Vitamin B 12

We have a nutritional dilemma with Vitamin B 12. Animal flesh, in particular their livers are rich in B 12, yet can be toxic and carcinogenic to the human body, as confirmed a recent World Health Organization  report and other published studies. On the other hand, non animal B 12 are difficult to find in the right form and dosage. Vitamin B 12 or cobalamin depends on the quality of the soil, the type of bacteria, fungi, hte prokaryotes archaea and algae as well as the absorption capacity of one’s intestinal flora, one’s age and digestive tract, the intrinsic factor and related conditions, from cooking to food combination, antibiotics intake, chlorine, oral contraceptives,  drugs like metformin and high alcohol. As a consequence, for those who rely only on plant-based foods and for most of the mainstream elderly, there is a need to check their Vitamin B 12 status from time to time, the best test of which is called MMA.(1)
Meanwhile, below, a few animal and non animal sources of Vitamin B 12. We will conclude this post with a few other factors that determine B 12 assimilation and offer recommendations.

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Source: Whole Foods Company
Examining this list, it would appear that sardines and salmon are the richest in vitamin B-12 with the least digestive and metabolic inconveniences. Nothwithstanding their cholesterol and mercury issue, sardines and salmons are also rich in other important health nutrients, including Co-Q-10, complete proteins and omega 3 essential fatty acids. With small dosages of sulfite-reduced organic red wine (like two table spoons can be enough), sardines and salmons’ nefarious bacteria and cholesterol can be partially mitigated (via the increase of the good HDL cholesterol, among other mechanisms) while cilantro, chlorella, garlic and sweating can help to eliminate the mercury. Likewise with organic eggs and good quality clean and if possible raw cheese, these foods can also be reasonable when ingested holistically and depending on the person’s specific needs and his or her unique metabolic and biochemical pathways. On the other hand, given the heavy metals and other toxins and allergens and carcinogenic elements in the bigger fish, with the proposed shell fish, cow’s milk, red meat and chicken, it would appear that supplementation, patches,  B-12 injections  and-or recourse to non animal B-12 rich foods or, even better, a re-education of our own intestinal flora, would be a more reasonable course of B-12 action, including, but not limited to organic soy and coconut yogurt.
Non animal fermented sources have B 12 because fermentation is done by bacteria and in the process, they produce B 12. So the longer veggies and fruits are fermented, the better. Again, it would not be reasonable to rely on just one plant based B 12 source because there are many conditions for the cobalin moleculre to be active, from the presence of cobalt to co-enzyme factors. Below a few examples.


Top: Picture of bacteria-rich sauerkraut: Photo Courtesy of CC3
1.1. Tempeh: Tempeh production requires molds belonging to the genus Rhizopus. A bacterium, identified as Klebsiella pneumoniae, was isolated from the commercial tempeh starter and determined to be the B12 analogue source. (2)
1.2. Sowerkraut and Kimchi: A 2010 study from Korea  showed that Korean centenarians  who ate only small amounts of animal products had normal vitamin B12 levels. The researchers measured the B12 content of plant foods using a biological assay and found many of the fermented foods and seaweeds to contain vitamin B12 analogues, which they considered to be active. They determined that the centenarians were getting about 30% of their B12 from plant foods and that it was a physiologically important amount. This could be the case, especially given that the subjects ate fermented foods at almost every meal, much of which is homemade age-old (over 10 months) kimchi. (3)
1.3. Japanese fermented black tea (Batabata-cha). A 2004 study by the Watanabe group found that fermented black tea (Batabata-cha) contained vitamin B12 analogues that, when fed to rats, improved their vitamin B12 status. (4)
1.4, Lactobacillus species. Lactobacillus is a genus of bacteria found in some people’s digestive tracts and in most probiotic supplements, yogurt, kifir and even in wine . There is evidence that some species produce vitamin B12. A 2003 study of Lactobacillus reuteri CRL1098 determined that it produces vitamin B12 and that this B12 was equivalent to cyanocobalamin. (5) In another study done in 2006, it was reported that Egyptian school children were fed yogurt fermented only with Lactobaccillus acidophilus, 2 cups daily with 5 X 109 colony-forming units. After 42 days, their B12 status was compared to children who were fed a commercially prepared yogurt. Urinary MMA levels went from 3.49 to 2.09 mmol/mol of creatinine in the experimental group (P = .02) versus no change in the commercial yogurt group. (6) In still another study (2000), four raw food vegans were fed a probiotic supplement containing Lactobacillus acidolphilus and other Lactobacillus species. After 3 months, the urinary MMA levels of 3 of the 4 subjects had decreased. (7) Miso, natto and other fermented plant-based foods have claimed to contain some B-12. But one must carefully read the label as not all fermented foods are equal.
