Vitamin B12 - A Critical Component of Health with the increased Plant-Based Diet trend
What is B12?
Vitamin B12 (also sometimes called cyanocobalamin or methyl-cobalamin) is a water soluble vitamin that is called an “essential nutrient” because our body cannot make it, in suffice levels, metabolically thus we must obtain from our food. It is made by some types of bacteria both aerobically (with oxygen) and anaerobically (without oxygen).
Plant-Based nutrition has become a popular topic in todays world and one that I feel really passionate about sharing education on purely because of the immense need for it to be done with a true knowledge of how to do it in a healthily way. I know that knowledge is powerful, hence why I always aim to empower others with evidence based nutrition knowledge to help you to understand the importance of your nutritional intake in regards to optimising your health.
I'm going to share some information about Vitamin B12 (Cobalamin), because this B-Vitamin is important in a big way as we start to see the trend of plant based arise to a mainstream diet.
I am sure if you follow a plant based diet you have heard of this vitamin, surely someone has told you to make sure you are getting enough Vitamin B12 or supplementing it. This is an incredibly important nutrient for plant based diets but not solely just plant based diets. All diets are purely just dietary choices and dietary behaviours. The actual result of each diet is an incredibly intrinsic & individualised biochemical process that is so much more than what goes in your mouth.
Other factors to consider with your diet
The digestion of the food both mechanically and chemically
The absorption of the nutrients, vitamins and minerals within the food
The health of the gastrointestinal tract
The microbiome composition within the digestive system
The transport and storage of the nutrients, vitamins and minerals
The cellular uptake & use of nutrients, vitamins and minerals
The excretion of waste
Why is B12 important?
It plays an important role in red blood cell formation - maintains and repairs our Red Blood Cells (which carry oxygen around our bodies).
It helps to protect our neurones from damage and conduct efficient signalling within the Nervous System. Neurones are cells within the nervous system that transmit information to other nerve cells, muscle, or gland cell. We have “Myelin Sheath” that protectively wraps around our neurones. Vitamin B12 is required to create this Myelin Sheath.
Vitamin B12 works with Folate to synthesise our DNA.
It helps to break down protein and fat so that our bodies can use these sources as energy
Vitamin B12 requirements?
The recommended daily intake (RDI) for adults (>18 years old) in Australia for Vitamin B12 is 2.4 micrograms per day. Slightly more for both pregnant and lactating women (2.6 and 2.8 micrograms respectively). In pregnant and breastfeeding women, vitamin B12 deficiency might cause neural tube defects, developmental delays, failure to thrive, and anaemia in offspring.
Deficiency symptomology
Once symptoms escalate, they can include neurological changes, such as numbness and tingling in the hands and feet. When someone has an extreme B12 deficiency, they can actually develop potentially irreversible and severe neurological disorders. So you can see, it’s a really important nutrient and should be taken seriously. Causes of vitamin B12 deficiency include difficulty absorbing vitamin B12 from food, lack of intrinsic factor (e.g. because of pernicious anaemia), surgery in the gastrointestinal tract, dietary insufficiencies and prolonged use of certain medications.
For example: Metformin or proton pump inhibitors are medications that adversely affect vitamin B12 levels. These drugs are used by western medicine to treat gastro-oesophageal reflux disease and peptic ulcer disease. They can interfere with vitamin B12 absorption from food by slowing the release of gastric acid into the stomach and thereby lead to vitamin B12 deficiency.
Where is dietary Vitamin B12 found?
Naturally, Vitamin B12 is created by bacteria such as in the gut of humans and animals. For us humans, it’s produced in the colon, a long way from where it needs to be in order for adequate absorption. Our bodies release Intrinsic Factor (IF) from the stomach which bind to Vitamin B12 in order for it to be absorbed in the ileum and transported to the liver. Traces of vitamin B12 can also be found in plant foods via contamination with soil. Some plant based foods are now fortified with Vitamin B12. Major dietary sources of Vitamin B12 are all derived from animal based foods, so it makes sense that plant-based diets are going to have a hard time getting enough Vitamin B12 and there is plenty of conditions that can also affect our bodies ability to absorb Vitamin B12. Such as pernicious anaemia- an autoimmune condition that attacks those cells in the stomach that produce IF, a protein that is needed to binding and absorption of B12.
