 2500 mcg once a week of vitamin B12 that dr. Greger suggests

  35. Hi spring03, thank you for your quick reply. I’m taking two 500 mcg supplements of B12 (Cyanocobalamin) a day for two days. Then leaving three days inbetween taking the B12 and 1 tsp of Dulse Flake Seaweed a day for three days. Does this sound an okay way to separate my iodine source from my B12 supplement?

    Also do you know if would be okay to take 5 x 500 mcg B12 supplement tablets in one dose, once a week. The bottle states one or two 500 mcg tables once daily.

    Thanks.

      1. Hi Shireen. I never saw a clear response to that article recently published, I believe in The Atlantic, about that study linking some cancers to cancer. The article/study was in part specifically to do with men with lung cancer. But, I don’t think the study was exclusive to this group. And it also spoke of doses that, while possibly high, were also the common amounts taken by those who supplement. Please help. Thanks

  36. Hi, I am currently taking a supplement called “Complement” made by Lightdrop that has 1000mcg of Vitamin B12 (as Methylcobalamin) in it. Is this safe? It somewhat concerns me that it’s 41,667% DV. I have also been giving my daughter (2 years old) a half dose. It’s recommended to take daily. It also has 50 mcg (2000IU) of Vitamin D3 (250%DV) (as Cholecalciferol) in it as well as 275 mg of SHA and 140 mg of EPA. We try to eat plant based but aren’t 100% yet. Appreciate the advice!!

  37. Hello Doctor G
    After reading “The China Study”, “The starch solution”, “How not to die’, etc I made the choice to have a mostly whole food plant based diet. about 2 years into it I started feeling chronically fatigued. I started taking a b12 supplement and it seems to have cured that problem. However. I recently saw this article that concerns me. Have toy review this research? should I be concerned about supplement? Are there more natural ways to get b12 than supplement? I know that unfiltered kombucha tea has b vitamins. I have heard that unfiltered home brewed beer or wine also has b vitamins. is this true, should I get my b vitamins from beer?

  38. In the interests of ensuring I’m making the right dietary choices as much as possible I have been making an effort to examine both sides of the arguments for and against veganism.

    Obviously my scientific understanding is limited, but I have read a number of articles which seem to suggest that the B12 available through supplements is not processed / absorbed in the same way as from animal sources, and may even inhibit absorption of “real” B12.

    One example I found here (https://ancestral-nutrition.com/dont-recommend-vegan-diet/):

    “Contrary to popular belief, there are no plant based forms of B12. No, not even nutritional yeast. This myth is especially pervasive because plant foods and supplements that are said to contain B12 actually contain B12 analogs called cobamides. These cobamides block the absorption of true B12 and increase the necessary intake of true B12 (source).”

    It would really put my mind at ease to hear an experts response on this.

    Thank you,

    Jacob

    1. Yes but what about unfiltered alcohol beverages. I have read the National fermentation produces B vitamins in things like kombucha Tea and even home brewed beer or wine assuming it is unfiltered and unsulfated.

  39. Someone please address the comment posted 1 May 17 by a user:

    “I am a fan and supporter of both Dr. Greger and Dr. McDougall.

    Dr. McDougall’s recent newsletter https://www.drmcdougall.com/misc/2017nl/apr/170400.htm
    recommends three other formulations of B-12, including methylcobalimine, over the cyanocobalamine that Dr. Greger consistently and repeated recommends. Both seem have studies supporting their positions.

    Dr. Greger, please address Dr. McDougall’s article, and give specific reasons for backing the cyanocobalimine.”

    It is difficult when you have two reputable doctors in the field disagreeing on this topic.

    1. Thanks for bringing that up again Dan. It’s a great a question. As far as I can tell, it’s not that Dr. G is recommending against the other forms of B12, it’s that he’s not as concerned about the possible ill effects that Dr.M is worried about. Although I truly respect Dr. M’s opinion and listen very carefully to everything he says, I tend to agree with Dr. G since I have not seen any evidence that the minuscule quantity of cyanide can accumulate and cause harm. That said, I take a mixture of the cobalamins myself, and I don’t think Dr. G would recommend against Dr. M’s recommendations, so there really is no conflict here.