Image: Courtesy of PD
Many seaweeds have been shown to have B12 analogues. Most seaweeds are macroalgae, which are technically not plants. Some macroalgae contain an enzyme that can use cobalamin, but also have an enzyme with the same function that does not require cobalamin in case it is not present. These macroalgae do not make their own cobalamin, but rather have a symbiotic relationship with cobalamin-producing bacteria (8).
2.1. Blue-green algae are also known as cyanobacteria, blue-green bacteria, and cyanophyta. They are not actually algae, but rather organisms with characteristics of both bacteria and algae. They can perform photosynthesis and are thought to be the ancestors to chloroplasts in algae and plants. Some companies have marketed algae from Klamanth Lake in Oregon and claimed that they are endowed with B 12, in particular those that use the strain, Aphanizomenon flos-aquae, which they called Super Blue Green Algae(SBGA) and sold via a multi-level marketing plan. (9)
 2.2. Chlorella: Different scientists measured B12 analogue levels in chlorella using both a Lactobacillus leichmannii ATCC 7830 and an intrinsic factor assay. Both methods showed about the same amount of B12 analogue. (10) In another study in 2015 (USA), Merchant et al. examined the impact of chlorella on the B 12 deficiency status of  vegans and vegetarians. A Chlorella pyrenoidosa supplement for 60 days was given to this group. The average serum MMA levels decreased from 441 nmol/L at baseline to 301 nmol/L at 30 days and 297 nmol/L at 60 days. Average serum homocysteine levels decreased from 10.0 µm/L at baseline to 9.5 µmol/L at 30 days and 9.0 µmol/L at 60 days. No adverse effects were noted from the chlorella regimen. (11)
2.3. Spirulina: Spirulina is more controversial. In a favorable study, an Indian research group published an article in 2010 examining the vitamin B12 content of spirulina (Spirulina platensis). They believed that they found 35 – 38 µg of methylcobalamin per 100 g of dry mass. (12)
2.4. Nori. Species belonging to the genus Porphyra are known as “purple laver” and are typically what the phrase “nori” refers to. However, it can also refer to the genus Enteromorpha, which is a “green laver.” Nori is used in many countries for wrapping sushi. In this perspective, Yamada et al., tested nori (P. tenera) to see if it could reduce methylmalonic acid (MMA) levels, the gold standard for determining the B12 activity of a food. Raw nori was purchased within 48 hours of harvesting. Dried nori was purchased from a store. Inactive vs. active B12 was determined by IF assay and confirmed by paper chromatography. 10 people (all nonvegetarian) were then studied.  The results indicate that B12 in raw nori can be changed into harmful inactive B12 analogues by drying, and that dried nori decreases B12 status. However, Yamada et al. said that although dried nori cannot be used as a B12 source, in small amounts it is not harmful. Furthermore, they believe that raw nori is an excellent source of genuine B12.(13)
Image: courtesy of CC. Chanterelles are relatively high in vitamin C (0.4 mg/g fresh weight),[9] very high in potassium (about 0.5%, fresh weight),[10] and are among the richest sources of vitamin D known, with ergocalciferol (vitamin D2) as high as 212 IU/100 grams fresh weight.[10] Scientific research has suggested that the golden chanterelle may have potent insecticidal properties that are harmless to humans and yet protect the mushroom body against insects and other potentially harmful organisms. (Cf. Cieniecka-Rosłonkiewicz A, Sas A, Przybysz E, Morytz B, Syguda A, Pernak J. (2007). “Ionic liquids for the production of insecticidal and microbicidal extracts of the fungus Cantharellus cibarius”. Chemistry & Biodiversity 4 (9): 2218–24)
