Can a Natural Diet Require Supplements?
by Jack Norris, RD
Some vegans wrote me after reading earlier versions of Vitamin B12: Are You Getting It?, saying that by implying vegans need to take a supplement, I am portraying the vegan diet as unnatural. One person said, "All the vegans I know are healthy and they neither take vitamin B12 supplements nor eat foods fortified with vitamin B12."
It is true that many vegans do not supplement with B12 and remain apparently healthy for many years. These vegans normally have no idea what their homocysteine levels are, nor what chronic diseases such elevated levels might be causing. They also do not know if they are suffering from unnoticeable nerve damage. You are taking a big chance by assuming you have transcended a need for a typical B12 intake.
As people live longer, homocysteine has more years to cause damage to the body. Because of this, the human need for B12 has increased over time. The longer a vegan does not supplement with B12, the lower their active B12 levels will drop, increasing their homocysteine levels.
In Western society today, it is easy to ensure an adequate B12 intake. Vegans who supplement with B12 can have superior B12 status to non-vegetarians who do not supplement. In fact, the Food and Nutrition Board says that all people (not just vegans) over age 50 should "meet their RDA mainly by consuming foods fortified with B12 or a B12-containing supplement."
I would encourage vegan advocates to make achieving superior B12 status for all vegans one of our goals. As such, all new vegans should be told to ensure an adequate supply of B12 by the people or organizations who encourage them to change their diet.