Pernicious Anaemia Society
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B12 deficiency- vegetarian vs normal diet

Hi. Does anyone have any idea what % of people who need b12 injections are vegetarian/ meat eaters? My friend seems to feel that mine and my daughters need for injections is due to our 'poor diet'. We have always eaten diary - daughter not so much. Is there evidence that supports her theory? Or is it just one of those things? My sons dont need injections.

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stats on prevalence of B12 deficiency in different populations seems to involve a lot of conjecture - projecting from small surveys onto large populations doesn't necessarily give accurate results.

dietary deficiency is really rare because the amount o B12 you need is really small. If you are on injections it won't be anything to do with your diet - it will be to do with an absorption problem - a dietary deficiency is easily rectified with smaller oral doses but you have the injections because, regardless of the amount you had in your diet you wouldn't get enough B12

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Hi

I have been a vegetarian verging on vegan for over 20 years and I was identified as b12 deficient over a year ago and had a range of neurological problems. I think that I was getting just about enough b12 in my diet but my doctor put me on omaprezole with 6 monthly repeat prescription. This drug reduces/stops the production of stomach acid - this will cause a deficiency even in omnivores!

Furthermore watch omnivores, especially males, and you will see that they regularly spurn the vegetables in favour of the meat and it is my view that they are often folate deficient without which b12 cannot be absorbed.

Make sure you and your family have foods with b12 added - Alpro milk, yoghurt etc does and so do the majority of breakfast cereals.

Chris

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B12 does not need folate to be absorbed.

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however, a lot of processes that use B12 also use folate so the processes won't run properly without sufficient B12 - not absorption but low folate will affect the metabolisation of B12.

Alfabeta the indicidence of dietary folate deficiency tends to be quite rare because so many foods are fortified these days.

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Thank you for correcting my mistake. Folate is mentioned so many times that I understood that, if folate deficient, one could develop b12 deficiency - is this not the case?

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No, it's not.

Both B12 and folate work together in one particular metabolic process - the conversion of homocysteine to methionine. The latter is an amino acid used in several processes.

If there's not enough B12 or folate in the cell then homocysteine levels will increase. High hCys can cause many symptoms commonly seen with B12 deficiency.

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I posted about this some time ago, but got shouted down. Here's what I said...

The NHS recommends 1.5 ug a day. The Mayo clinic recommends 2.4 ug a day.

One egg contains about 0.4 ug. 50 g of cheddar also contains 0.4 ug. So a 2-egg cheese omelette contains 1.2 ug of B12, half that recommended in America. And you've got to eat one of them every day.

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Don't you love our era of evidence-based medicine?

On the basis that pretty much the same evidence is available in the UK and the USA, how do they manage to come up with such different requirements?

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No vegetarians are likely to eat a 2-egg cheese omelette daily, so all of them should end up B12 deficient fairly rapidly, once liver store depleted.

And even if they did, they are daily 0.3ug short of the NHS recommendation, so will eventually be B12 deficient anyway.

Does this sound right to you ? Me neither.

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