A 2012 study from the Watanabe group (35) found what they thought was active vitamin B12 in the following mushrooms (per 100 g of dry weight): 2.9 – 3.9 µg in black trumpet (Craterellus cornucopioides) 1.3 – 2.1 µg in golden chanterelle (Cantharellus cibarius). 1.3 µg in parasol (Macrolepiota procera).  .3 – .4 µg in porcini (Boletus spp.).  .2 µg in oyster (Pleurotus ostreatus).  .1 µg in black morels (Morchella conica)
The authors noted that 100 g of dry weight was the equivalent of about 1 kg of fresh mushrooms. They said that a moderate intake of black trumpet or golden chanterelle “may contribute slightly to the prevention of severe B12 deficiency in vegetarians.”  As for the source of the B12, the authors were not sure, but they said:
“The high concentration of vitamin B12 in peel suggests that it was not synthesized within the mushrooms but was either absorbed directly from the compost or synthesized by bacteria on the mushroom surface. The latter is more likely because mushrooms have no root system to take up the vitamin in the compost as is the case with the uptake of vitamins by root plants from the soil containing fertilizers.” (14).
A 2005 study from Italy found significant amounts of vitamin B12 analogue in mushrooms. 250 g of P. nebrodensis contained 4.8 µg of vitamin B12. They used an immunoenzymatic assay. From the paper, it appears that the soil did not have organic waste of any kind. It is not clear if the B12 analogue was active though. (15)
Other sources of B 12 can be found, from eating dirt and fesces to different food and plant combination. In this perspective, it is common in vegan circles to hear that if your produce has soil on it (especially organic soil made from cow dung) and you do not wash the produce before eating it, bacteria that lives in the soil and on the produce will provide B12. Substantiating this claim, a published study showed that a group of  plant eating Iranians growing plants in night soil (with human manure) and who did not usually wash the vegetables had enough amounts of B12  to prevent deficiency. (16)
Another source is hydroponic Lettuce Absorbs B12 Bito et al (2013) tested to see whether hydroponically grown lettuce would absorb vitamin B12 if it was injected into the growing medium. It did so at a rate of .02% to .03%. Enough B12 was absorbed that two lettuce leaves could meet the RDA of 2.4 µg. (17)
And yet  another claimed B-12 source is a Japanese plant called Ashitata, botanically known as Angelica keiskei, which is a relative of celery. However, we did not find credible supporting published studies that show that active cobalamin is generated by this plant. While this chalcones-rich plant has been shown to exhibit some antitumor, antioxidant, antidiabetic and antithrombotic properties,the scientific literature is silent on B-12, except that one of its related species did generate B-12, notwithstanding a plant B-12 than can’t be correctly used by human. (18)
Still another way to get non animal B 12 is by combing whole brown rice with different forms of seaweed. In this field,  Suzuki (1995, Japan) studied 6 vegan children eating a genmai-saishoku (GS) diet, which is based on high intakes of brown rice, legumes and contains plenty of sea vegetables, including 2-4 g of nori per day (“dried laver”); as well as hijiki, wakame, and kombu. The foods are organically grown and many are high in cobalt (buckwheat, adzuki beans, kidney beans, shiitake, hijiki). Serum B12 levels of the children  were satisfactory. (19)
Nutritional yeast grown on a molasses medium is yet another non animal form of B 12. One widely available brand has more than twice the Dietary Reference Intake (DRI) for B12 in one and one-half tablespoons of yeast. Not all nutritional yeasts are rich in vitamin B12, however. Probiotic rich soy and coconut yogurts would also be indicated and all the more so that they would be accompanied with prebiotics.  And lastly, maybe the best form of B 12 is one’s own gut, provided that it is healthy and well taken care of with a holistic life-style.
