Got Energy? Why B12 is Vital for Vegans

I personally am acquainted with a person who has been vegan and gluten free for 10 years, eats a very wide variety of fruits,  vegetables, grains, seed, nuts, and legumes just like we are supposed to. He slowly began feeling ill, and finally was experiencing such serious symptoms that warranted being hospitalized. He was undergoing a battery of tests to determine the cause, the doctors actually thought he had MS. It turned out that it was a B12 deficiency. After just a week of daily supplements, he was feeling better than he has in years! He says it had been insidiously developing over time, and it wasn't until he was nearly to the point that he could not function any longer that he sought medical help.

A vegan or vegetarian diet could very easily lack one thing that is not abundant in a plant-based diet: vitamin B12. Vitamin B12 is sometimes called "the energy vitamin". Making a point of getting B12 is especially important for everyone on a plant based diet, people with Celiac or Crohn’s disease, ulcerative colitis, or IBS, (or others with "leaky gut"), persons who have had part of the stomach or small intestine removed, someone with Pernicious Anemia, heavy drinkers and smokers, pregnant and breast-feeding women, persons with bacterial growth in the intestine or parasites, people on  Metformin, PPIs, or acid suppressing medications that inhibit B12, as well as all persons over the age of 50. The body stores 3 to 5 years worth of B12 and several months’ supply of folate in the liver, deficiencies and their associated symptoms can take months to years to manifest in adults. 
Infants and children will show signs of deficiency more rapidly. Symptoms of a B12 deficiency are:

• diarrhea 
• constipation
• pale skin
• lack of energy
• poor appetite
• light headedness when rising from sitting or lying
• swollen, sore tongue and/or bleeding gums
• chest pain
• rapid heartbeat
• shortness of breath on exertion
• weakness
• jaundice
• eye twitching
• insomnia
• migraines
• memory loss

If the deficiency has been present a long time, it can damage your nerve cells, and advanced symptoms include:

• loss of balance
• confusion or change in mental status
• psychosis
• chest pains
• numbness and tingling in extremities
• depression
• difficulty walking
• rapid and frequent mood changes
•  in severe cases dementia/Alzheimer's

Deficiencies often go undiagnosed because the symptoms overlap with many other diseases. Vitamin B12 is needed to make red blood cells and plays an important role in DNA synthesis and neurologic function. Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels. Studies such as 2008 University of Oxford study have shown that the brain actually begins to atrophy (shrink) when a person has a B12 deficiency.

Don't let it happen to you. Include some of the following in your diet:

• Nutritional Yeast: You can sprinkle the flakes or powder into your recipes, it adds a savory flavor to foods. I often use it in tofu scramble for a cheesy flavor, and it's excellent when making cashew 'cheese'.
• Energy Drinks: They’re vegan and fortified with 100% of your daily allowance of B12
• Fortified non-dairy Milk: You can easily get my 100% daily allowance of B12 from fortified almond, hemp, soy, or rice milk every day.Use it for your breakfast cereal, smoothies, in recipes, or in your coffee or tea.
•  Beer: A source of Brewer's Yeast. ( Nutritional yeast is heated and has a slightly different texture and flavor. Most people find that nutritional yeast has a pleasant, cheesy flavor. Brewer's yeast can be bitter and have some of the flavors from the beer making process. The nutritional content is almost identical.) If you happen to be a beer drinker on occasion, it's good to know that most beer have 50% of your daily recommended allowance of B12, but those of us who are gluten free must look for gluten-free beer or avoid beer altogether.
• Some meat analogues (foods that are vegan that are made to resemble meat), some soy-based products and some brands of fortified cereals
• However, so-called pseudo-B12 refers to B12-like substances which are found in certain organisms, including Spirulina (a cyanobacterium) and some algae. These substances are active in tests of B12 activity by highly sensitive antibody-binding serum assay tests, which measure levels of  B12 and B12-like compounds in blood. However, these substances do not have B12 biological activity for humans, a fact which may pose a danger to vegans and others on diets who may not ingest sufficient quantities of B12   producing bacteria, but who nevertheless may show normal "B" levels in the standard immunoassay which has become the normal medical method for testing for B12 deficiency.  (SOURCE: http://www.vrg.org/nutrition/b12.htm).

