5. Vitamin B12

Yes. In any way, shape or form, we cannot stress enough the importance of having a reliable source of this powerhouse vitamin in your diet. This is one nutrient that vegans absolutely need to supplement and not doing so can have very serious consequences.

Vitamin B12 is essential to the body for maintenance of the nervous system and the production of DNA (and consequently for cell division). A deficiency can lead to Megaloblastic anemia and neurological damage, which can include everything from depression, mental uncertainty, blurred vision, memory loss, and even paralysis. While Megaloblastic anemia is reversible with Vitamin B12 therapy, neurological damage may not be.

From Ginny Messina, MPH, RD, a registered dietitian specializing in vegan nutrition:

Although anemia usually occurs first, this isn’t always the case. One problem is that another B vitamin, folate, can “mask” anemia due to B12 deficiency. Folate steps in and prevents anemia, but it can’t prevent nerve damage. So, if your diet is rich in folate but low in vitamin B12, nerve damage can actually be the first symptom of a B12 deficiency. This is a concern for vegans in particular, because our diets are often high in folate which is abundant in leafy greens and beans.

According to Messina, a blood level of Vitamin B12 about 200 pg/ml (picograms per milliliter) is enough to prevent anemia and nerve damage- but levels need to be above 400 pg/ml for optimal health. Recent research has also shown that adequate vitamin B12 levels can lower homocystein levels in the blood, which is great news since elevated homocysteine levels can cause heart disease and strokes.

Recommeded Reading: Vitamin B12: A Vegan Nutrition Primer

Unfortunately, there is no reliable plant food that will provide vegans with this essential vitamin. You might read that sea vegetables (seaweed), mushrooms, or tempeh are good sources of Vitamin B12 but these claims are unfounded. Many contain inactive B12 analogs- compounds similar to B12 but without vitamin activity. Relying on these foods to meet the RDA of Vitamin B12 is dangerous and can raise your risk for B12 deficiency. Therefore, it is critical to include a fortified food or supplement of Vitamin B12 in your diet.

The only two reliable sources of Vitamin B12 for vegans is fortified foods and supplements. The Recommended Daily Allowance (RDA) for Vitamin B12 is 2.4 mcg per day. But Messina recommends 4 to 7 mcg a day to prevent potential deficiency symptoms, including elevated homocystein levels.

Figuring out appropriate dosages of B12 gets tricky, though, because of the way this vitamin is absorbed. Small amounts of vitamin B12 attach to receptors for absorption. These receptors quickly become saturated by just 1 to 2 mcg of vitamin B12 and they stay that way for several hours. This is the amount of vitamin B12 you might expect to get from a single meal that includes animal products or fortified foods. If you ingest a big dose of vitamin B12 from a supplement you can still absorb a little bit of the excess that can’t attach to receptors. But absorption of that extra amount is just a very small percentage of the total.

You can easily meet the RDA for this nutrient by consuming several small servings of Vitamin B12 fortified foods throughout the day. However, if you are taking a supplement to meet your RDA needs, you’ll need a lot more since the absorption rates are so low. The following recommendations provided by Messina will help you meet your Vitamin B12 RDA:

Eat two servings per day of foods fortified with at least 2 to 3.5 mcg of vitamin B12 each, consumed at least 4 hours apart for optimal absorption.

Take a daily supplement providing 25 to 100 mcg of (cyanocobalamin) vitamin B12.

Take a supplement providing 1,000 mcg of (cyanocobalamin) vitamin B12, twice per week.

A Note About Cyanocobalamin

Cyanocobalamin is the form of Vitamin B12 that is recommended by vegan nutrition experts, however many brands of Vitamin B12 supplements that are widely available contain methylcobalamin instead. Before Vitamin B12 can do its job, the body must convert cyanocobalamin into methylcobalamin. So why not just take methylcobalamin directly? It’s not because one is better than the other, it’s because there is more reliable information about appropriate dosage levels for cyanocobalamin. For that reason, we recommend only those supplements that contain cyanocobalamin.

If you are taking a supplement that contains methylocobalamin in place of cyanocobalamin, taking 1,500 mcg per day will likely meet your RDA for Vitamin B12.

Shop for Vegan B-12 Sublingual Tablets

Without a doubt, the easiest way to meet the RDA of Vitamin B12 is to take a sublingual tablet. These are tablets that you place under your tongue and allow them to dissolve. The Vitamin B12 is then absorbed into your body through the blood vessels in your mouth. The following supplements are vegan and contain Vitamin B12 in the form of cyanoobalamin:

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