How Can I Get Vitamin B12

When Should I Start Supplementing A Plant

• First of all, congratulations on making an excellent health choice. I suggest all infants be exclusively breastfed for the first 6 months and that mom take a daily supplement so that her breast milk has B12. Formulas, if used, will contain B12.
• Once baby stops getting a large portion of his or her calories from breast milk or formula, it probably is worth supplementing . I suggest the smallest dose of B12, smashed up into an even smaller amount, and put in the food fed to baby. Many foods are already fortified with B12. Fortified foods may be sufficient if you carefully monitor how much baby gets.

What Are The Symptoms

If your vitamin B12 deficiency is mild, you may not have symptoms or you may not notice them. Some people may think the symptoms are just the result of growing older. As the anemia gets worse, you may:

• Feel weak, tired, and lightheaded.
• Have pale skin.
• Have a sore, red tongue or bleeding gums.
• Feel sick to your stomach and lose weight.
• Have diarrhea or constipation.

If the level of vitamin B12 stays low for a long time, it can damage your nerve cells. If this happens, you may have:

• Numbness or tingling in your fingers and toes.
• A poor sense of balance.
• Depression.
• A decrease in mental abilities.

What Foods Might Naturally Contain B12

• Animal foods, including meat, milk, and eggs, contain B12 and are essentially the exclusive source of the vitamin in the American food supply .
• Two varieties of edible algae and purple seaweed ) have been found to have active B12, but other algae have inactive B12-analog compounds that have no apparent benefit in animal metabolism.
• Some varieties of mushrooms and some foods made with certain fermentation processes have very small amounts of active B12.
• Plants found in our food supply do not contain B12, though plants grown in experimental settings with B12-enriched soils or water do actually take up B12.

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Causes Of A Vitamin B12 Or Folate Deficiency

There are a number of problems that can lead to a vitamin B12 or folate deficiency.

These include:

• pernicious anaemia where your immune system attacks healthy cells in your stomach, preventing your body absorbing vitamin B12 from the food you eat this is the most common cause of vitamin B12 deficiency in the UK
• a lack of these vitamins in your diet this is uncommon, but can happen if you have a vegan diet and do not take vitamin B12 supplements or eat foods fortified with vitamin B12 , follow a fad diet or have a generally poor diet for a long time
• medicine certain medicines, including anticonvulsants and proton pump inhibitors , can affect how much of these vitamins your body absorbs

Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74.

Could Boost Energy Levels In Cases Of Deficiency

Its commonly claimed that vitamin B12 improves energy levels. In theory, this statement does have some truth behind it.

Vitamin B12 helps your body metabolize food and turn it into energy.

Whats more, vitamin B12 deficiency can cause anemia, which is associated with lower energy levels. So, if youre deficient in vitamin B12, taking a supplement could help you feel more energetic.

However, if youre already getting enough of the vitamin from your diet, its unlikely that youll notice any changes to your energy levels by taking a vitamin B12 supplement.

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People At Risk Of A Vitamin B12 Deficiency

• Older Adults with Atrophic Gastritis – Atrophic Gastritis is a condition affecting 30-50% of adults over age 50 and hampers their ability to absorb vitamin B12 from natural foods. Supplements are recommended for people in this group.
• People with Pernicious Anemia – A condition that affects 1-2% of adults and can only effectively be treated with vitamin B12 injections or shots.
• Vegans and Vegetarians – Vitamin B12 is naturally found in animal products, however there are some natural vegetarian foods high in vitamin B12.
• Pregnant and Lactating Women who are Vegetarian or Vegan
• People taking Certain Medications
• Proton pump inhibitors, such as omeprazole and lansoprazole , which are used to treat gastric or pepetic ulcer disease can inhibit absorption of vitamin B12.
• Metformin – often used for type II diabetes, Metformin may interfere with vitamin B12 absorption in certain people.
• Histamine antagonists, such as cimetidine , famotidine , and ranitidine , used to treat peptic ulcer disease, can reduce absorption of vitamin B12 by slowing the release of hydrochloric acid into the stomach.
• Bacteriostatic Antibiotics, like Chloramphenicol , can interfere with the red blood cell response to vitamin B12 supplements.
• Anticonvulsants – Anticonvulsants have been shown to interfere with vitamin B12 and vitamin B9 metabolism. One study found that people taking folate supplements and anticonvulsants experienced a 50% decline in Vitamin B12 blood levels.

How Often Should I Get A Vitamin B12 Injection

Keep in mind that everyone is different and has unique needs. If youre diagnosed with anemia associated with vitamin B12 deficiency, youll likely be given 100 mcg into the muscleonce dailyfor about one week. Eventually, the frequency of this injection will be down to once every month. That said, the frequency and dosage will change, based on improved blood work and symptoms. In most other cases, a single session per month is suitable.

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How Much Vitamin B12 Do I Need

Adults need about 1.5 micrograms a day of vitamin B12.

If you eat meat, fish or dairy foods, you should be able to get enough vitamin B12 from your diet.

