Thanks, Matt.

Can I clone you? :O)

Are you suggesting that all vegans need a regular B-12 injection to avoid a deficiency? Because the literature and the experiences of hundreds of thousands of vegans around the world say differently.

Ho, C., et al. Journal of the American Dietetic Association. V 99, I 6, P 725-727, 1999.

This article (and the references therein) indicates that even if you have protein-bound B-12 malabsorption, dietary supplement B-12 (i.e. all vegan sources of B-12) are not affected by this. The abstract from the above article:

"In response to research findings that 10% to 30% of people aged 51 years and older may have protein-bound vitamin B-12 malabsorption, the National Academy of Sciences’ Institute of Medicine recommends that these people consume a majority of the new Recommended Dietary Allowance (RDA) of 2.4 μg/day in its synthetic form rather than in its food form. Protein-bound vitamin B-12 malabsorption in older adults has been attributed to reduced pepsin activity and gastric acid secretion, which interfere with cleavage of vitamin B-12 from dietary protein before absorption. Unlike patients with pernicious anemia, most people with protein-bound vitamin B-12 malabsorption produce intrinsic factor and have the ability to absorb synthetic vitamin B-12 normally. Early diagnosis is necessary to prevent the untoward effects of vitamin B-12 deficiency. A thorough assessment of vitamin B-12 status entails measurement of multiple biochemical assessment indexes, including serum vitamin B-12, methylmalonic acid, and homocysteine concentrations. Dietitians and other health care professionals should be aware of the prevalence of vitamin B-12 deficiency in older adults and be familiar with sources of synthetic vitamin B-12 to facilitate implementation of the new RDA. J Am Diet Assoc. 1999;99:725-727."

Stomach acids are only needed to cleave the B-12 from the protein to which it is attached if you're getting your B-12 from animal products. Synthetic B-12 is not protein-bound, so stomach acidity has no effect on its absorption. The parietal cells of the stomach produce the intrinsic factor which is needed to bind to the B-12 in the small intestines so that it may be absorbed into the blood stream. The parietal cells produce both intrinsic factor and gastric acid, but lower acid production does not necessarily translate to a deficiency in intrinsic factor. Sounds like you may just have pernicious anemia.

en.wikipedia.org/wiki/Pernicious_anemia

Perhaps you should get a better grip on the topic before spouting a bunch of half-information?

(Sassy here. Please excuse my name and photo at this time -- I'm in the midst of a joke on another tribe.)

Andrew, I was thinking about NOT replying to your post. First of all because it's just completely rude. And 2nd because it's filled with inaccuracies.

I'm very sorry you had trouble with your stomach acid. "Vegan" doesn't automatically mean troubles with intrinisic factor. I'm vegan. I've been vegan for 14 years. I don't have any problems with intrinisic factor. My husband has been vegan for the same amount of time. He doesn't have problems with intrinisic factor. In fact, I would bet the MAJORITY of vegans don't have problems with their intrinisic factor.

When writing for the general public, it's quite difficult to cover every single solitary physical issue they might have. Which is the reason for my qualification at the end of the article:

"Note: The above information is the general rule for MOST people. This does not include pregnant or nursing mothers, those with digestive disturbances (like Krohn's disease), or those who take some very specific prescription drugs. Be sure to check with your physician to ensure you're getting the B12 you need."

I found your choice of quotes interesting:

"Since efficient absorption of vitamin B12 in humans depends on intrinsic factor, diseases which decrease the secretion of intrinsic factor (e.g. atrophic gastritis), interfere with cleavage of the binding proteins (e.g. pancreatic exocrine insufficiency) or decrease binding and absorption of the intrinsic factor-vitamin B12 complex (e.g. ileal disease or resection) can result in this type of anemia. "

This has nothing to do with Vegans. This has to do with people who have diseases which decrease the secretion of intrinsic factor.

When one eats animal products, the B12 is attached to a protein. Stomach acids and enzymes help to break this protein down so the B12 becomes available.

In those who don't eat animal products, the B12 we ingest (found in supplements, B12 fortified nutritional yeast, etc.) isn't attached to a protein therefore these same stomach acids and enzymes aren't needed for the B12 to become available. This is called passive diffusion. And for those who have intrinsic factor defects (such as, I believe, you may have) this passive diffusion can actually provide the B12 you need if you take enough of it. Apparently, you weren't providing your body with what it needed.

So please, don't sit here and spout off all YOUR (mis)information in an attempt to scare Vegans.

The rest of your post is filled with slander. I wonder if that's allowed here on Tribe?

You know why talk of B12 makes me sick? Because I NEVER not one time, NEVER, gave any vitamins any thought before I was a vegan and ate like a garbage disposal.

I really resent people over and over and over, without my asking, warning me of the dangers of vitamin B12 deficiency one millisecond after they learn I'm a vegan. Where were all these helpful nutritional experts when the only vegetables I ate were breaded, deep friend, and came with ranch dressing or ketchup? Why don’t they hang out in front of the Carl’s Jr. and help those people?