      Dr. Ben

    2. Hi thanks for your great question. Dr. McDougall was a mentor and great inspiration to Dr. Greger. So they have far more in common than in conflict. Dr. McDougall has a great talk on youtube about diet wars and how the experts promoting a plant based diet with minor differences like, Dr. Esselstyn, his son Rip Esselstyn, Dr. Campbell, Dr. Popper, need to focus on their common ground and take a stand against very different and very dangerous diets, like the Atkins diet.
      https://www.youtube.com/watch?v=srkd-irmrC0
      I don’t think Dr. Greger would discourage you from following Dr. McDougall’s plan and Dr. McDougall would not discourage your from following Dr. Greger’s plan.

      So as far as Vitamin B, I am by no means qualified to critique either of these 2 brilliant Drs, but even Dr. McDougall’s newsletter says of the different forms, “all of which have been shown in clinical studies to improve the vitamin B12 status of an individuals”. I think the differences are minor. Dr. Greger also says if you prefer, you can use supplemented foods and not even take a Vitamin B12 supplement. I think if you are taking a supplement, regardless of which one, and your level is normal, there is no need to worry too much about it.

      NurseKelly
      Health Support Volunteer

  40. Could anyone recommend some supplements ( brand name or reputable source) that actually contain the amount of active ingredient it states on the label? I am very aware that many products do not contain the ingredients or dose they claim to. I am looking for Vitamin B12, D2, D3, and algae derived omega 3 long chain fatty acids. Is there any way I can check the supplements are legitimate? Thanks.

    1. Michelle, I trust Garden of Life. I currently use their My Kind B12 spray but I hope and wish they’d make a tablet. They seem to be a really reliable company from my understanding. Good question though! I’d be interested in learning about other good brands. I’m not sure if Blue Bonnet has a B12 supplement but I also trust their brand.

      1. Hello it was just brought to my attention that by vitamin B12 as a supplement can increase a man’s risk of lung cancer, found this article in the PubMed Library please have Dr. Gregger look this up he may have to remove the recommendation on his daily dozen app. I can send the article to you if you need me to. It happens over a 10-year period of time.

        Sent via the Samsung Galaxy Note8, an AT&T 4G LTE smartphone

        1. Steveo, we need B12 to survive and we basically only get it through supplementation. Even those eating animal products are getting it through supplementation because the only reason the animals people are eating have any, is because they’re being supplemented themselves. Do you have a link to the study? It’s important to link referenced studies if you want a legitimate response. There are lots of studies out there, not all are good or even relevant depending on how they were conducted. But I would imagine that if this were true (hypothetically… I don’t believe it is) that the benefits of a WFPB diet would counteract any risk whereas a WFPB diet without supplementation of B12 would at it’s very best, be inadequate but because B12 is so important, it could be very dangerous. That isn’t to say animal products are the answer, again, if you’re eating animal products, you’re consuming B12 supplements through them. We could eat dirt, but thanks to industrialization that isn’t really safe.

    1. I’m sure if there were a real concern, Dr. Greger would have addressed it by now. I’ve never heard of this anywhere else. But in any case, without B12 supplementation, we’d die or die a lot sooner than later anyway, so I’d say the benefits would out weight any potential risks by far. One might argue “well you don’t have to supplement if you eat animal products,” but that’s simply not true. If you’re eating animal products you’re consuming the supplement through the animals you’re eating as the animals are supplemented. Bottom line is we absolutely need B12 and unless we go around eating dirt (maybe insects, but please don’t) we’re not going to get enough.

  41. Folate and B12 in prostate cancer.

    Hello,
    I am currently getting treated for low risk prostate cancer (proton therapy pencil beam).
    Do I need to stop taking my multivitamin (Mykind organics certified whole food
    Mens multi 40+)

    It has vitamin B12 60 mcg but the source is not from meat, it is
    Methylcobalamin (from Saccharomyces cerevisiae, a yeast)
    Does it matter what the source is?

    https://www.ncbi.nlm.nih.gov/pubmed/23724740

      1. Adam thank you so much for responding you have a great day.

        Sent via the Samsung Galaxy Note8, an AT&T 4G LTE smartphone

      2. Adam I want Dr Greger and you for this site, hopefully what I would like to see in the future is something tailored for the people who are fighting specific diseases, in my case I am getting treated for low-risk prostate cancer with proton therapy using the pencil beam delivery system.

