Vegetarian / Vegan Diet and B12 Deficiency

Sources of B12 (hope you’re not vegan)

Tell someone you’re a vegetarian (or vegan) and the first thing they will say is, “That’s nice, but where do you get your protein from?”  Yeah… that’s the main question among carnivores.

Forks Over Knives and this article explain the simple truth that as long as you are eating enough calories on a whole foods, plant based diet, then you are getting enough protein.  Period.

The real question they should be asking you (and you should be asking yourself) is, “Where do you get your B12 from?”.  The reason is that B12 (for the most part) can only be found in… that’s right, animal products.  Whomp whomp! 

But let’s rewind a little bit…  After being an on-again / off-again vegetarian for the past few years, in November I made the commitment to go full vegan.  I immediately dropped what little excess weight I had, my nasal congestion cleared, and overall I just felt… better.  That was nine months ago and things were going great, so I thought.

Then in May when I was approaching my next full marathon I started to noticed some things.  Things I didn’t like.  Things that freaked me out!

The first symptom was fatigue.  It wasn’t a “I can’t get out of bed in the morning” type fatigue, but my runs began to feel very taxing.  In fairness, I was at the tail end of an 18 week marathon training program and was running 50+ miles per week.  I shook it off and thought it was normal for the training.

Second, my hair started to fall out!  Not in huge chunks or anything, or even enough for people to notice, but enough for me to be concerned.  I’ll be honest, this one upset me.

Then on race day (it didn’t go well, don’t ask) at around Mile 22 both of my arms began to radiate numbness and tingle.  It almost felt like they were being electrocuted.  And even weirder, I could feel my heartbeat pulsing though my arms.  Not cool.

Obviously these seemed like legitimate symptoms so I did some research and B12 deficiency seemed like the culprit.  This article in particular provided a lot of useful information.  It also freaked me out even more.  Upon reading that prolonged B12 deficiency can cause permanent neurological symptoms (yikes!), I scheduled a doctor appointment / blood test.

Guess what the blood test revealed.  You guessed it!  A B12 deficiency!  In the U.S. doctors suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL.  In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL (the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss).  My level was 170 pm/mL. 

So the doctor’s plan was for me to get monthly B12 injections for three months.  This was to get my levels up to an “acceptable level” and then I could maintain that level with a B12 supplement.  My doctor suggested under the tongue drops like these.  Apparently these are more readily absorbed than pills.

I also researched how vegans can boost B12 levels though diet alone.  They aren’t many options out there, but the one thing that kept coming up was nutritional yeast.  Nutritional yeast is basically flakes that you can sprinkle on salads, soups, etc… to boost the B12 content of your meal.  Scott Jurek even has a “Buttery” Omega Popcorn recipe in his new book Eat and Run that uses nutritional yeast and its quite delicious!

I haven’t had another blood test yet (I’ll keep you all updated), but I have had three injections and been taking the drops everyday for a month.  I have to say, I feel much better!  My energy is back and my hair isn’t falling out anymore!  Also my arms don’t feel like they have lightening running through them! 

As a vegetarian (for me anyways) it was very easy to get enough B12.  I would eat dairy often to compensate for not eating meat.  Whole wheat pizza, burritos, mac and cheese, eggs, milk… it all tastes so good!  Once you go vegan though, all that stuff goes bye bye.  That’s where I got into trouble.

Be careful out there and keep an eye on your B12 intake!