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In 1853, a bedridden vegetarian was reported to experience a remarkable recovery upon eating meat. Probably didn’t help he was an opium addict, but he had been doing that for a decade. It was only after five years as a vegetarian did he end up bedridden, covered in bedsores, but a little beef and mutton and he was eventually up and about. Can’t blame the poor guy, as this was nearly a century before the discovery and identification of vitamin B12, resulting in just one of six separate Nobel prizes awarded for teasing out its structure and function. One of the most dramatic events in the history of medicine was the curing of pernicious anemia, a B12 deficiency disease––an otherwise fatal disorder––with a special diet centered around calf and beef liver.
Vitamin B12 levels start to drop within months of cutting out meat. Yes, there are all sorts of benefits of adopting a more plant-based diet, but underestimating the risk of developing a B12 deﬁciency nullify the health beneﬁts of a vegetarian diet, or even a diet centered around plant foods but contains meat only a few times a week. Even moderate amounts of animal products may not be sufficient to restore and maintain adequate vitamin B12 function.
Vitamin B12 is not made by plants. It’s not made by animals either, but rather microbes that blanket the earth. We presumably used to get B12 drinking out of a mountain stream or well water, based on studies showing vegetarians in developing countries who drink purified water appear to be at higher risk. But now, we chlorinate the water supply to kill off any bacteria. So, we don’t get a lot of B12 in our water anymore, but we don’t get a lot of cholera, either—that’s a good thing that we live in such a nice sanitary modern world. Vegetarians living in developing world slums appear to have fewer B12 problems. Basically, the more hygienic our meals, the less B12 we get. Our fellow great apes, like gorillas, get all the B12 they need eating their own feces; I prefer supplements.
Before getting into the nitty gritty of how much to take, how frequently, and which type is best, what are the symptoms of B12 deficiency?
What aren’t the symptoms of B12 deficiency? It’s known as “The Great Masquerader.” It can cause everything from abdominal distention and chronic diarrhea to shortness of breath and swollen red painful feet. It can also cause Parkinson’s syndrome-like symptoms, skin darkening that resolved with supplementation, and something I had never heard of before—bilateral useless hand syndrome.
The “Many Faces” of B12 deﬁciency include neurologic symptoms such as numbness and tingling in the hands and feet, muscle cramps, dizziness, cognitive disturbances, difficulty walking, erectile dysfunction, as well as fatigue and psychiatric symptoms like depression and even psychosis.
For example, a 47-year-old woman with a five-year history of psychosis, treated with antipsychotic drugs, cognitively impaired, reporting visual hallucinations, until finally her mother revealed that the patient was following a strict vegan diet for seven years. She started B12 supplements, and her symptoms went away. Years of her life lost in a psychotic haze, all apparently because she didn’t want to take a supplement. But vitamin B12 supplementation is mandatory for anyone eating plant-based diets.
Becoming psychotic is bad, but hey, better than falling into a coma, and not to mention, suddenly going blind with multiple organ failure––all thanks to B12 vitamin deficiency on a vegetarian diet. Looking into his eyes, they saw “exuberant haemorrhages” – he was bleeding into his eyes. You don’t have to be an ophthalmologist to recognize this is not what the back of your eyes should probably look like.
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