Vitamin B12 | Dietitians Australia

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We need this vitamin to make red blood cells and new DNA for growing and dividing cells. Vitamin B12 also helps maintain the health of the conductive coating that surrounds and protects nerves." /> <link rel="canonical" href="https://dietitiansaustralia.org.au/health-advice/vitamin-b12" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://dietitiansaustralia.org.au/health-advice/vitamin-b12" /> <meta property="og:title" content="Vitamin B12" /> <meta property="og:description" content="Vitamin B12 (also called cobalamin) is an important vitamin. We need this vitamin to make red blood cells and new DNA for growing and dividing cells. 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</div> <div class="navbar col-11 col-lg-3 bg-white shadow-sm p-5 p-lg-3 p-xl-5 mt-5 mb-n5 my-lg-0 mx-auto me-lg-0" id="navbar-top"> <a target="_blank" href="https://member.dietitiansaustralia.org.au/faapd" class="btn btn-sm btn-outline-primary d-flex align-items-center justify-content-center w-100"><i class="bi bi-geo-alt fs-3 me-4"></i>Find a dietitian</a> </div> </div> </div> </div> <div class="featured-top position-relative "> <aside class="featured-top__inner section container clearfix" role="complementary"> <section class="row region region-featured-top"> <div data-drupal-messages-fallback class="hidden"></div> </section> </aside> </div> <div id="main-wrapper" class="layout-main-wrapper clearfix position-relative pb-4 pt-6"> <div id="main" class="container"> <div class="row row-offcanvas row-offcanvas-left clearfix"> <main class="main-content col" id="content" role="main"> <section class="section pe-lg-6"> <a id="main-content" tabindex="-1"></a> <div id="block-diet-aus-theme-content" class="block block-system block-system-main-block"> <div class="content"> <article class="node node--type-health-advice node--view-mode-full clearfix"> <header> </header> <div class="node__content clearfix"> <div class="h2 mb-4">Key points</div><div class="mb-5 me-md-8 me-lg-6"><ul> <li>Vitamin B<sub>12</sub> is an essential nutrient needed for the making of red blood cells, the production of DNA and the healthy functioning of the nervous system</li> <li>Vitamin B<sub>12 </sub>is found almost exclusively in animal-based foods including meats, poultry, seafood, milk, cheese and eggs</li> <li>Vitamin B<sub>12</sub> deficiency is a potential concern for someone following a vegan or vegetarian diet</li> <li>If you follow a vegan or vegetarian diet, eating foods fortified with vitamin B<sub>12</sub> or taking a supplement can be good ways to help reduce the risk of diet-related deficiency</li> </ul> </div> <div class="h2 mb-4">On this page</div> <div class="mb-5"> <div class="h6"><a class="text-decoration-none" href="#anchor-body">Details</a></div> <div class="h6"><a class="text-decoration-none" href="#anchor-field-see-dietitian">When to see a dietitian</a></div> <div class="h6"><a class="text-decoration-none" href="#anchor-field-top-tips">Top tips</a></div> </div> <div class="h2 mb-4" id="anchor-body">Details</div><div class="mb-5 me-md-8 me-lg-6"><h6>3 minute read</h6> <p>Vitamin B<sub>12</sub> (also called cobalamin) is an important vitamin. We need this vitamin to make red blood cells and new DNA for growing and dividing cells. Vitamin B<sub>12</sub> also helps maintain the health of the conductive coating that surrounds and protects nerves.</p> <h3><strong>Vitamin B</strong><sub><strong>12</strong></sub><strong> deficiency</strong></h3> <p>Vitamin B<sub>12</sub> deficiency can be slow to develop. This means symptoms can appear gradually and intensify over time. Initial signs that someone could be deficient in vitamin B<sub>12</sub> include the following:</p> <ul><li>pale skin</li> <li>confusion and memory problems</li> <li>fatigue</li> <li>headaches</li> <li>mood changes</li> <li>difficulty concentrating</li> </ul><p>Many of the symptoms of vitamin B<sub>12</sub> deficiency can be explained by its important role in making red blood cells. Deficiency of vitamin B<sub>12</sub> impairs the production of healthy red blood cells, giving rise to anaemia. The anaemia occurs due to a slowing of DNA synthesis resulting in the inability of red blood cells to divide. This type of anaemia is also called megaloblastic anaemia because the red blood cells appear large and immature under a microscope.</p> <p>Vitamin B<sub>12</sub> deficiency has two main causes. Either from impaired absorption through the small intestine or from eating a diet that is low in this nutrient.