Of all the nutrients that vegans must pay attention to, Vitamin B12 is at the very top of the list. It is essential for nervous system health, so every vegan needs to take this nutrient seriously. People with B12 deficiency risk nerve damage, neurological problems, and elevated homocysteine levels that can cause inflammation that may lead to heart attacks or stroke.
Vitamin B12 is found exclusively in foods of animal origin, and the amount of this nutrient present in an unfortified vegan diet is essentially zero. It can, however, take several years for a deficiency to arise, since B12 is stored in the liver. It’s dangerous to be complacent about finding a reliable source of B12 because deficiency can creep up over time, silently doing damage before symptoms arise. One of the great annoyances of being vegan is that you will sometimes encounter other vegans who insist that there’s no need to take a B12 supplement. Generally speaking these people will say something like, “I’ve been vegan for eight years, never take B12 supplements, and I’m in perfect health,” but meanwhile they’re all twitchy and something just isn’t right. In many cases these people will experience a health crisis, return to eating meat, and then tell the world that a vegan diet leads to failed health. Unfortunately, having a productive dialog with these folks is generally futile, just like there’s no reasoning with the Vegan Police.
Why are there so many vegans who take pride in spurning B12 supplements? It’s because back in the 1980s and 1990s several prominent vegan advocacy books came out that dismissed the need for vegans to take B12. Because these books were published at a time when there weren’t many reliable vegan books available, B12 misinformation got a big head start on the truth. There are all sorts of ludicrous arguments asserting that vegans don’t need B12, ranging from the idea that it’s produced in your intestines (it isn’t, at least in a way that you can absorb), that it’s found in algae or seaweed (no, it’s not), or that you can get enough B12 by not washing your vegetables (that’s just silly.)
In at least a couple cases, the vegan authors contributing to B12 complacency went back to eating animal products. But the damage these books have done have produced ripple effects continuing to today.
Meeting Your B12 Needs
The B12 needs of vegans can easily be met through supplements or by regularly eating B12 fortified foods. Some B12 supplements contain non-vegan ingredients, but the supplements featured on this page are all vegan.
B12 isn’t absorbed especially well when it’s swallowed in a tablet. You’ll get better absorption if you purchase B12 lozenges or ‘sublingual tablets’, which are different words for the same thing. You let these tablets dissolve under your tongue, and the B12 is absorbed through the capillaries in your mouth. A sensible dosage is a 1000 to 2000 microgram tablet taken a few times a week. Note that many brands of B12 contain methylcobalamin, but cyanocobalamin is currently considered the better choice by nutritionists who’ve carefully studied the topic.
Foods commonly fortified with B12 include non-dairy milks, cereals, meat substitutes, energy bars, and nutritional yeast. You have to check the nutrition label for B12, since many of these foods aren’t supplemented, or are supplemented in tiny amounts. Note that B12 fortified foods are dosed with the very same B12 that gets put into tablets, so obtaining your B12 through fortified vegan foods is in no way more “natural” than getting it through tablets. Additionally, it may be difficult to meet your B12 needs through fortified foods, since comparatively few products are fortified, and B12 fortification of foods is often at low levels.
For most vegans, it’s therefore much easier and more reliable to simply buy a bottle of vegan B12 lozenges. Sublingual B12 supplements are easy to find online or at any natural foods store. Of the dozens of B12 supplements Amazon stocks, probably the best buy is Now Foods’ 1000 microgram cyanocobalamin lozenges. A 250-lozenge bottle comes in at around $10 and will last more than a year if taken three times a week.
Unless you like burning money, avoid sprays or other high-priced alternative ways to get B12. While sprays may perhaps be more absorbable than lozenges, they also cost vastly more. The one thing you should care about when choosing a vegan B12 brand is bang for the buck. You want to get the most micrograms of cyanocobalamin in the bottle at the lowest cost, while choosing lozenges instead of pills intended to be swallowed. If you pay a premium price for your B12, you’re just being victimized by slick marketing.
Ability to absorb vitamin B12 decreases with age, and some people cannot absorb sufficient B12 orally. Luckily, determining your B12 levels is one of the cheapest bloodwork tests available, and it’s standard on every basic nutrient panel. If your levels are low despite regular use of sublinguals, injections may be warranted. Since injections go straight into the muscle, they guarantee that high levels of B12 will be absorbed. These injections require a prescription in the United States, but hypodermic needles pre-loaded with B12 are sold over the counter in Mexico and many other countries. Obviously, injections should only be done by someone with proper qualifications.
For more information about nutrients of special interest to vegans, see our Vitamin and Supplement Guide.