B12 Status: Raw Foodist Vegans

Summary: Raw foodist vegans' B12 status appears to be no different than other vegans. There is some evidence that some probiotics (supplements of intestinal bacteria) could improve B12 status to a small degree.

Letter from a Raw Foodist Vegan

April 24, 2003

Someone gave me a hard copy of your Vitamin B12: Are You Getting It? (06 2000). I wish I had had all this information when I developed a severe B12 deficiency (macrocytic anemia & peripheral neuropathy) about 8 1/2 years ago due to a dietary deficiency of this vitamin. This was the hospital consultant's diagnosis. I had been a raw food vegan for many years before I developed the B12 deficiency symptoms.

- A.K., London, UK

Hallelujah Acres Diet

Donaldson,¹ (2000, USA) studied people following the Hallelujah Acres diet, a vegan diet consisting mostly of raw foods with small amounts of cooked whole grains and root vegetables.

Subjects in the study did not take B12 supplements. Some ate small amounts of nutritional yeast resulting in an average intake of 5 ± 11 µg B12/month, with a median intake of .7 µg/month. Results are in the table:

Results of Donaldson¹
	Number
Total	49
sB12 < 347 pg/ml	44
sB12 < 200 pg/ml	6
sB12 < 160 pg/ml	0
uMMA ≥ 4 µg/mg creatinine	23
sB12 - Serum B12

19 subjects had normal sB12 levels with elevated uMMA levels. Subjects with elevated (and one with borderline) uMMA were divided into four groups to receive different treatment:

1. Sublingual B12: 500 µg Twinlab sublingual B12 3x/wk.
2. Nutritional yeast: 5 µg B12/day via 1 tablespoon of Red Star Vegetarian Support Formula nutritional yeast.
3. Probiotic Formula intestinal bacteria: 2 capsules/day which contain 5 bacteria species:

Lactobacillus plantarum
Lactobaccillus salivarius
Lactobacillus acidolphilus
Bifidobacterium bifidus
Bacillus subtilis

4. Flora Food intestinal bacteria: 2 capsules/day which contain 2 bacteria species:

Lactobacillus plantarum variant OM
Lactobacillus salivarius

The results after 3 months were:

Results of treatment in Donaldson¹
	Sublingual B12	Nutritional yeast	Probiotic Formula	Flora Food
Total number	8	8	4	4
uMMA ≥ 4.1 µg/mg creatinine after 3 months	1 (uMMA = 4.1)	5 (all improved)	4 (3 improved)	4 (1 improved)
uMMA - Urinary Methylmalonic Acid

Donaldson suggests that the small improvement from taking intestinal bacteria could be from:

The bacteria producing B12 while still in the supplement.
The bacteria taking up residence in the digestive system and producing B12.

In either case, these probiotics were not enough to normalize B12 status and are not recommended for vegans to rely on in improving their B12 status.

Living Food Eaters in Finland

Rauma et al.² (1995, Finland) examined the B12 status in long-term adherents of a strict, uncooked (raw) vegan diet called the "living food diet." They assumed their large intake of bacterially fermented foods (about 2 kg/day in this study) would provide plenty of B12 as well as modify their intestinal bacteria to provide more B12.

In Part 1 of the study, food consumption data were collected and blood samples were taken from 9 vegan "living food eaters" (LFE) (1 male, 8 females), 2 years apart. Six of the 9 vegans showed slow, consistent deterioration of B12 status over this period, indicating that the supply of B12 from the "living food diet" was inadequate to maintain the sB12.

In Part 2, sB12 of LFE were compared to nonvegetarians. Blood values (MCV, hemoglobin) of LFE did not differ significantly from the nonvegetarians' nor did they correlate with B12 levels. In the vegan group, B12 analogue intake (through nori and chlorella) correlated with sB12. Results were:

Results of Rauma et al., Part 2²
	#	sB12 (pg/ml)	< 203 pg/ml
LFE	21	261^A R: 47-551	6
consuming seaweed	16	298 R: 101-551
not consuming seaweed	5	142 R: 47-340
NV	21	420^A R: 177-651	1
A – Statistically significant difference between groups with same letters LFE - Living Foods Eaters NV - Non-vegetarians R - Range

The Finnish eaters of the living food diet participating in this study started to supplement their diet after finding out their low vitamin B12 status.

Natural Hygiene Society Conference

Dong & Scott³ (1982, USA) examined 83 subjects from an American Natural Hygiene Society conference. They tended to follow natural hygiene diets consisting of whole raw fruits, vegetables, nuts, and seeds, with a minimal intake of grains and legumes. They considered this to be a natural primate diet and believed their bodies received B12 through small intestinal bacteria which live only in the intestines of those who follow whole raw food diets. The table below shows the results among subjects who did not supplement with B12.

Results of Dong & Scott³
	#	sB12 < 200 pg/ml	sB12 < 100 pg/ml
Vegans	13	92%	53%
LV	28	64%
LOV	15	47%	13%
SV	10	20%
LOV - Lacto-ovo-vegetarians LV - Lacto-vegetarians SV - Semi-vegetarians

Macrocytic anemia among the vegetarians was minimal. One 63-year-old vegan with a B12 level of 117 pg/ml had a nerve-related disorder. For males who did not take B12 supplements, there was a correlation between length of time as a vegetarian and lower B12 levels. Among subjects who had taken B12 or multivitamins, all had B12 levels above 200 pg/ml. Dong & Scott concluded that there is no indication that natural hygiene vegetarian diets contribute to higher B12 levels than other vegetarian diets.

Notes for Raw Foodist Vegans and B12

1. Donaldson MS. Metabolic vitamin B12 status on a mostly raw vegan diet with follow-up using tablets, nutritional yeast, or probiotic supplements. Ann Nutr Metab. 2000;44(5-6):229-34. And personal communication with author Jan 31, 2002.

2. Rauma AL, Torronen R, Hanninen O, Mykkanen H. Vitamin B-12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised. J Nutr. 1995 Oct;125(10):2511-5.

3. Dong A, Scott SC. Serum vitamin B12 and blood cell values in vegetarians. Ann Nutr Metab. 1982;26(4):209-16.