</p> <p>Inadequate absorption of vitamin B<sub>12</sub> can occur due to a lack of hydrochloric acid in the stomach or a lack of a special protein needed to bind to vitamin B<sub>12. </sub> This protein is called intrinsic factor. With less stomach acid, the vitamin is not released from food and is not available for binding to intrinsic factor. Without intrinsic factor, the vitamin cannot be absorbed.</p> <p>Many people over the age of 50 develop a chronic inflammatory condition of the stomach called atrophic gastritis. This affects the cells lining the stomach. Without healthy stomach cells, the production of hydrochloric acid and intrinsic factor diminishes. This can put a person with atrophic gastritis at risk of vitamin B<sub>12</sub> deficiency.</p> <p>Surgery of the gastrointestinal tract, such as weight loss surgery or surgery to remove all or part of the stomach, can result in a loss of cells that produce hydrochloric acid and intrinsic factor. This reduces the amount of vitamin B<sub>12</sub> absorbed.</p> <p>The second main cause of vitamin B<sub>12</sub> deficiency is from not having enough in the diet. A diet lacking in vitamin B<sub>12</sub> is common in people who follow a vegan or vegetarian diet unless it includes foods fortified foods like some plant-based milk. That鈥檚 because natural food sources of vitamin B<sub>12</sub> are mostly limited to animal foods.</p> <p>Depending on the cause, vitamin B<sub>12</sub> deficiency may be treated with dietary changes, vitamin B<sub>12</sub> injections or oral supplements.</p> <h3><strong>Food sources of vitamin B</strong><sub><strong>12</strong></sub></h3> <div class="align-center me-md-n8 me-lg-n10 mb-4"> <img loading="lazy" src="/sites/default/files/styles/wide/public/2022-11/Vitamin%20B12%20-%20Health%20Advice%20-%20Meats.jpg?itok=kg840SeM" width="627" height="417" alt="Uncooked raw steaks -fish salmon, beef or veal and turkey breast fillet. Top view." class="image-style-wide img-fluid" /></div> <p>Vitamin B<sub>12</sub> is unique among the vitamins because it is found almost exclusively in foods derived from animals. That includes fish, meat, poultry, eggs, milk, and milk products. Bioavailable vitamin B<sub>12</sub> is rarely present in plant foods.</p> <p>Anyone who eats reasonable amounts of animal-based food can be confident of an adequate intake of vitamin B<sub>12</sub>. People who are vegetarians and consume milk products or eggs also have a good level of protection from deficiency.</p> <p>People who follow a vegan diet need a reliable source of vitamin B<sub>12</sub>. With few exceptions, vitamin B<sub>12</sub> found naturally in plant foods is likely to be in an inactive form.</p> <p>For someone following a vegan diet, consuming fortified foods or taking a vitamin B<sub>12</sub> supplement are the only viable ways to obtain enough of this nutrient. Food Standards Australia New Zealand permits only a limited number of foods to be fortified with vitamin B<sub>12</sub>. This includes selected soy milks, yeast spread, and vegetarian meat analogues such as soy-based burgers and sausages.</p> <p>Spirulina, which is a type of blue-green algae, is sometimes promoted as a good source of vitamin B<sub>12</sub>. But it is present in an inactive form that the body cannot make use of and could even interfere with the absorption of other sources of vitamin B<sub>12</sub>.</p> <p>Popular fermented foods such as tempeh, kimchi, sauerkraut and kombucha only contain trace amounts of vitamin B<sub>12</sub>.</p> <p>Mushrooms do contain a small amount of active vitamin B<sub>12</sub>. But the amount of mushrooms needed to supply adequate amounts of B<sub>12</sub> is impractical to make these a useful food source.</p> <p>If you are pregnant or breastfeeding and follow a vegan or vegetarian diet, you should make sure you get enough vitamin B<sub>12 </sub>to provide for your developing baby. If a breastfeeding mother is deficient in vitamin B<sub>12</sub>, her infant may also become deficient.</p> </div> <div class="h2 mb-4" id="anchor-field-see-dietitian">When to see a dietitian</div> <div class="copy mb-5 me-md-8 me-lg-6"> <div class="align-right me-md-n8 me-lg-n10 mb-4"> <img loading="lazy" src="/sites/default/files/styles/wide/public/2022-01/Dietitians_Australia_APD_Logo_RGB_72ppi_150.png?itok=4WhA-TBo" width="150" height="149" alt="APD Logo" class="image-style-wide img-fluid" /></div> <p>Plant-based diets which can be low in vitamin B<sub>12</sub> need to be well planned to meet your nutritional needs. An Accredited Practising Dietitian (APD) can help you meet your individual needs.