Vegan dietary sources would not benefit those who for reasons mentioned above do not absorb B12 from the intestines. A sublingual B12 supplement would be best:

• Vegan supplements: B12 supplements are inexpensive, safe, and probably the easiest way to ensure you are getting your B12. Vegans/vegetarians need to read the label to make sure the source of the B12 is not "beef juice" commonly used. Swallowing 500 mcg of Vitamin B12 can result in absorption of as little as 1.8 mcg. However, sublingual type tablets are a more  absorbable type, whereby the B12 is taken under the tongue to dissolve and be absorbed quickly through the mucous membranes, and goes directly to the bloodstream bypassing the GI system. B12 is a water soluble vitamin, so it is not possible to get too much, excess will be flushed out of the body. Methylcobalamin (Methyl B-12) is the superior form of B12, it is better absorbed and retained than the other forms of B12, cyanocobalamin or hydroxycobalamin (frequently used in Europe). Methyl B-12 protects nerve tissue and brain cells, promotes better sleep and reduces toxic homocysteine to the essential amino acid methionine. B12 is a water soluble vitamin, meaning that any excess that your body does not need is flushed out, so you do not need to worry about getting too much, only about not getting enough.    

Cyanocobalamin is the most commonly supplemented form of vitamin B12, but you might be surprised to discover that this form of vitamin B12 does not actually occur in plants or animal tissues. In other words, outside of the chemically synthesized cyanocobalamin that you encounter as B12 in most vitamin supplements, you would be extremely hard pressed to find this compound in nature (in fact you would not be able to find it). As the name implies, cyanocobalamin contains a cyanide molecule. Most people are familiar with cyanide as a poisonous substance. Although the amount of cyanide in a normal B12 supplement is small and from a toxicology point, viewed as insignificant, your body stores months worth in the liver, and will need to remove and eliminate this compound. This removal is accomplished through your detoxification systems with substances like glutathione being very important for the elimination of the cyanide.
Compared with cyanocobalamin, it appears that sublingual methylcobalamin is better absorbed and retained in higher amounts within your tissues. In simple terms, they are used much more effectively. In general, methylcobalamin is used primarily in your liver, brain and nervous system. See more by Dr. Peter D'Adamo here.

 Japanese studies indicate that methylcobalamin is even more effective in treating the neurological sequelae of B12 deficiency, and that it may be better absorbed because it bypasses several potential problems in the B12 absorption cycle. On top of that, methylcobalamin provides the body with methyl groups that play an role in various biological processes important to overall health.

Injectable B12 is cyanocobalamin, the least effective form of B12. Usually, these shots are prescribed for persons with malabsorbtion problems described in the first paragraph, every 1 to 2 days for about 2 weeks. After this, a shot is given once every month. Studies show the sublingual  form is equally effective in preventing or treating B12 deficiency. Your doctor can help decide whether pills or shots are right for you. A rather "fad" of sorts developed in the last 35 years for weight loss clinics to prescribe B12 injections. It was purported to aid in weight loss for patients on a starvation diet. In essence, the shots provided a much needed boost of energy to the otherwise starving patient that kept the patient compliant with severe dietary restrictions. No scientific data exists to support any effect of B12 on weight loss. The injections do not harm the patient, other than the pain at the injection site and possible development of scar tissue  under long term injection sites.


Vitamin B12 supplementation also improves the arterial function of vegetarians and vegans http://1.usa.gov/R8Gyyd 
Unfortunately, since many vegans are not supplementing, B12 deficiency is rampant: http://nutritionfacts.org/video/vegan-epidemic/