        I have started transitioning my diet almost two years ago when I first got my PSA test at age 50 and it was a little high. Now I am trying to to transition to a vegan lifestyle eating routine,I currently do eat Alaska salmon about twice a week or I substitute it with scallops or shrimp.

        I am trying to build my menu around fruits vegetables and nuts that have the highest chance of reversing and slowing and preventing metastasis specifically for prostate cancer.

        I am trying to put together a list of foods and supplements that would be most appropriate for my situation.
        There is a lot of information out on the internet which makes it very confusing.

        I am considering becoming a patient of this Doctor Geo mentioned in the link below.
        A few days ago I attended a virtual seminar and we were allowed to ask questions.

        I mentioned to him that I recently saw a video on nutritionfacts.org about reducing Methionine levels to starve cancer.
        The video talked about fish and shellfish as being a significant source of Methionine.

        When I mentioned this to the Doctor, he said that he holds Dr Greger in high regard but he still recommends eating Salmon a couple of times a week.
        Dr Geo does have a program (diet, supplements, exercise, fasting, meditation) custom tailored to patients who have prostate cancer, are there any plans in the future to provide specific advice to people with specific disease’s ?

        Doctor Geo’s book.

        https://www.amazon.com/Dr.-Geo-Espinosa/e/B01BX3GRHM/ref=sr_tc_2_0?qid=1520256528&sr=1-2-ent

        1. Steveo, did you read Dr. Greger’s book “How Not To Die” yet? I think he has a chapter on prostate cancer, if memory serves. Not sure all your questions will be answered but I’m sure you’d find it helpful if you haven’t read it already. He also mentions this disease in various videos on this site which I’m sure you’ve seen. Sometimes the info is scattered, I’m sure I haven’t seen all of them on this subject. Anyways, I would go with Dr. Greger in regards to seafood, yes I’m a vegan which means my stance is first and foremost morals and ethics (second sustainability, and then health which is still a major concern of mine) but that’s not why I’m weighing in here. I would go by Dr. Greger because he goes by what the best evidence has to say and fish contain very high levels of heavy metals and one of the most contaminated “foods” in general. Plus, animal protein not only promotes, but helps to spread and proliferate cancer. The only thing unique to salmon that I could think anyone would recommend it for, would be the DHA/EPA, but there are algae based DHA/EPA supplements which Dr. Greger recommends due to available evidence on supplementation and evidence on the contamination of fish and fish products.

          Good luck and hope you get a response from someone from NF!

          1. Thank you Shaylen, BTW I like your first and last name.

            Any hoo I am slowly converting to a Vegan, I am eating fish or shrimp or lamb about once a week.
            Most other times I am eating pasta, salads and vegetables galore. I really need to find a really easy online application that will help me plan and print all of my meals for the week.
            This would include grocery list and menus. Let me know if you know of anything that could help.

            Here is the link on the vitamin B12 increasing a mans risk of lung cancer.

            https://www.ncbi.nlm.nih.gov/pubmed/?term=28829668

  42. So I currently take Garden of Life’s B12 spray. I like to do a once a week dosage so I use the amount of sprays it takes to accomplish said recommended dosage. The thing I worry about is if I lose any during the spraying process so I tend to spray some extra. I’m also not happy about Garden of Life switching to plastic (which they claimed when I contacted them is bpa free) containers over their previous glass containers. Anyways, I’d prefer a tablet form but I like that Garden of Life’s My Kind B12 spray is so natural. Does anyone have any good recommendations or what to share their preferred brand?

    FYI, if anyone is interested in the B12 spray, even though it doesn’t say it on the package, it should be refrigerated. The spray nozzle gets mold when stored in the cupboard but the problem completely goes away if you refrigerate the bottle.

  43. I’ve been enjoying Dr Greger’s book so much and as a result have been eating a plant-based diet for the last couple of weeks and feeling great. It is such an incredible resource for which I’m so grateful!
    My query to Dr Greger & team is regarding Vitamin B12. Every time I have ever had a supplement containing any combination of the Vitamin B group I find my mood dramatically altered. I’d been feeling so good and happy on all this wonderful plant food that I thought I’d give it another go. I tried one tablet of 100 mcg Vitamin B12 (Cyanocobalamin). Within a few hours my mood dropped; I became irritable and unhappy even though there was nothing external to attribute my reactions to. I left it for a few days and gradually returned to my normal, contented self. Then I tried again. That afternoon – yesterday – my mood plummeted again. This has been a consistent pattern with Vitamin B suppliements across my life. I’ve recently done some google searching (as you do) and have found that I am definitely not the only one to respond to Vitamin B supplementation this way. My base state is one of contented optimism and I really want to continue with this plant-based diet. What would you suggest?
    All the best.