The intrinsic factor is a specialized glycoprotein release by specialized stomach cells called parietal cells, and its job is to bind together with B12 and facilitate its absorption. At the very end of the small intestine (called the terminal ileum, see image top), intestinal cells have special locations on their outer membranes and its proteins serve as the location for taking the IF-bound form of B12 out of the intestine and up into the cells. The parietal cells  are the epithelial cells that secrete hydrochloric acid (HCl) and intrinsic factor. These cells are located in the gastric glands found in the lining of the fundus and in the body of the stomach. The intrinsic factor is required for the absorption of Vitamin B12 in the diet. A long-term deficiency in vitamin B12 can lead to megaloblastic anemia, characterized by large fragile erythrocytes. Pernicious anaemia results from autoimmune destruction of gastric parietal cells, precluding the synthesis of intrinsic factor and, by extension, absorption of Vitamin B12. Pernicious anemia also leads to megaloblastic anemia. Atrophic gastritis, particularly in the elderly, will cause an inability to absorb B12 and can lead to deficiencies such as decreased DNA synthesis and nucleotide metabolism in the bone marrow. See below for more. Image: courtesy of PD.
1. DOSAGE: In terms of physical amount, the normal daily intake level for B12 is 2.4 micrograms for an adult. However, this norm depends on one’s own bacterial B-12 production, its assimilation ability and other  facts. In the animal world, sardines, salmon, tuna, cod, lamb, scallops and animal livers are the richest sources. On the other hand, one cup of crimini mushrooms will only provide you with about 3% of the daily recommend amount.Vitamin B12 has the lowest daily requirement of all the B vitamins, and it is needed in about 1/1000th the amount of some other B vitamins. Vitamin B12 is the only vitamin that contains a metal element (cobalt), it therefore needs some cobalt.
2. B 12 ASSIMILATION DEPENDS ON THE MICROBIOME: One can take more than the daily requirement of B 12 and still be deficient and someone else can have an insufficiency of dietary B 12 and have enough serum B 12. The reason being that everyone has a different microbiome. As described earlier, bacteria and other microorganisms are the only life forms that can be described as definitively able to produce B12. However, research studies have shown that bacteria capable of producing B12 can live inside our human intestinal tract. One of the bacterium known to produce B12 and also able to colonize parts of our digestive tract is Propionibacterium shermanii. This B12-producing bacteria, among others the Institute’s workshops delve into, resides in the very last segment of our small intestine known as the terminal ileum.The terminal ileum is especially important for vitamin B12 nourishment since it is the primary site for B12 absorption.
3. IMPACT OF COOKING, STORAGE AND PROCESSING: Even though the structure of vitamin B12 is complicated, it is a relatively stable molecule to storage and cooking. However, most of the B12 losses come from the cooking of B12-rich foods, which falls into the range of 10-50%. At the 50% end of the spectrum, most of the studies have involved boiling. Since B12 is a water-soluble vitamin,  it’s therefore more reasonable to either eat these foods raw or to steam them lightly. If boiling is retained, it should be done for short durations so that the B-12 does not leach out.
4. HIGH ALCOHOL INTAKE, ORAL CONTRACEPTION, METFORMIN AND CHLORINE: Drinking too much also hinders B-12 absorption. When too high alcoholic contents are poured down the esophagus, damaging effects on the stomach lining ensues, causing a condition called atrophic gastritis, or inflammation of the stomach. When this occurs, the cells of the stomach cannot do correctly their job of making and secreting a substance called intrinsic factor, which enhances B-12’s absorption. A sclerotic liver also hinders the B-12 mechanism. Likewise, oral contraceptive can hinder B-12 absorption. Interestingly, lower blood levels of B12 in women who use OCs appear to occur independently from dietary intake. In other words, these lower levels of B12 do not appear to change, even if dietary intake of B12 is increased. There are also B-12 issues with Metformin, chlorine and other compounds. For example, we know that chlorine kills soil bacteria and these are the ones that make B-12, including in our micro biome, where 80 percent of our immune system resides. When hot chlorinated showers are taken, chlorine molecules penetrate deep into tissues. No wonder chlorine has been related to brain cancer, as well as other forms of malignancies, theimmune system, among other effects. More research is warranted, some of which is being done to determine the significance of these findings.
