Did my veggie diet cause my b12 issues?

Hi. I have been having b12 injections for 3 years, my daughter also. I am worried that I caused this condition to happen to myself and to my daughter, and that I might cause it to happen in my youngest son. But she is the middle child (17 years) of 3 (the boys don't seem to have any signs of deficiency) yet they have always had basically the same diet (the eldest is 19 and does eat meat these last few years; the 10 year old won't touch meat.)

To be fair I have always eaten a lot of eggs, cheese, and milk in tea etc, (not so much my daughter though) so is it something that would have happened anyway? I know meat eaters who have the injections so perhaps I didn't cause it ?

I read yesterday that the contraceptive pill can deplete b12, is it possible that during the 25 years of taking it had an effect and caused me to be unable to absorb?

Thanks to anyone who can shed some light.

31 Replies

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  • Yes, it is quite possible that your diet has caused B12 issues, despite eating eggs, milk and cheese. Here's something from a post earlier this week -

    30g of cheddar contains about 0.2 ug of B12. 1 egg contains about 0.5 ug of B12.

    20ml of milk contains about 0.1 ug.

    The NHS recommends 1.5 ug a day. In the US it's 2.4 ug a day. That would mean eating a 4-egg cheese omelette every single day - with extra cheese, plus two milky teas.

    The good news is, if it is due to diet, then you may not need the injections. If you're worried about your children then just give them a B12 tablet every week/month depending on the amount. A 1000 ug tablet every 30 days will give them more than they need.

  • OK Thanks - interesting to hear how high the figures are as to how much is needed. Yes I will do that with the supplements. My b12 does go down every few weeks before the injection so I assumed from that that I couldn't hold on to the b12. But from what you are saying if I consistently don't eat enough/take enough b12 then of course it would keep going down. ok Thanks a lot. :)

  • In most people B12 can be recycled. It goes out in the bile and reabsorbed lower down the intestine. But that only works if you make Intrinsic Factor and dont have any other absorbtion prblems. . The fact that you dont seem to be very good at recycling probably means you do need the jabs.

    But your children could well be different.

  • when I make a cheese omelette I would generally use at least 2 eggs and probably quite a bit more than 30g of cheese.

    Many breakfast cereals are fortified with B12. Whilst vegetarians may run a higher risk of B12 deficiency if they aren't monitoring and supplementing their B12 intake that is a long way from saying that vegetarianism will even be a probable cause of a B12 deficiency. Absorption problems are much more common and they will happen regardless of whether you are vegetarian or not.

  • Without the intake of additional B12 (from supplements or fortification) the incidence of B12 deficiency in vegetarians is quite high.

    ncbi.nlm.nih.gov/pubmed/233...

  • the abstract fails to provide any relative figures for vegans v vegetarians.

    The abstract mentions taking measures to ensure adequate intake of B12 - something I wouldn't disagree with and I regularly nag colleagues and friends who are vegetarian to ensure that their B12 intake is adequate, which could include taking supplements

  • that does make me feel better :)

  • Ok thank you . :) In your opinion would you think it's worth asking the dr. to test whether it absorbtion or intrinsic factor?

  • Hi,

    link about causes of b12 deficiency

    b12deficiency.info/what-are...

    Has pernicious anaemia (PA) been ruled out?

    PAS website

    pernicious-anaemia-society....

  • My goodness that is an interesting website - no pa hasn't been tested for. do you think it is worth being checked for?

    thanks for you input :)

  • Yes, I think it's worth checking for PA. People can have more than one cause of B12 deficiency at the same time.

    The IFA (intrinsic Factor Antibody) test can help to diagnose PA but the test is not always reliable. It is still possible to have PA even if IFA test comes back negative(known as Antibody Negative PA).

  • oh thanks!

  • It is possible to stay well/optimally fed on a veggie diet, but its a lot more difficult than when you eat meat. Eggs help if you were eating them.

    Overall I wouldn't blame yourself too much. Statistics used to show that vegetarians lived longer although that is a bit of a blunt instrument. Vegetarians do tend to eat more fresh fruit and veg, and less ready made food. If you lived on frozen (veggie) pizza I might judge you a bit more harshly, but I bet you didn't! We do the best we can, and its basically luck if it happens to be healthy for us as an individual. Apparently 10% of the population can live on a high carb low fat diet, but it nearly killed me!

    I know its difficult for a veggie but the most important animal thing to eat is liver! I find the various guidelines really difficult to follow. But I do eat oily fish three times a week, as long as you include sardines in a tin. And I eat liver once a week. I can give you some recipes if you like. On a keto diet there is no way I can eat 10 portions of fruit and veg but I feel so fantastic that it has to go. Its probably a good recommendation for people who live on convenience food and takeaways, and judging by how much space 'junk' food occupiess in the supermarket that must be most of the population.

  • hi. thanks. so do you need b12 supplements if you are eating all that meat/fish?

    I am still veggie and do eat pretty healthily, which is why it's frustrating to be deficient in things. Oh well, great to hear other peoples experiences. :)

  • Some people, even those without pernicious anaemia, can have trouble absorbing B12, whatever they. It occurs particularly in people who have unusually low stomach acid, but sometimes seems to happen for no obvious cause.

    We do the best we can, and then its just down to luck!

  • Whenever I mention I eat liver people react in horror (not vegetarians I may add) Yet it was the original treatment for PA (raw!) - I'll see if I can find that old 1930s film....

