Although being a pescatarian or lacto-ovo vegetarian gives me more food options than being a vegan, I am still susceptible to nutrient deficiencies. Nevertheless, I don’t regularly take supplemental vitamins because I am believer in food first for nourishment. Another reason? I’m not keen on taking pills.

However, when I went to get my annual physical recently, my healthcare provider told me that my Vitamin B-12 levels were on the cusp of being below normal. She recommended that I take a supplement to make sure I do not become deficient. After 8 years of being a mostly lacto-ovo vegetarian, I guess it’s about time to commit myself to supplementing daily to ensure good health.

What’s so important about Vitamin B-12?
Vitamin B-12 is one of the key players in forming our red blood cells and keeps our neurological functions working well. That means vitamin B-12 is essential for a healthy life. But because most foods highest in vitamin B-12 are from animal proteins like meat, fish, and dairy, vegetarians and vegans have a tougher time meeting their daily needs.

The recommended daily amount of vitamin B-12 for both males and females are:

Vitamin B-12 levels below 200 pg/mL is consistent with deficiency.  If we become deficient, we can develop pernicious anemia and can experience changes in our neurological function. Physical signs of this can be fatigue, weakness, loss of appetite, weight loss, and numbness and tingling in hands and feet.

What to eat?
As mentioned, animal protein and animal byproducts are always going to have more vitamin B-12 than vegan sources. Fortified foods and nutritional yeast are the main sources of vitamin B-12 for a vegan. To note, when looking for fortified sources of vitamin B-12 in foods, it is important to look at the ingredient label. In my product research, most brands of almond milk, oats, and tofu are not fortified. Therefore, please see below for examples and some product recs:

Also, while there may vitamin B-12 in  spirulina, nori, and kombu, research has shown that they mostly contain an inactive form of vitamin B-12 and therefore they are not a good food source for B-12.

Supplementing
For general oral supplementation, the recommended dose of vitamin B-12 is 1-25 mcg/day. If you are deficient or have pernicious anemia, a dose of 300-10,000 mcg/day has been shown to help. However, keep in mind that the larger the dose taken, the less your body tends to absorb. For example, only 10 mcg of a 500 mcg dose is absorbed in a healthy person.

Without getting too much into detail, you can find oral vitamin B-12 supplements that come in the form of cyanocobalamin, methylcobalamin, hydroxocobalamin, and adenosylcobalamin. Cyanocobalamin is most available form on the market and has shown to be effective in raising your levels. Some suggest that methylcobalamin has the best absorption rate of the four, but the evidence is limited at the moment and more research is needed.

Choosing the type of oral supplementation may be overwhelming too because they can come in many forms such as lozenges, tablets, drops, capsules, nasal gels, liquid, and sprays.

My suggestion is to go with what you’re comfortable with and can afford. If you’re not a lover of pills, I suggest the lozenges or the liquid. The most important thing to consider when looking for a supplement is to find a brand that is honest and transparent with its processing procedures. The FDA does not closely regulate the supplement industry, so be careful about what companies state on their packaging.

Here are some products that you may consider:

At the end of the day, beyond all the science and the knitty-gritty, as plant-based eaters it is important to both get our daily needs of vitamin B-12 both from a variety of food sources and supplementation. While I didn’t have symptoms from having low levels for so long, I could’ve avoided it by taking a supplement from day one.