5.  REPRODUCTION: Pregnancy and lactation (breastfeeding) increase the need for B12, and the Dietary Reference Intake (DRI) recommendations for pregnancy and lactation are 2.6 micrograms and 2.8 micrograms, respectively.
6.  VITAMINS B COMPLEX: Because folate and B12 work so closely together, both folate deficiency and folate excess can increase the need for B12. While folate excess has been controversial in health research primarily in relationship to dietary supplementation of this vitamin in high doses, some scientists believe that folate fortification of food (in the absence of simultaneous B12 fortification) can also create imbalances in the ratio of B12-to-folate. The relationship between vitamin B6 and vitamin B12 is also at stake.  A deficiency in any one of these three Bs can impair the activity of the others. Most alarmingly, when people use high dose supplements of folic acid, it can be harder to spot vitamin B12 deficiency, leading to more serious symptoms.
7. RISK GROUPS:  Two groups are especially are risk with proper B-12 absorption: uneducated vegans and elderly (past 50 years old).  The most common cause of vitamin B12 deficiency symptoms in the U.S. is not a dietary deficiency, but a problem related to malabsorption. This condition is called pernicious anemia, and it is a relatively common condition in older adults. An estimated 10-30% of people over the age of 50 have some amount of malabsorption of this vitamin. In pernicious anemia, various immune system reactions cause damage to the stomach lining. As a result of this damage, specialized cells in the stomach called parietal cells become unable to produce intrinsic factor (IF). Since IF is needed for B12 absorption, this process results in poor absorption of B12, and the need for much greater amounts of B12 than can be obtained from food.
Pernicious anemia is not the only absorption-related problem associated with risk of vitamin B12 deficiency.  Hereinafter,  a short summary of the complicated nature of B12 absorption: (1) Stomach acids are needed to release B12 from our food and allow it to bind with a glycoprotein called haptocorrin provided in saliva and in stomach fluids. (2) When leaving the stomach, protease enzymes provided by the pancreas are needed to separate B12 from haptocorrin and allow it to bind together with intrinsic factor (IF). IF is a specialized glycoprotein release by specialized stomach cells called parietal cells, and its job is to bind together with B12 and facilitate its absorption. (3) At the very end of the small intestine (called the terminal ileum), intestinal cells have special locations on their outer membranes (consisting of two proteins called cubulin and amionless) and these proteins serve as the location for taking the IF-bound form of B12 out of the intestine and up into the cells. (4) Once inside the intestinal cells, B12 must be reconfigured and attached to a different protein called transcobalamin for passage through the bloodstream. These many different digestive tract steps make B12 absorption readily influenced by digestive tract problems. For example, overgrowth of the bacterium Helicobacter pylori in the stomach has been associated with increased risk of B12 deficiency. Insufficient secretion of protein-digesting enzymes by the pancreas has also been shown to compromise B12 status. Various other health problems have also been associated with increased deficiency risk for this vitamin. In addition to pernicious anemia, these other conditions can be related to B-12 problems: atrophic gastritis, neuropathy, fatigue, depression, kidney disease, memory loss, tinnitus, migraines, macular degeneration, asthma, shingles, multiple sclerosis and Alzheimer’s disease. Indeed, if one compares the symptomatology between Alzheimer patients and those who are seriously deprived of B-12, it is similar.  Other diseases can cause serum B12 levels to increase higher than normal, these include liver diseases, cancer, and duodenal ulcers, diabetes, obesity and cyanide metabolism defects.  And as we saw, B12 deficiency can be hidden by high alcoholism because excess B12 is released into the blood from a damaged sclerotic liver.


TOP: The Vitamin B-12 molecule, a highly complex work of Nature made especially by our bacteria friends. Image: courtesy of PD.
