Vitamin B12 Guide
Vitamin B12 is an important nutrient for us. It is required for many biological processes in our body like the proper formation of blood cells and DNA synthesis, hemoglobin synthesis, conversion of macronutrients into energy, maintenance of myelin sheath (protective coating of nerves) etc.
There is a compound named homocysteine, which is made in the body by methionine breakdown as a byproduct. Its abnormal level affects arteries and bone health. It can trigger heart disease by damaging the linings of the blood vessels. (1, 2, 3)
Therefore, it is very important to get Vitamin B12 supplementation regardless of listening to people talking about it without scientific evidence.
Whole Food Plant-Only Diet
We recommend everyone to follow a whole food plant-only diet to get better health, stop climate change, and reduce animal agriculture impact on health and the environment.
When you start following a whole food plant-only (WFPO) diet, you can develop Vitamin B12 deficiency. You should take a Vitamin B12 supplement, as recommended underneath.
Recommended Dosage
| Age Group (in years) | Daily Single Dose | Daily Multiple Dose | Weekly Dose |
| ½ – 3 | 5 μg | 1 μg x 2 | – |
| 4-10 | 25 μg | 2 μg x 2 | – |
| 11-18 | 50 μg | 2 μg x 3 | 1000 μg x 2 |
| 19-65 | 50 μg | 2 μg x 3 | 1000 μg x 2 |
| 65+ | 1000 μg | 500 μg x 2 | – |
| Pregnant | 25 μg x 2 ** | 2 μg x 3 | 1000 μg x 2 |
| Lactating | 50 μg | 2 μg x 3 | 1000 μg x 2 |
Note: ** During pregnancy, you should take 25 μg twice a day to increase B12 bioavailability. (4) We generally recommend everyone to take 25 μg twice a day for getting better absorption. So, the best way is:
| Age Group (in years) | Daily Dose |
| ½ – 3 | 5 μg |
| 4-10 | 25 μg |
| 11-18 | 25 μg x 2 |
| 19-65 | 25 μg x 2 |
| 65+ | 500 μg x 2 |
| Pregnant | 25 μg x 2 |
| Lactating | 25 μg x 2 |
You should split the dosage into two separate halves to get better absorption of Vitamin B12. You can easily get tablets containing 100 μg cyanocobalamin. We recommend taking it in the dosage of 25 μg twice daily. So, you can take a quarter (1/4) of the tablet in the morning and a quarter in the evening.
Can I get Vitamin B12 from fortified foods?
Yes, you can get it, but we recommend to avoid factory-made and processed foods. Most of the fortified foods are on our restriction list. Check Dietary Guidelines for more detail.
Recommended Fortified Foods
As per our current guidelines, we only recommend the limited use of Tofu as fortified food sources. Tofu is still processed food, so it should be used with caution.
How To Treat Vitamin B12 Deficiency
If you have Vitamin B12 deficiency, you should take Cyanocobalamin daily for about 3-6 months.
The optimum recommended dosage for treating Vitamin B12 deficiency is 50 mcg daily or 2000 mcg weekly. (5)
The research recommends taking a single dose containing 50 mcg of cyanocobalamin daily or 2000 mcg weekly. We encourage people to take it in 25 mcg twice a day for better absorption. Alternatively, you can also take 1000 mcg twice a week.
Vitamin B12 Forms
Four forms of vitamin b12 are available for supplementation.
- Adenosylcobalamin (also known as 5-deoxy-5-adenosylcobalamin, cobamamide, cobinamide, and dibencozide).
- Cyanocobalamin.
- Hydroxocobalamin.
- Methylcobalamin.
We usually recommend cyanocobalamin.
Methylcobalamin & Adenosylcobalamin
If you have Vitamin B12 deficiency and homocysteine levels remain elevated after 3 months of continuous use of cyanocobalamin (as recommended above), then go for the combination containing 500 mcg methylcobalamin and 500 mcg adenosylcobalamin. Take it daily for 2 months.
Hydroxocobalamin
If homocysteine levels remain elevated even after treating with methylcobalamin and adenosylcobalamin, then go for a hydroxocobalamin shot.
Can I take multivitamins?
According to our current guidelines, we only recommend Vitamin B12. Vitamin D is rarely recommended, and only for people who cannot take sunbath daily. Except for these two, you get all vitamins and minerals from plant-based sources. Multivitamin or B-complex supplements are known to cause side effects.
Why Should You Take Vitamin B12 Supplement?
- Around 30-60% of the population have a suboptimal level of Vitamin B12, especially in developing countries, according to a study. (6)
- A plant-based diet or vegan diet is deficient in Vitamin B12. Therefore, all people who follow a plant-based diet require a supplement. (7)
- Vitamin B12 deficiency can lead to neuropsychiatric symptoms, megaloblastic anemia and other health problems. (8)
I just discussed a few studies above. Several studies indicate people following a plant-based diet, vegan and vegetarian, even occasional non-vegetarian are deficient in Vitamin B12. Therefore, you should take a Vitamin B12 supplement.
If it is so important, should I take animal food?
No. Animal food cause more damage to your body. Animal protein cause inflammation in the body, which is the root of almost every disease. Animal food is scientifically known to cause diabetes, heart disease, cancer, hypertension, arthritis, etc., according to various studies.
Secondly, the most commonly eaten animal food does not provide a sufficient amount of Vitamin B12 that your body requires daily. So, you still require a Vitamin B12 supplement.
Taking a Vitamin B12 supplement is the safer option. It is not expensive. It is safe even in a high dosage.
NATURAL SOURCES OF VITAMIN B12
Vitamin B12 is made by bacteria that present everywhere on the earth’s surface. Our ancestors were getting it from the water and unwashed plant leaves and fruits. Some animals are getting it from eating their feces. Now, we are drinking chlorinated and clean water. Chlorine kills the bacteria, which also helps to prevent water-borne diseases.
There are some natural sources of Vitamin B12:
- Duckweed or Water Lentil (Whole Lemnaceae): A US company claims it.
- Fermented Millet Porridge or Gruel: According to Dr Khadar Vali.
There is no scientific evidence available to support the claims. As per current research, these might not be reliable sources.
Recommended Tests
Serum Vitamin B12 level is used to detect Vitamin B12 deficiency, which is not a reliable test. It is not an accurate test to detect intracellular concentrations of Vitamin B12. Therefore, if you have low intracellular concentration and normal serum vitamin B12, you might have functional Vitamin B12 deficiency. There are a few other tests that can accurately detect the deficiency.
- Serum Homocysteine Level: Its elevated level suggests a vitamin B12 deficiency.
- Methylmalonic Acid (MMA) Level: A higher MMA level is also an indication of B-12 deficiency.
You should ask your doctor for these tests to detect if you have a functional deficiency of Vitamin B12.
If you have low Vitamin B12 or its functional deficiency, you should get treatment with the high dosage of Cyanocobalamin, as described above.