</p> <p>We recommend seeing a dietitian if you:</p> <ul><li>have been diagnosed with vitamin B<sub>12</sub> deficiency and want some support on the dietary management of this condition</li> <li>need nutritional advice to help ensure you're meeting your individual nutrient requirements</li> <li>if you have specific nutritional needs, such as during pregnancy or for children</li> <li>would like advice on whether you need to add a vitamin B<sub>12</sub> supplement to your diet</li> </ul><p>Accredited Practising Dietitians (APDs) are university-trained nutrition experts. They can help you with personalised, easy-to-follow and evidence-based advice.</p> <p>APDs are Australia's most trusted dietetics professionals.</p> <p><a class="btn btn-outline-primary" href="https://member.dietitiansaustralia.org.au/faapd">Find a dietitian</a></p> </div> <div class="h2 mb-4" id="anchor-field-top-tips">Top tips</div> <div class="copy mb-5 me-md-8 me-lg-6"> <ul> <li>If using a plant-based milk like soy or almond milk, choose one that is fortified with vitamin B<sub>12</sub></li> <li>If you follow a vegan diet, it may be good to speak to your doctor about getting your vitamin B<sub>12</sub> blood levels checked regularly</li> </ul> </div> <div class="copy mb-5 me-md-8 me-lg-6"> <h6><strong>This health advice page was peer-reviewed by an Accredited Practising Dietitian (APD) in November 2022.</strong></h6> </div> </div> </article> </div> </div> <div class="views-element-container block col px-0 py-5 block-views block-views-blockcontextual-health-advice" id="block-contextual-health-advice"> <div class="content"> <div><div class="container view view-contextual view-id-contextual view-display-id-health_advice js-view-dom-id-4d3c5494d9f28bbf2c78ea7fc9dc540fb55c82ec336a35fabb9c2819941be8fa"> <div class="view-content row"> <div class="accordion g-0" id="accordion-health-advice"> <div class="accordion-item"><div class="accordion-header h4" id="heading-references"> <a class="accordion-button collapsed text-decoration-none" role="button" data-bs-toggle="collapse" href="#references" aria-expanded="false" aria-controls="references">References</a> </div> <div id="references" class="accordion-collapse collapsed collapse" aria-labelledby="heading-references" data-bs-parent="#accordion-health-advice"> <div class="accordion-body"> <p>Australian Government Department of Health and Ageing, National Health and Medical Research Council (Australia), Ministry of Health (New Zealand), Nutrient Reference Values for Australia and New Zealand, Canberra: Commonwealth of Australia and New Zealand Government (2006). https://www.nrv.gov.au/nutrients/vitamin-b12 [Accessed January 2022]</p> <p>National Institutes of Health, <em>Vitamin B12 Fact Sheet for Health Professionals</em>, https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional [Accessed February 2022]</p> <p>Zeuschner CL et al. Vitamin B<sub>12</sub> and vegetarian diets. <em>Med J Aust</em> 2013;199:S27-S32. https://www.mja.com.au/journal/2013/199/4/vitamin-b12-and-vegetarian-diets [Accessed February 2022]</p> </div> </div></div><div class="accordion-item"><div class="accordion-header h4" id="heading-helpful-websites"> <a class="accordion-button collapsed text-decoration-none" role="button" data-bs-toggle="collapse" href="#helpful-websites" aria-expanded="false" aria-controls="helpful-websites">Helpful websites</a> </div> <div id="helpful-websites" class="accordion-collapse collapsed collapse" aria-labelledby="heading-helpful-websites" data-bs-parent="#accordion-health-advice"> <div class="accordion-body"> <p>For more dietary tips and information on vitamin B<sub>12</sub>, visit:</p> <p>healthdirect, <a href="https://www.healthdirect.gov.au/foods-high-in-vitamin-b12">Foods high in vitamin B12</a></p> <p>Mayo Clinic, <a href="https://www.mayoclinic.org/drugs-supplements-vitamin-b12/art-20363663">Vitamin B-12</a></p> </div> </div></div><div class="accordion-item"><div class="accordion-header h4" id="heading-contributors"> <a class="accordion-button collapsed text-decoration-none" role="button" data-bs-toggle="collapse" href="#contributors" aria-expanded="false" aria-controls="contributors">Contributors</a> </div> <div id="contributors" class="accordion-collapse collapsed collapse" aria-labelledby="heading-contributors" data-bs-parent="#accordion-health-advice"> <div class="accordion-body"> <p>Accredited Practising Dietitians in Dietitians Australia's Vegetarian Interest Group.</p> </div> </div></div> </div> </div> </div> </div> </div> </div> </section> </main> <div class="sidebar_second sidebar order-last col-lg-3 mt-6 mt-lg-0" id="sidebar_second"> <aside class="section" role="complementary"> <div class="views-element-container block mb-5 block-views block-views-blockcontextual-actions" id="block-diet-aus-theme-contextual-actions--3"> <div class="h5">Actions</div> <div class="content"> 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