B12 plays such a key role in red blood cell production. This means that deficiency of this vitamin can actually cause a form of anemia called B12 deficiency anemia. Often, when it appears to occur, it is actually a by-product of pernicious anemia in which immune system antibodies interfere with the production or function of intrinsic factor (IF). IF is a glycoprotein produced by specialized stomach cells called parietal cells and it is required for proper metabolism of vitamin B12.
A second important role for B12 in cardiovascular support involves prevention of excessive homocysteine build-up. A long list of cardiovascular diseases have been associated with excessive accumulation of homocysteine in the bloodstream, including coronary heart disease, peripheral vascular disease, and stroke. Vitamin B12 helps normalize levels of homocysteine in the blood by allowing conversion of homocysteine to methionine. (This conversion process takes place through activity of the enzyme methionine synthase.)
Vitamin B12 is a necessary co-factor for the production of DNA, the genetic material that acts as the backbone of all life. This process requires folate and vitamin B6 as well, and disruptions of any of these nutrients can lead to problems. The diagnosis of vitamin B12 deficiency is often dependent on problems with DNA production. When vitamin B12 is low, normally rapidly dividing blood cells are not able to effectively reproduce their DNA, leading to abnormally big cells. This phenomenon, called macrocytosis, is often the first way doctors suspect problems with the vitamin.
Along with the heart, liver, muscles, and kidneys, the brain is an organ that utilizes a large amount of energy in a form called aerobic energy. Aerobic energy means oxygen-requiring energy production in specialized cell parts called mitochondria.
When levels of vitamin B12 get very low, nerve damage can ensue. The insulation sheath around nerve fibers begins to break down, making it harder for signals to get to more distant areas of the body (called peripheral areas). As you might guess, symptoms first become apparent in the hands and feet. While the exact mechanisms are not fully understood, researchers know that severe B12 deficiency can cause these “peripheral neuropathies” and that restoring optimal supplies of B12 can keep these problems from becoming more severe.
B12 (in several of its cobalamin forms) in supporting the activity of the osteoblast (bone-forming) cells. At the same time, B12 also appears to help regulate activity of tumor necrosis factor (TNF). TNF overactivity can result in too much bone breakdown and remodeling by a second type of bone cells called osteoclasts. Too much osteoclast activity (regardless of the reason for its occurrence) is also associated with increased risk of osteoporosis. Despite these logical connections between B12 deficiency and osteoporosis risk, however, actual research findings are inconsistent in making the B12 connection to bone status.
So far i have seen a ton of ignorance with regard to vitamin B-12 in both animal and plant-based eaters, but more in the keto-paleo group who tend to use the “argument” that if vegan diet was natural, B-12 would not be an issue. As mentioned, B-12 is abundant in spring water and organic garden soil…so people who live holistically in mountains have no deficiency of B 12, this vitamin is made by soil bacteria and archaea including those in our gut…but It is synthesized by our gut flora in the colon, downstream from the small intestine, where the absorption of most nutrients occurs, so there is an absorption issue, there is evidence that for some vegans who dont eat dirt or drink mountain spring water, they still get enough B 12 for DNA replication and other processes via the small intestinal migration of some of these B 12 arachaea and bacteria back upstream where they can get absorbed…furthermore, there are issues with methylation (SNPs) and interactions (with with metformin, anti-acids etc), so even meat eaters can have B-12 problems, hence the importance of living holistically and non violently. Moreover,  nutritional scientists have shown that the IGF1, mTOR, epigenetic, nutrient sensing, protein misfolding, autophagy and, among others, inflammation pathways tend to be better activated via  a plant-based diet, much more than a keto-paleo one. But most of all, perhaps one of the biggest “arguments” is this one, if a grass fed cow with her kids looked at you lovingly, would you put a knife in her throat if there were no butcher around to do this for you ? Constrictor boa snakes are designed to suffocate and eat live their preys, but humans ?
