Introduction
In the last two posts about Vitamin B12 I covered everything from B12 testing to reasons for B12 deficiency to B12 reference ranges. In the final post, I’ll discuss where B12 actually comes from, addressing too much B12 and end of with my final thoughts.
Vitamin B12 Origins
There’s a common misperception that B12 comes from animal products whereas this is not the case. No animal, plant, or fungus can synthesize Vitamin B12. Only certain single-celled organisms—bacteria and archaea—have the enzymes required to build this incredibly complex molecule. These include Ruminococcus species, Bacillus megaterium and Klebsiella species amongst others. Primates do contain some these organisms in our gut which is why we make scant amounts of B12 – but not enough to use for our biological processes.
We have been identifiable human for the past 200,000 to 300,000 years and for most of that history we were eating little to no meat at all because of our primate herbivorous/omnivorous nature. So the question arises where did we get our B12 from, if we make so little internally? The answer is that prior to industrialization which then led to sanitation, we got B12 from everywhere in nature. B12 was abundant in the natural world. It was in the water, the soil, on our vegetables – basically everywhere, because these B12 producing bacteria were everywhere in the natural world. But we started sanitizing our water in the late 1800s to prevent cholera and other deadly outbreaks, so we also inadvertently killed copious amounts of our B12 producing bacteria and archaea. The same happened with our soil due to our crop lands losing microbial diversity with the over use of pesticides and herbicides, etc. Now you won’t find naturally occurring B12 in our water or food.
We get sanitized water and food free from nasty viruses and bacteria, but one of the costs has been our friendly bacteria. We solved one problem and introduced another.
This means we need to get B12 from other means, and it’s interesting to note that even livestock get B12 supplementation.
Too much B12
Since we’re now living in an era where we don’t get B12 easily from the natural environment we supplement B12; either via direct supplementation, or via eating meat or via fortified foods. This means there’s there possibility of getting too much. Your body should be able to excrete out the excess because B12 is a water soluble vitamin, however I have heard of too much B12 causing lung cancer after extended use – I thought this might be worthwhile mentioning.
In the 2021 study “The association between dietary vitamin B12 and lung cancer risk: findings from a prospective cohort study” it was found that higher intake of dietary vitamin B12 was associated with increased risk of lung cancer. This highlights the potential harmful effect of vitamin B12 supplementation for lung cancer. The level that seems concerning appears to be around 428 pmol/L. As the graph shows below lung cancer risk starts at about 428pmol/L with high risk starting at 531 pmol/L. A lot of B12 reference ranges recommendations fall into this area which is very troubling.
To me the science around this aspect of B12 dosage is not adequate or clear. It’s also troubling to note that a prominent Vegan personality Chef AJ has recently been diagnosed with lung cancer. By the grace of God she will overcome that horrible affliction.
Veganhealth.org also has a good article that covers this aspect of B12 and lung cancer.
Vegan Doctor Recommendations
Practically everyone including doctors have recommendations about how much B12 to ingest on a regular basis, but practically no one says what the correct serum B12 levels, Homocysteine and MMAU levels should be. This is ridiculous considering the importance of B12. The only doctor I’ve ever seen give somewhat of a recommendation is Dr Klapper and Gojiman. They state the optimal serum B12 range should be ng/dL 600 to 900.
B12 Deficiency Scorecard
I’ve covered a lot of information in this and previous posts, but the interesting insights come about when you put all of it together. Here is a table listing all the potential issues that could affect B12 absorption. I’ve used this table as a sort of B12 deficiency scorecard for anyone to get an idea of how prone to deficiency they may be.
| Malabsorbtion Issue | Do I have this? | |
|---|---|---|
| 1 | Pernicious Anemia | 0 |
| 2 | Gluten Sensitivity | 1 |
| 3 | Helicobacter Pylori | 1 |
| 4 | MTHFR Genetic Mutation | 1 |
| 5 | Medium Taster/ Super Taster | 1 |
| 6 | Intestinal Parasite | 0 |
| 7 | Harmful Combinations of Pharmaceuticals | 0 |
| 8 | Viruses / Post Viral Syndromes | 1 |
| 9 | Vegan/Vegetarian/Plant Based | 1 |
| Total Count | 6 out of 9 |
Based on the Total Score you can see I’ve got quite a lot of these malabsorption issues. This really highlights how easily we can fall into deficiency especially when you consider the biggest risk of B12 deficiency as being irreversible brain damage. How do you rate given these factors?
Final Thoughts
I’ve covered a lot of material from where B12 comes from, to testing, reasons for deficiency, methylation, reference ranges, etc.
It’s clear to me that with respect to B12 the science is vague, the reference ranges are arbitrary and the requirements are not well defined; especially when considering the causes for deficiency. Furthermore, in South Africa awareness of the available tests and just plain availability of those tests is worrisome.
The lack of accurate complete B12 information in South Africa is extremely poor and this is true of both the health care professional community and the Vegan community.
We’re left in a position where it’s difficult to know for sure what your B12 status is and thus how healthy you are. The fact that irreversible brain damage is the worst possible outcome and lung cancer being just as bad leaves us in a very troubling place.
Know Thyself
I’ve come to the conclusion that the ancient Greek aphorism “Know thyself” is likely the best approach to understanding your B12 status. Run the tests and find out how your body handles B12; do you have genetic SNPs of MTHFR or PEMT, do you have a parasite, do you have the bacteria H Pylori, do you have leaky gut, etc.
We’re able to ask enough questions, and get enough answers with the available tests to put us in a more informed position. Knowing all of this allows you to “know thyself” and manage your B12 status appropriately.
One with the Microorganisms
As I reflect on all this information, it dawns on me that we much more dependent on bacteria and archaea than we think. The microscopic world plays an integral role in our lives. Yes, we live in a cleaner world that’s more sanitized, but we now risk irreversible brain damage if our food isn’t supplemented with B12 which nature used to provide for free.
l have started to realize that we’re much interconnected with the planet than we could have ever imagined. If a few species of bacteria or archaea can have such a direct impact on our minds, can you imagine what the rest of them are capable of.
Conclusion
This is the kind of information I wish was presented to me when I first went Vegan. It would have been profoundly useful. Because it doesn’t exist in a substantive and succinct manner, I decided to document everything I learned over the past five years into these three posts. I suspect that there’s a whole lot more to the Vitamin B12 story than we realize, and no doubt in time we’ll learn a whole lot more.
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