Metabolic Vitamin B12 Status On a Most Raw Vegan Diet With Follow-Up Using Tablets, Nutritional Yeast, Or Probiotic Suplements

Original Paper
Ann Nutr Metab 2000;44:229–234
Received: February 24, 2000 Accepted: August 7, 2000

Metabolic Vitamin B12 Status on a Mostly Raw Vegan Diet with Follow-Up Using Tablets, Nutritional Yeast, or Probiotic Supplements
Michael S. Donaldson
Hallelujah Acres Foundation, Shelby, N.C., USA

Key Words Vegan W Vegetarianism W Raw food W Cobalamin W Vitamin B12 W Methylmalonic acid WProbiotic supplements W Nutritional yeast

The urinary MMA assay is effective for identifying early metabolic cobalamin deficiency. People following the Hallelujah diet and other raw-food vegetarian diets should regularly monitor their urinary MMA levels, consume a sublingual cobalamin supplement, or consume cobalamin in their food.
Copyright © 2000 S. Karger AG, Basel

Abstract Background:Pure vegetarian diets might cause cobalamin deficiency due to lack of dietary intake. It was hypothesized that a population following a vegan diet consuming mostly raw fruits and vegetables, carrot juice, and dehydrated barley grass juice would be able to avoid vitamin B12 deficiency naturally. Methods: Subjects were recruited at a health ministers’ reunion based on adherence to the Hallelujah dietfor at least 2 years. Serum cobalamin and urinary methylmalonic acid (MMA) assays were performed. Follow-up with sublingual tablets, nutritional yeast, or probiotic supplements was carried out on subjects with abnormal MMA results. Results: 49 subjects were tested. Most subjects (10th to 90th percentile) had followed this diet 23–49 months. 6 subjects had serum B12 concentrations ! 147 pmol/l(200 pg/ml). 37 subjects (76%) had serum B12 concentrations ! 221 pmol/l (300 pg/ml). 23 subjects (47%) had abnormal urinary MMA concentrations above or equal to 4.0 Ìg/mg creatinine. Sublingual cyanocobalamin and nutritional yeast, but not probiotic supplements, significantly reduced group mean MMA concentrations (tablet p ! 0.01; yeast p ! 0.05, probiotic 1 0.20). Conclusions:

IntroductionThe vitamin B12 status of people who avoid eating all animal products remains an important scientific question. Vitamin B12 is important in DNA synthesis, erythropoiesis, and development and maintenance of the myelin sheath of nerves. Deficiency of vitamin B12 leads to pernicious anemia, gastrointestinal disorders, and neurological damage. Generous folate intake by health-conscious vegans preventseasy detection of pernicious anemia, with the first signs of vitamin B12 deficiency being neurological [1]. Symptoms of neurological damage due to poor vitamin B12 status include numbness and/or tingling in outer extremities, decreased vibration sense and/or position sense, decreased visual acuity, unsteadiness, poor muscular coordination with ataxia, moodiness, mental slowness, poor memory,confusion, agitation, depression, delusions, hallucinations, and even overt psychosis [1]. There is significant overlap in the symptom picture with Alzheimertype dementia [2].

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© 2000 S. Karger AG, Basel 0250–6807/00/0446–0229$17.50/0 Accessible online at: www.karger.com/journals/anm

Michael S. Donaldson, PhD Hallelujah AcresFoundation PO Box 2388 Shelby, NC 28152 (USA) Tel. +1 704 481 1700, Fax +1 704 481 0345, E-Mail michael@hacres.com

Fig. 1. Initial vitamin B12 status. The graph is divided into four quadrants (I–IV), based on the normal ranges for serum B12 and urinary methylcobalamin. P = Subjects with elevated concentrations; j = subjects with normal MMA concentrations.

Since true cobalamin is not found inany appreciable amount in plant foods [3], it would be expected that all people avoiding animal products would eventually develop symptoms of vitamin B12 deficiency. However, it has been reported that vitamin B12 can be synthesized by bacteria residing in the small intestine [4]. Furthermore, dehydrated cereal grasses have been reported to contain a small amount of vitamin B12. Therefore, it was...