Given the seriousness with the malabsorption of this vitamin and with an excess of homocysteine in the bloodstream (i.e., strokes and heart attacks), a few caveats: When one or more of the symptomatology mentioned above is felt and when one is an elderly, a heavy alcohol drinker or a vegan, a doctor’s visit should test the MMA levels, which should be below 270 nmol/L. Although we prefer a more holistic approach via a rich inner bacterial milieu which can make our own B-12 (See our workshop on clinical nutrition which has a section on the re-education of the intestinal flora), the easy route, to be on the safe side, especially when one is traveling, is to eat fortified B 12 foods or to get transdermal patches, injections and-or supplements or have a sardine or piece of salmon once a week, with a small amount of “sulfite-free” organic red wine to facilitate digestion and upregulate the good cholesterol (HDL)
There is no established Tolerable Upper Intake Level for vitamin B12. In fact, medical doctors routinely supplement or inject people who have pernicious anemia with large amounts of vitamin B12 that are several hundred-fold greater than the DRI recommendations. As such, for now, there is no known reason to be concerned about excessive intake of vitamin B12 and all the more so that an abundance of B-12 can help to protect against brain atrophy or shrinkage associated with Alzheimer’s disease and impaired cognitive function. (20).
Still, in light of the evidence examined and from best holistic and scientific perspectives, the Institute feels that organic whole foods B-12 intake with a non chlorinated healthy micro biome and a reeducation of our intestinal flora is the best and most sustainable and cost-friendly approach, if only because our gut has the potential to make all of the B-12 we need. Furthermore, when there are no malabsorption issues, B-12 can usually be stored for over one year in one’s liver, provided the liver functions correctly.
Ch. J (Director of H.M. institute)
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(1). The methylmalonic acid (MMA) test may be used to help diagnose an early or mild vitamin B12 deficiency. It may be ordered by itself or along with a homocysteine test as a follow-up to a vitamin B12 test result that is in the lower end of the normal range. MMA is a substance produced in very small amounts in the body. It is necessary for metabolism and energy production. In one step of metabolism, vitamin B12 promotes the conversion of methylmalonyl CoA (a form of MMA) to succinyl Coenzyme A. If there is not enough B12 available, then the MMA level begins to rise, resulting in an increase of MMA in the blood and urine. Measuring methylmalonic acid in the blood or urine can help detect early vitamin B12 deficiency.
(2). Albert MJ, Mathan VI, Baker SJ. Vitamin B12 synthesis by human small intestinal bacteria. Nature 1980;283(Feb 21):781-2.
(3). . Kwak CS, Lee MS, Oh SI, Park SC. Discovery of novel sources of vitamin b(12) in traditional korean foods from nutritional surveys of centenarians. Curr Gerontol Geriatr Res. 2010;2010:374897.
(4).  Kittaka-Katsura H, Ebara S, Watanabe F, Nakano Y. Characterization of corrinoid compounds from a Japanese black tea (Batabata-cha) fermented by bacteria. J Agric Food Chem. 2004 Feb 25;52(4):909-11.
(5). Taranto MP, Vera JL, Hugenholtz J, De Valdez GF, Sesma F. Lactobacillus reuteri CRL1098 produces cobalamin. J Bacteriol. 2003 Sep;185(18):5643-7.
(6). Mohammad MA, Molloy A, Scott J, Hussein L. Plasma cobalamin and folate and their metabolic markers methylmalonic acid and total homocysteine among Egyptian children before and after nutritional supplementation with the probiotic bacteria Lactobacillus acidophilus in yoghurt matrix. Int J Food Sci Nutr. 2006 Nov-Dec;57(7-8):470-80.
(7). 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.
(8).  Smith AG, Croft MT, Moulin M, Webb ME. Plants need their vitamins too. Curr Opin Plant Biol. 2007 Jun;10(3):266-75.
