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Vegans are regularly advised to mind their levels of vitamin B12, but vegetarians and even meat eaters often come up short on this important nutrient, which helps keep nerves and blood cells healthy. In this informative Q&A—and in the video below—
Dr. Sofia Pineda Ochoa goes deep on where vitamin B12 comes from, why we need it, and how to ensure we’re getting enough.

> ds are not the best source because consuming them increases our levels of IGF-1 (a hormone consistently associated with increased cancer risk and tumor growth), TMAO (a substance that injures the lining of our blood vessels and promotes the formation of cholesterol plaques), as well as other unhealthy substances such as heme iron, which is associated with oxidative stress and the formation of free radicals.

> t past president of the American College of Cardiology, Dr. Kim Williams, stated during his tenure that the extensive medical evidence linking TMAO to cardiovascular disease was, in his opinion, sufficient reason for people to avoid consuming all animal foods (even without considering all of the other highly problematic health issues associated with meat, dairy, and eggs).

> e the symptoms of B12 deficiency?
Symptoms of vitamin B12 deficiency are fairly non-specific, and can include fatigue, weakness, lightheadedness, and loss of appetite. Shortness of breath, numbness, and memory problems can also occur. The wide-ranging and imprecise nature of these symptoms underscores the importance of being proactive in avoiding this vitamin deficiency.

> ppens if B12 deficiency is overlooked or ignored?
Because vitamin B12 helps in the formation of nucleotides (genetic material), a deficiency can impair our normal production of DNA. This can first manifest as difficulty with the normal production of red blood cells, and can result in anemia. It can also result in problems with the maintenance of the nervous system, causing a wide variety of neuropsychiatric symptoms.

> uld take a supplement or get tested?
Given the prevalence of deficiencies in the general population, regardless of one’s diet, everyone should monitor their vitamin B12 status or take a supplement (or both). This is a deficiency that’s usually easy for a medical professional to identify and treat.

Fe with no known deficiency, a blood test including vitamin B12 levels at your annual physical is normally appropriate. Keep in mind that vitamin B12 can be stored in the liver for a few years and keep our blood levels high, even if we are no longer absorbing or consuming enough of it.

Aable to further evaluate and diagnose a suspected B12 deficiency include methyl malonic acid and homocysteine levels (both of which are usually elevated when there is a B12 deficiency).


Vitamin B12 is an important and necessary nutrient. However, animal foods are not the best source due to the health issues noted above. Everyone (regardless of their diet) should monitor their vitamin B12 levels and ensure they have a reliable source by taking a vitamin supplement or eating B12-fortified plant foods (or both). In the end, avoiding vitamin B12 deficiencies is easy and inexpensive, but it is something we should be mindful of. ofia Pineda Ochoa, MD,