    1. Hi Marianne – My name’s Janelle and I’m a Health Support Volunteer for Dr. Greger and a Registered Dietitian. Thanks for your question! That is so awesome to hear about your success with transitioning to a plant-based diet! As far as the simplest option for supplementing with vitamin B12, Dr. Greger recommends one 2500 microgram sublingual, chewable, or liquid supplement of cyanocobalamin once a week (https://nutritionfacts.org/video/cheapest-source-of-vitamin-b12/). You could always try this and see how you feel since it’s only taken once/week versus daily.

      If supplements continued to not be tolerated, you can also get vitamin B12 from eating enough B12-fortified foods on a daily basis. It is recommended to consume at least 1 serving of a vitamin B12-fortified food that contains at least 25% of your Daily Value (this information can be found on nutrition labels or looked up online) at ALL 3 of your meals daily. For example, 2 teaspoons of a vitamin B12-fortified nutritional yeast (such as Red Star brand) could count as 1 of your 3 daily servings of vitamin B12, and can simply be sprinkled onto foods. (https://nutritionfacts.org/video/daily-source-of-vitamin-b12/).

      Vitamin B12 can also be found in other foods fortified with B12 like some breakfast cereals, plant milks, and soy products. Always check the label to ensure the product has been fortified and contains at least 25% of your Daily Value of vitamin B12 per serving. It is important to obtain these 3 servings of B12 daily to prevent deficiency from occurring over time if you are not taking a supplement. I hope this helps give you some insight!

      Here are a few additional resources to check out:
      https://veganhealth.org/vitamin-b12-vegan-sources/
      http://www.choose-healthy-food.com/brenda-davis-interview-vitamin-b12-foods.html

      1. Thanks very much for this info JanelleRD. I wonder, as the B Vitamins work in concert, whether the delicate balance can be upset in some people. That it might be dragging through other B vitamins & causing symptoms because of low levels of other B types. Just a thought.
        Cheers.

  44. So these studies perhaps are not accurate for everyone?
    Because I never had a b12 deficiency when eating high quality raw animal foods, yet once going vegan now for just about 3 weeks i’m showing symptoms of a b12 deficiency… :O
    Perhaps some people DO absorb a lot more than what you mention from eggs or liver?
    It seems likely to me, i will try a supplement first when i hit the 3 week mark if the symptoms continue, and see what happens. If it helps ill stop and wait to see if they reoccur – then try some raw wild game liver and see if that is effective :D

    1. what about the study in PubMed vitamin B12 can increase a man’s chance of getting lung cancer over a 10-year period

      Sent via the Samsung Galaxy Note8, an AT&T 4G LTE smartphone

  45. Our family, including my teenage daughter, switched to a WFPBD three months ago. I am concerned about her B12 levels as I’ve noticed a bit of fatigue. She has battled acne for several years now, so I am hesitant to put her on B12 supplementation. Thoughts?

    1. In the B12 groups, they say B12 is a natural antioxidant so it detoxes the body, including from homocysteine and methionine which the body can’t detox when low in B12.
      H-pylori bacteria can also cause acne and fatigue, so it may be worth asking her GP for the test in view of the Quadruple Therapy antibiotics which are reportedly most effective. Peppermint, nettle and fennel tea may otherwise help.

    2. Hi, Laurie! It is unlikely, unless your daughter was already deficient in vitamin B-12 before switching to a WFPB diet, that 3 months would be long enough for her to become deficient. The human body can store vitamin B-12, and stores can, in some cases, take years to deplete. That said, a vitamin B-12 supplement is a good idea for those on WFPB diets and anyone over the age of 50. There is no known toxicity for vitamin B-12, and deficiency can result in permanent neurological damage. You may also want to have your daughter’s iron levels checked. Menstruating females can become iron deficient due to monthly blood loss. If she is deficient in iron, there are plant-based supplements available that can help get her back to optimal iron levels without some of the gastrointestinal discomfort often associated with other iron supplements. In fact, there is a plant-based, liquid iron supplement that also provides B vitamins, including B-12. I hope that helps!

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