If you would like to maintain your Vitamin B12 using a plant based diet alone, proper planning is required or at least a generous amount of certain foods regularly. But this must go hand in hand with improved gut health interventions to ensure the digestion, absorption and transport of B12 is optimised. Research suggests that fermented soy products (Tempeh), certain forms of algae, seaweed (Nori sheets!) and specific mushrooms (eg. Shiitake) have significant amounts of Vitamin B12.
Plant based foods containing small amounts of Vitamin B12:
Tempeh:
While soybeans (and tofu) themselves do not contain considerable amounts of Vitamin B12, its product, Tempeh, can! The process of producing Tempeh involves fermentation of the soybeans, and fermentation is a process involving BACTERIA, remember, Vitamin B12 is produced by certain types of bacteria (hooray for bacteria!!). Some sources suggest Tempeh may contain 0.7-8.0 micrograms of Vitamin B12 per 100g (varies greatly based on that degree of fermentation and bacteria type!). Take home message: do not rely on Tempeh as a sole source of B12
Algae/Seaweed:
Various batches of nori are found to contain significant amounts of the B12 analogue (types of B12) there is a good chance that some of this B12 is active.
Mushrooms:
Mushrooms contain variable amounts of active/bio-available (absorbable) B12. It varies from crop to crop and the majority was found in the surface/outer layer (skin). This is most likely due to bacterial fermentation on the mushroom surface but more likely due to soil/compost contamination. One serve will provide about 2-4% of the RDI. Shiitake mushrooms have been researched and believed to contain good amounts of the active Vitamin B12, however it would require 50g of dried shiitake mushroom daily to meet the requirement which is not considered achievable or safe and studies are yet to show its ability to increase levels of B12 in humans (and lower MMA). While the amount of B12 in the average serve of mushrooms is not much, regular intake can assist in obtaining your requirement. Also, importantly, you should not rely solely on mushrooms but consider that they MAY assist.
I consume fortified nutritional yeast flakes, almost daily, sometimes twice daily, to help support my vitamin B12 intake. For example: Bob's Red Mill Nutritional Yeast Flakes contains 5.8 micrograms per 5 grams. Nutritional Yeast flakes are a savoury, almost cheesy flavour, and taste absolutely delicious sprinkled on basically everything savoury.
If you are sitting here reading this and know you follow a predominantly or exclusively plant based diet and are worried your not getting enough Vitamin B12, what should you do?
My advice would be to first, see your Clinical Nutritionist and have a blood test to check your Vitamin B12 levels. Routine blood tests (6 monthly) is an important health precaution every body should take to ensure you are not deficient or overloaded in any nutrient. It is important to get a qualified & fully registered health professional to analyse your blood test results such as a Clinical Nutritionist or Doctor. This is because solely looking at your B12 result on a blood test doesn’t necessarily indicate you are low. This is due to the complexity of intrinsic interactions occurring within our blood chemistry that need reading in a holistic manner to join all the dots and get to the root cause of any imbalances. For example, a high amount of folate in your blood can actually mask a B12 deficiency and a deficiency should be confirmed by checking the level of a substance in the blood called methylmalonic acid (MMA). A high level indicates a true B12 deficiency.
If your levels of Vitamin B12 are below the recommended range and you follow a plant based diet taking a Vitamin B12 supplement is recommended. I of course believe you should tackle nutritional health with nutrition interventions first, however as this deficiency potentially dangerous, supplementation to get yourself back into the healthy range is a good idea.
Supplements
While I advocate for a food first approach, unfortunately, supplementation is the most widely researched and backed-by-evidence approach to achieving adequate Vitamin B12.There are so many of these out there on the market today. Oral supplements, lozenges and oral sprays. I recommend taking an oral Liposomal supplement. Even though the recommended intake of B12 is only 2.4 micrograms a day, many supplements provide 500-1000 micrograms. This is because there are such large variations in absorption rates among individuals. As always, speak to your Doctor, Clinical Nutritionist or Naturopath about which supplement they recommend for your individual health.