Hi Andrew...

I am, and have always been, an informational sponge and would never turn my nose up at any information anybody shares with me, no matter what the topic. I appreciate you taking the time to share this information with us as I'm quite sure your intentions are good. I'd like to go through it now...

"Just the facts this time...*Note this is not directed at vegans specifically. B12 deficiency can inflict vegans, vegetarians, Fruititarians, macrobiotic, and carnivores without discrimination.*"

Andrew, you say things like this, but then further into your post nearly all of your evidence is directed at vegans. It's things like this that lead me to believe that, in fact, you are directing your posts at vegans. As you can see, others have since responded to your post with negative comments because it's just so apparent that you're directing your comments at us. And that's cool. But just be honest with us, man.

"This is meant to inform, not scare, and I hope the blame the victim rhetoric ("you failed to nourish yourself properly") can be replaced with factual information."

The "blame the victim rhetoric" came about due to hurt feelings that were caused with your derogatory statements against my website, which in all practical purposes is my baby. I apologize if I didn't let your comments sit with me long enough to avoid making a derogatory statement myself. It can be tough out here to work so hard to get information out to my fellow vegans (and non-vegans) for absolutely no monetary gain (I think the most I made with Adsense was 30 cents in one day). I use Adsense to TRY to offset the costs of building this site. I hope that the hours I spend each and every day will pay off some day, but until then it's just 100% a labor of love. I think it would be helpful if we can all be just a little more careful with each other's feelings. I'll sure do my best.

Andrew, I agree that B12 is an extremely important topic. And it CAN be tricky for vegans who don't supplement their diet with B12-fortified foods and supplements. The simple fact that we don't eat animals and their feces, and plants that are covered in dirt (well, the majority of us eat very clean veggies) means that we're not getting the B12 naturally from our food. We MUST supplement our diets with B12-fortified foods and supplements. Any vegan who isn't taking care to get their B12 from somewhere could be in big trouble down the road. It's a very serious topic, and one I don't take lightly.




"-Low stomach acid will promote B12 deficiency, regardless of quantity of ingested B12."

This is only partly true, depending on where you're getting your B12 from. If you're relying on animal proteins to supply your B12, and you don't have the acid in your tummy to release the enzymes necessary for B12 absorption, then you could be in trouble. If you DON'T rely on animal proteins, and instead are relying on B12-fortified foods and supplements, you don't need these stomach acids in order to move things along..

From Wikipedia (en.wikipedia.org/wiki/Vitamin_B12): "The human physiology of vitamin B-12 is complex, and therefore is prone to mishaps leading to vitamin B-12 deficiency. The vitamin as it occurs in foods enters the digestive tract bound to proteins, known as salivary R-binders. Stomach proteolysis of these proteins requires an acid pH, and also requires proper pancreatic release of proteolytic enzymes. (Even small amounts of B-12 taken in supplements bypasses these steps and thus any need for gastric acid, which may be blocked by antacid drugs)."





"-B12 shots or oral B12 sprays are technology to embrace and can benefit a lot of people, not just vegans."

I agree. And I don't think any of us have ever disputed this fact, have we? However, it's interesting to note (en.wikipedia.org/wiki/Vitamin_B12): "Injection is sometimes used in cases where digestive absorption is impaired, but there is some evidence that it may not necessary with modern high potency oral supplements (such as 500 to 1000 mcg or more). [27][28] These supplements carry such large doses of the vitamin that the many different components of the B-12 absorption system are not required, and enough of the vitamin (only a few mcg a day) is obtained simply by mass-action transport across the gut. Even pernicious anemia can be treated entirely by the oral route."





"-sprinkling a little nutritional yeast on your food may make it taste better, but it will not prevent B12 deficiency (nutritional yeast is fortified with B12, the B12 in nutritional yeast is the same stuff you get in pills) (Ref: www.worldclassnutrition.com/nutrit...l.html) AND nutritional yeast is often cultured on honey, not even VEGAN.

The nutritional yeast you choose MUST be fortified with vitamin B12 (such as that provided by Red Star). Not all nutritional yeasts are created equally. Most nutritional yeast is NOT cultured on honey, my friend, it's usually grown on molasses -- (www.bulkfoods.com/yeast.htm): "Red Star� nutritional yeast is an excellent source of protein, dietary fiber, vitamins and minerals. Lesaffre Yeast Corporation derives its primary grown nutritional yeast from pure strains of Saccharomyces cerevisiae grown on mixtures of cane and beet molasses." I would go so far as to say that nearly all nutritional yeasts are vegan.






"Point 1: Reduction in stomach acid promotes B-12 deficiency.
A reduction in gastric (stomach) acids is associated with the development of bacterial colonies in the stomach that produce analogues of vitamin B-12, which can accelerate or promote B-12 deficiency. From Herbert et al. [1984, p. 164]."