But as vitamin B12 is not found naturally in foods such as fruit, vegetables and grains, vegans may not get enough of it.

Read about the vegan diet for nutrition information and advice.

More Cereals High In Vitamin B12

• 251% DV per cup of Kellogg’s Special K
• 250% DV per cup of General Mills Whole Grain Total
• 250% DV per 2/3 cup of Kellogg’s Low Fat Granola
• 250% DV per cup of Kashi Heart to Heart Oat Flakes
• 125% DV per 3/4 cup of Wheaties
• 121% DV per 3/4 cup of Post Honey Bunches of Oats

See the complete ranking of 200 cereals high in vitamin B12.

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What Is Fortified Cereal

Fortified foods contain added vitamins and minerals that arent naturally present in them.

Fortification is meant to improve peoples levels of particular nutrients and is common for foods that adults and children typically eat, such as grains, milk, and juice. Cereal is one of the most commonly fortified foods.

For example, 1 cup of fortified Total cereal boasts 40 mg of iron 100% of the Daily Value .

As the same size serving of an unfortified wheat cereal meets only 10% of the DV, much of breakfast cereals iron content may be due to fortification .

Its important to monitor your nutrient intake, as many people in the United States dont consume enough iron, calcium, or vitamins A, C, D, and E. Deficiencies may lead to negative health effects (

6 ).

However, fortified cereals are not inherently healthy. While some are made with whole grains and high in fiber and protein, others contain almost no nutrients.

For example, Kelloggs Frosted Flakes offers no fiber and only 1 gram of protein per 3/4 cup .

You can tell if a cereal is fortified because the added nutrients will be specified on the packaging. Often, below the ingredient list, theres a list of vitamins and minerals used to fortify the product.

Keep in mind that fortification varies by region. Its more common to find fortified cereals in Western countries .

Eating fortified cereal may help prevent nutrient deficiencies.

Top 12 Foods That Are High In Vitamin B12

Vitamin B12 is an essential nutrient that your body cant make on its own, so you need to get it from your diet or supplements.

Vegetarians, pregnant or breastfeeding women, and others at risk of deficiency may want to track their diets closely to make sure theyre getting enough.

This article lists 12 foods rich in vitamin B12 to add to your shopping list.

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Should You Take A Multivitamin

Foods with B12 are always the first choice, but if you have trouble eating B12-rich foods, or have problems absorbing B12, another potential vitamin B12 source is a multivitamin. In fact, the federal government’s Dietary Guidelines for Americans suggest that people older than age 50 take a multivitamin supplement as a way to ensure adequate B12 intake.

Many store multivitamins contain high amounts of B12. An average brand may contain about 25 mcg, which is more than 400% of the recommended daily value. Check with your doctor to determine if multivitamins is right for you. There is little risk from taking too much B12, however, high amounts may interact with certain medications.

Executive Editor, Harvard Men’s Health Watch

Folate And Folic Acid

Folate is a B vitamin found in many foods. The manmade form of folate is called folic acid.

Folate is also known as folacin and vitamin B9.

Folate helps:

• the body form healthy red blood cells
• reduce the risk of birth defects called neural tube defects, such as spina bifida, in unborn babies

A lack of folate could lead to folate deficiency anaemia.

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What Is Vitamin B12

This water-soluble vitamin has many essential functions in your body.

Its necessary for keeping your nerves healthy and supporting the production of DNA and red blood cells, as well as maintaining normal brain function.

The Reference Daily Intake is about 2.4 mcg but slightly higher for pregnant or breastfeeding women .

Vitamin B12 is absorbed in the stomach with the help of a protein called intrinsic factor. This substance binds to the vitamin B12 molecule and facilitates its absorption into your blood and cells.

Your body stores excess vitamin B12 in the liver, so if you consume more than the RDI, your body will save it for future use.

You may develop a vitamin B12 deficiency if your body does not produce enough intrinsic factor, or if you dont eat enough vitamin-B12-rich foods .

Vitamin B12 is mainly found in animal products, especially meat and dairy products. Luckily for those on vegans diets, fortified foods can be good sources of this vitamin, too (

4 ).

Lamb, veal, and beef kidneys are also high in vitamin B12. Lamb kidneys provide about 3,000% of the DV per 3.5-ounce serving. They also provide more than 100% of the DV for vitamin B2 and selenium .

Summary

A 3.5-ounce serving of lamb, beef, or veal liver contains up to 3,500% of the DV for vitamin B12, while the same serving of kidneys contains up to 3,000% of the DV.

Questions Answered Regarding Vitamin B12

Vitamin B12 is one of the most common topics I get asked about for those interested in a plant-based diet. I think we have a natural tendency to make sure we are getting enough of everything, and vitamin B12 is a legitimate concern for exclusively plant-based eaters, so it causes a fair amount of anxiety.