    My V daughter sprinkles B12 yeast over her meals & takes supplements occasionally too.

  • I also eat kidneys! And marrow if I can get it, they mostly feed it to dogs, of course.....

    The thing about liver is that it's not just iron/B12 but also ceruloplasmin which helps us regulate copper. SUCH good stuff, and increasingly difficult to get.

    Not much use B12 wise if you have PA of course.

  • I like most offal too - somehow satisfying, & fish. Interesting about copper - too much associated with low zinc - low zinc & no sense of smell - which I now find saddening (was very annoying).

    but mostly annoyed that I can't find the 1930s film experiment with raw liver,

    can't remember where it is now - & not on youtube it seems.. grr! :( anyone saved it?

  • OK - thanks ;)

  • I've been mostly vegetarian for 25 years. My B-12 deficiency was from intrinsic factor antibodies, which is basically an autoimmune reaction that destroys a substance that the body needs to absorb B-12. Having Intrinsic Factor Antibodies is considered 'diagnostic' for pernicious anemia, although I personally never had anemia. So, no matter how much B-12 I ate, it wouldn't matter because I could not absorb it. (To be absolutely precise, people with intrinsic factor antibodies can actually absorb 1% of B-12 through passive absorption but unless I ate 100x the amount of a normal diet, it wouldn't matter how much I ate).

    A funny thing about me is that, back when I decided to become a vegetarian 25 years ago, I specifically read about vitamin deficiencies and this was part of the reason why I do allow myself certain fish, plus eggs and cheese -- all high sources of B-12. By the way, shell fish like oysters and shrimp are especially high in B-12. I have strictly avoided beef, pork, and chicken including things like broth, gelatin, etc.

    A lot of people look askance at me when they hear about my B-12 deficiency, because they think I did it to myself with the vegetarianism. I can't find much of anything on what causes the body to make Intrinsic Factor Antibodies. So far in my reading, I don't think I could have done it to myself.

  • thanks for your info. Just out of interest how old are you and when (ish) did you notice you had a problem being unable to absorb b12? I am 50, have been veggie since age 21, I was only noticing a problem since I was 46 (coincidently coinciding with my unexpected 26 yr marriage break-up in 2013, which was what I originally thought was the cause of my exhaustion) . I wonder if the trauma of the breakup had anything to do with it? Everything physically was fine until 2013; then the sh@t hit the fan and I got very low - hey presto had the b12 thing going on all of a sudden. Total coincidence possibly, but also almost to much of a coincidence...

  • I'm 40, and I was just diagnosed last year. The B-12 very quickly cured what I previously thought was a mental health problem which I had for 4 years. I actually thought I had something along the lines of late onset ptsd. I could barely remember new things from one minute to the next, yet old bad memories from childhood seemed like yesterday. So I definitely believe I had it for at least 4 years. But actually, looking back, I think I had at least a slight deficiency for most of my life. I've always felt a little clumsier and more bulbous than others, even though from the outside people think I'm pretty fit and don't notice. I definitely think stress or trauma could deplete your B-12 and bring a deficiency to the fore.

  • thank you for your response. Out of interest how long into your veggie diet did you realise you had b12 issues?

  • I've also read that the contraceptive pill depletes B12. I've been on it for 20 years, so am thinking that maybe that is the reason for my deficiency.

  • I have since read that this idea is a falicy; but who knows what is right/wrong? I would be interested to see haw many other ladies have been on the pill and then had this issue.

  • The oestrogen only pill is mentioned as being a reason for lower B12 results in the B12 and folate deficiency treatment guidelines: pernicious-anaemia-society....

  • I wouldn't beat yourself up.

    If you are on injections and have problems with intrinsic factor then being vegetarian might have accelerated the problem but it certainly won't have caused it.

    A lot of breakfast cereals are fortified with B12 (think about 1/4 of RDA) and there are a lot more than eggs and cheese to get B12 into a vegetarian diet.

    PA - the most common absorption problem does seem to have a genetic component so more likely to be that coming to the fore. Testing might be an idea but remember that the IFA test is notoriously prone to false negatives (40-60% of the time depending on the assay method) so a negative doesn't rule out PA as the problem.

  • thank you

  • Hi

    There are may reasons why people can become B12 deficient Pernicious anaemia, diet, absorbtion problems due to crohns, coeliac, stomach or intersinal surgery, medications (metformin, PPIs, the pill), and various others. Diet is only 1 possible reason.

    It is perfectly possible to get enough B12 from diet alone as a veggie. Dairy and eggs are a major source but there are many other fortified sorces too such as cereals, some spreads and others. vegsoc.org/B12 It just takes a little more thought than tucking into a chunk of meat but is very managable! You could also ask your GP to refer you to a dietician if that would help? They may be able to help you to feel more confident that you and your family's diet is meeting your needs if you are still feeling a bit worried. :-)

    My whole family is veggie and has been since I was a child. I only developed a B12 deficiency as a result of pernicious anaemia (my mum too although she is anti-Intrinsic factor antibody negative). My brother got checked after my mum and I were diagnosed and is absolutely fine with a B12 mid range and has no symptoms. Dad is fine too... In our family it seems to be down to genetics... *shrug*

  • These may help too:

    bda.uk.com/foodfacts/vegeta... (the 1st page won't load properly in firefox for me but is fine in other browsers)

    lnds.nhs.uk/Library/Vitamin...

  • thats so interesting that the boys in your family (as in mine) seem to be OK?

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