(9).  On April 16, 2003, Cell Tech’s now defunct website stated: “Is the vitamin B12 in SBGA bioavailable and bioactive? Yes. The Super Blue Green Algae (SBGA) strain, Aphanizomenon flos-aquae, has been tested by Lancaster Labs for B12 analog levels using microbiological testing methods that are comparable to methods 952.20 and 960.46 of the Association of Analytical Chemists (AOAC). Unlike other plant foods such as Spirulina, which contain corrinoids with virtually no vitamin B12 activity, Aphanizomenon flos-aquae is a reliable source for vegetarians seeking to supplement their diets with a bioactive form of this important nutrient.”
(10).  Kittaka-Katsura H, Fujita T, Watanabe F, Nakano Y. Purification and characterization of a corrinoid compound from Chlorella tablets as an algal health food. J Agric Food Chem. 2002 Aug 14;50(17):4994-7.
(11). Merchant RE, Phillips TW, Udani J. Nutritional Supplementation with Chlorella pyrenoidosa Lowers Serum Methylmalonic Acid in Vegans and Vegetarians with a Suspected Vitamin B(12) Deficiency. J Med Food. 2015 Oct 20.
(12).  Kumudha A, Kumar SS, Thakur MS, Ravishankar GA, Sarada R. Purification, identification, and characterization of methylcobalamin from Spirulina platensis. J Agric Food Chem. 2010 Sep 22;58(18):9925-30.
(13).  Amada K, Yamada Y, Fukuda M, Yamada S. Bioavailability of dried asakusanori (porphyra tenera) as a source of Cobalamin (Vitamin B12). Int J Vitam Nutr Res. 1999 Nov;69(6):412-8.
(14). Watanabe F, Schwarz J, Takenaka S, Miyamoto E, Ohishi N, Nelle E, Hochstrasser R, Yabuta Y. Characterization of Vitamin B(12) Compounds in the Wild Edible Mushrooms Black Trumpet (Craterellus cornucopioides) and Golden Chanterelle (Cantharellus cibarius). J Nutr Sci Vitaminol (Tokyo). 2012;58(6):438-441. Assuming that the B12 is  a B 12 active analogue, it would take anywhere from 7 to 326 cups of mushrooms to meet the RDA.
(15). La Guardia M, Venturella G, Venturella F. On the chemical composition and nutritional value of pleurotus taxa growing on umbelliferous plants (apiaceae). J Agric Food Chem. 2005 Jul 27;53(15):5997-6002.
(16).  Herbert V. Vitamin B-12: plant sources, requirements, and assay. Am J Clin Nutr. 1988;48:852-8.
(17).  Bito T, Ohishi N, Hatanaka Y, Takenaka S, Nishihara E, Yabuta Y, Watanabe F. Production and Characterization of Cyanocobalamin-Enriched Lettuce ( Lactuca sativa L.) Grown Using Hydroponics. J Agric Food Chem. 2013 Apr 12.
(18). Ashitata which is a form of Angelica. But up to now, we have not seen any published science supporting this claim. Every so often, a new claim about vegetable sources of vitamin B12 pops up. The problem is that some plants like angelica sinensis, coca leaf or American ginseng do contain molecules structurally related to the known variants which might be new forms of vitamin B12. But the only substances known to be fully active vitamin B12 are cyanocobalamin and methylcobalamin. Angelicas are not known to provide full vitamin B12 activity in humans. For example, the substances contained in “Dang Gui” may show vitamin B12-like activity when it comes to blood formation, but might lack vital vitamin B12 activity in one or several other areas (e.g. removal of homocysteine, myelin formation etc.).  Any claim that purports to show that a plant can make an active full spectrum vitamin B12 should show is contains cyanocobalamin or methylcobalamin as well as a molecular structure that exhibits full vitamin B12 activity in humans.
(19) 4. Suzuki H. Serum vitamin B12 levels in young vegans who eat brown rice. J Nutr Sci Vitaminol 1995;41:587-594.
(20). Vogiatzoglou A, Refsum H, Johnston C, et al. (2008). “Vitamin B12 status and rate of brain volume loss in community-dwelling elderly”. Neurology 71 (11): 826–32.
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Top: The antioxidant, anti-insulin-resistance, quercetin promoting Ashitaba plant.
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