Because of this, I spent some time reviewing literature regarding B12 when I was writing my book The Campbell Plan, in which I discuss B12, other supplements, and many other hot topics as people transition to a plant-based diet. What youll learn is that B12 certainly need not cause anxiety once you have a little bit of understanding about the vitamin and what you should do to get enough.

Here is a conversation covering the basics. This is my interpretation of the evidence for general knowledge and should not be taken as medical advice. There are many clinical scenarios that might alter the advice below. Please discuss with your doctor.

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Reason For Shortage: Weight Surgery

One of the more common weight loss operations is called âgastric bypass.â After the surgery, food bypasses parts of your stomach and small intestine. Thatâs usually where B12 breaks down into usable form. Your doctor likely will monitor your B12 levels and suggest supplements or shots if you need them.

Fortified And Enriched Foods For Kids

Children are particularly vulnerable to nutrient deficiencies. Without added vitamins and minerals, many children and teens dont meet daily nutrient requirements. Fortified and enriched foods are important sources of nutrients for kids, especially for iron, zinc, and B vitamins.

Unfortunately, many fortified or enriched foods are heavily processed and packaged. They often come with high sodium, fat, and sugar content. Fortification doesnt make them inherently healthy or good for you.

Many younger children are also at risk of overdosing on some added vitamins, according to a report from the Environmental Working Group . The report showed that many fortified foods currently available contain levels of vitamins that arent appropriate for children. Many children may also exceed daily recommended values by eating a variety of fortified foods throughout the day, or by eating more than one serving. Nearly half of children ages 2 to 8 get too much zinc, and 13 percent consume too much vitamin A. These overdoses are potentially dangerous.

• vitamins A, D, E, and C.

Older adults and pregnant women are especially vulnerable to vitamin deficiencies.

People with special diets also need to be aware of potential vitamin deficiencies. Vegans, for example, can benefit from foods fortified with vitamin B-12.

However, adults can overconsume certain vitamins with enriched or fortified foods, especially if they are also taking supplements.

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Vitamin B12 Deficiency: Recognition And Management

ROBERT C. LANGAN, MD, FAAFP, and ANDREW J. GOODBRED, MD, St. Luke’s Family Medicine Residency Program, Bethlehem, Pennsylvania

Am Fam Physician. 2017 Sep 15 96:384-389.

Patient information: A handout on this topic is available at .

• References

Vitamin B12 is a water-soluble vitamin obtained through the ingestion of fish, meat, and dairy products, as well as fortified cereals and supplements.1,2 It is coabsorbed with intrinsic factor, a product of the stomach’s parietal cells, in the terminal ileum after being extracted by gastric acid1,2. Vitamin B12 is crucial for neurologic function, red blood cell production, and DNA synthesis, and is a cofactor for three major reactions: the conversion of methylmalonic acid to succinyl coenzyme A the conversion of homocysteine to methionine and the conversion of 5-methyltetrahydrofolate to tetrahydrofolate.1,2

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Patients with risk factors for vitamin B12 deficiency should be screened with a complete blood count and serum vitamin B12 level.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Vitamin B12 absorption and transport.

Figure 1

Vitamin B12 absorption and transport.

More Dairy Foods High In Vitamin B12

• 108% DV in a 16oz glass of low fat milk
• 96% DV in a 16oz glass of whole milk
• 62% DV per cup of non-fat yogurt
• 38% DV per cup of plain yogurt
• 51% DV per cup of hot chocolate
• 48% DV in a 1/4 cup of buttermilk
• 18% DV per 1/2 cup of soft serve ice-cream

See the full list of dairy foods high in vitamin B12.

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Milk And Dairy Products

Milk can be the answer to many nutritional deficiencies. It not only takes care of your vitamin B12 content, but is also a rich source of calcium and vitamin D. Just one cup of milk gives you 1.2 micrograms of vitamin B12. Another way to load up on vitamin B12 content is to add dairy products in your diet plan. Dairy products such as yoghurt and cheese not only offer you high amount of protein, but they also are a great source of vitamin B12. You can get up to 0.8 micrograms of this vitamin by having a cup of yoghurt.

What Does The Department Of Health And Social Care Advise

You should be able to get the amount of niacin you need by eating a varied and balanced diet.

If you take niacin supplements, do not take too much as this might be harmful.

Taking 17mg or less of nicotinic acid supplements a day, or 500mg or less of nicotinamide supplements a day, is unlikely to cause any harm.

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If You’re Pregnant Or Could Get Pregnant

If you’re pregnant, trying for a baby, or could get pregnant, it’s recommended that you take a 400 microgram folic acid supplement daily until you’re 12 weeks pregnant.

Folic acid supplements need to be taken before you get pregnant, so start taking them before you stop using contraception or if there’s a chance you might get pregnant.

This is to help prevent neural tube defects, such as spina bifida, in your baby.

Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose of 5mg of folic acid each day until they’re 12 weeks pregnant.

This is important and unlikely to cause harm, as it’s taken on a short-term basis, but speak to your doctor first.

Get more advice about vitamins and minerals during pregnancy, including who should take a higher dose of folic acid.