Note the words "can accelerate" which is not, in fact, a fact. It is dependent on the individual. We are all different and we all must be vigilant when it comes to our own health.





"Point 2: What causes hypochlorhydia or achlorhydria (low or no stomach acids)?
-Low Protein Diets
-Age over 50 years
-Overeating of carbohydrates
-Zinc and thiamine deficiency
-Oral Contraceptives
-low estrogen levels (i.e. menopause)
-Drinking alcohol with meals
-Smoking marijuana
-Stress
-Food intolerance, especially soya
-Predisposing factors such as anemia, auto-immune disease, hyperthyroidism, IBS, Crohn's disease"

Thank you for including this list of what can cause low stomach acids. It can be very helpful for both vegans and non-vegans alike.





"-B12 injections are very beneficial for B12 deficient vegans and a wide swath of people, even lacto-ovo vegetarians and carnivores. Your not a loser or vegan failure if you choose to protect yourself from B12 deficiency."

Agreed.





"-B12 deficiency may not show up for 5-20 years."
Agreed.





"B-12 levels in long-term vegans. Bar-Sella et al. [1990] examined the serum B-12 levels of 36 strict vegans who had followed the diet long-term (5-35 years). The vegans had an average serum B-12 level of 164 pg/ml; the control group (standard Western diet) had an average serum B-12 level of 400 pg/ml. The difference between the two groups was significant at the 0.001 level. 26 vegans (from a sample of size of 36, i.e., 72.2% of vegans in the sample) had B-12 levels below 200, the lower limit of the normal range [Bar-Sella et al. 1990, p. 310]. None of the vegans displayed hematological defects (i.e., signs of anemia); however, 4 vegans with B-12 levels below 100 had neurological symptoms. Three of the four (with neurological symptoms) were followed, and they all showed clinical improvements in symptoms after intramuscular (injected) vitamin B-12 supplementation."

Andrew, this study doesn't really tell me much. 36 strict vegans? I'm sorry, that's just not a very big chunk of us. I would have to learn about their backgrounds, genetics, supplementation, etc. -- this little slice of the pie only supports your argument that injections of B12 can help. I don't think any of us have ever disputed this fact, have we?





"Intrinsic factor is ABSOLUTELY NECESSARY to absorb ingested B12
en.wikipedia.org/wiki/Intrinsic_factor"

Andrew, as in a previous post, I'd like to point out to you that we're speaking about two different B12s, you and I. The B12 you're referencing is the kind found naturally in food. The B12 I'm referencing is that found in B12-fortified foods and supplements.

From Wiki (en.wikipedia.org/wiki/Vitamin_B12): "Plants only supply B-12 to humans when the soil containing B-12-producing microorganisms has not been washed from them. Vegan humans who eat only washed vegetables and have minimal intake of feces, must take special care to supplement their diets accordingly. According to the U.K. Vegan Society, the only reliable vegans sources of B-12 are foods fortified with B-12 (including some plant milks, some soy products and some breakfast cereals) and B-12 supplements.[21] Fortified breakfast cereals are a particularly valuable source of vitamin B-12 for vegetarians and vegans.

While lacto-ovo vegetarians usually get enough B-12 through dairy products, it may be found lacking in those practicing vegan diets who do not use multivitamin supplements or eat B-12 fortified foods, such as fortified breakfast cereals, fortified soy-based products, and fortified energy bars. Claimed sources of B-12 that have been shown through direct studies[21] of vegans to be inadequate or unreliable include, laver (a seaweed), barley grass, and human gut bacteria. People on a vegan raw food diet are also susceptible to B-12 deficiency if no supplementation is used[22].

However, the more alkaline intestines of vegans[citation needed] are better able to metabolize hydroxocobalamin, a more efficient cobalamin than cyanocobalamin.

For the much lower amounts of B-12 found in food sources [note from Sassy: "food sources"] , however, oral absorption is complex and requires stomach acid and also specific intestinal transport proteins (intrinsic factor) produced in the stomach. Lack of function in these systems is the causes of much of the increased risk in many elderly persons who develop B-12 deficiency later in life. However, it can be treated with a simple high dose oral B-12 supplement. "





"Intramuscular injection of vitamin B12 will create a high concentration of B12 in your blood which drives the B12 into the cells, where it can work its magic. Many naturopathic doctors who have more than a correspondence school degree regularly give injections of B12 in excess of 1 milligram (not a typo). It is water soluble so the worst problem is that you will urinate the excess."

Agreed. I don't think any of us have ever disputed that intramuscular injections of B12 can be helpful to those suffering from B12 deficiency, have we?





"What part of this peer-referenced, evidence based, NON BIASED, info don't you understand?"

Perhaps we can come to an agreement that we'll all stop comments like this, and others in this thread (and this Tribe), that we likely wouldn't say if we were face to face?

With much respect to all,
Sassy