Plant-Based Dieters Are At Risk For Vitamin B Deficiency

More people than ever are eating fewer animal products. In fact, the popularity of plant-based diets has risen by more than 600 percent since 2014. But there’s one common issue plant-based eaters often run into, even when their diet seems balanced: falling short on B vitamins.

B vitamins—especially B12, B6, and folate—are required for proper energy metabolism, mood stability, red blood cell production, fertility, and brain health. When levels fall, your body (and mind) can usually feel it—and the effects can become quite serious if deficiencies go unaddressed.

So how can vegetarians, vegans, or even “plant-leaning” eaters make sure they’re getting enough of these essential nutrients? Below, experts weigh in on how to support your B vitamin status when eating mostly (or all!) plants, plus when to consider supplementation.

• ABOUT OUR EXPERTS: Chelsea Azarcon, N.D., is a naturopathic medical doctor. Courtney Pelitera, R.D., is a registered dietitian with Top Nutrition Coaching.

Why B Vitamins Are So Important, Especially on a Plant-Based Diet

The B vitamin family is made up of eight different water-soluble vitamins that help your body convert food into usable energy. B vitamins help form DNA, support the nervous system and metabolic function, and build healthy red blood cells, says naturopathic medical doctor Chelsea Azarcon, N.D. Adequate intake of B vitamins is vital for mental health, as these nutrients help regulate the production of neurotransmitters like serotonin, GABA, and dopamine.

Read More: How To Support A Fried Nervous System

Since B vitamins are involved in so many important body processes, low levels often show up as significant mood changes, sleep problems, or mental fatigue, according to Azarcon. (More on these later!)

Why Are Plant-Based Eaters More at Risk for B Vitamin Deficiencies?

There are several reasons plant-centric eaters may fall short on certain B vitamins (especially vitamin B12, but sometimes B6 and folate, too), Azarcon says. A few of them:

• Vitamin B12 is only naturally found in animal products
• Cooking can reduce the B vitamin content of many foods (this is especially true for folate)
• Some plant compounds (like phytates in grains) can interfere with nutrient absorption

Throw in the fact that B vitamins are water-soluble and not stored well in the body—and that certain medications, including birth control pills, can deplete B vitamins—and it’s no wonder so many people (particularly those who forego animal foods) are short on these important nutrients.

B12 is the biggest—and most well-known—concern here. “B12 is not naturally found in plant foods,” says Courtney Pelitera, R.D., a registered dietitian with Top Nutrition Coaching. This doesn’t mean you have to eat meat to be healthy, but rather that plant-based eaters must be intentional about getting B12 through fortified foods and/or supplements, she says.

How To Cover Your B Bases

In addition to vitamin B12, many herbivores also run the risk of consuming too little vitamin B6 and folate, Pelitera says. Here’s a breakdown of why these Bs are so vital, how to sniff out if you might be low on them, and how to up your intake, stat.

Vitamin B12: The Hardest to Get from Plants

Vitamin B12 (or cobalamin) is essential for DNA synthesis, red blood cell formation, nerve function, and cognitive performance, Azarcon says. But because it’s only found in meaningful amounts in animal foods, it’s the one B vitamin that strict animal-free eaters almost always need to supplement with.

“Symptoms of B12 deficiency can start to manifest similarly to stress, lack of sleep, and mood fluctuations, which makes it difficult to diagnose without lab testing,” Pelitera explains. As B12 deficiency progresses, symptoms can potentially include:

• Fatigue
• Brain fog and memory problems
• Depression or mood changes
• Muscle weakness or nerve tingling
• Low drive and energy
• In extreme cases: psychosis, permanent nerve damage, or anemia

Low B12 is particularly concerning during pregnancy. “Low B12 levels can affect pregnancy and contribute to developmental abnormalities, including neural tube defects, low birth weight, and impaired brain and cognitive development,” Pelitera notes.

How To Get Enough B12

Vitamin B12 supplementation is essential for anyone who avoids meat and dairy, such as vegans. The recommended daily allowance (RDA) of vitamin B12 is 2.4 micrograms per day for most adults. Supplements often contain much more than the RDA to help prevent or reverse deficiencies.

The best food sources of B12 are animal-based, like beef liver, sardines, clams, tuna, salmon, and eggs. For animal-free eaters, fortified foods like cereals and plant milks (like soy, almond, oat milk, etc.) can provide some of the vitamin. For example, two tablespoons of fortified nutritional yeast deliver 2.5 micrograms of B12.

Vitamin B6: Easier to Find, But Still Vital

Vitamin B6 (pyridoxine) is involved in over 100 enzyme reactions, many related to protein metabolism, neurotransmitter production, and immune function. While B6 is easier to find in plants than B12, you can still miss out if your diet lacks variety, says Azarcon.

Symptoms of B6 deficiency can include:

• Cracked or scaly skin on the lips and mouth
• Glossy, swollen tongue
• Irritability
• Anemia
• In extreme cases: seizures or confusion

The good news: Most plant-based eaters can get enough B6 from food—assuming they focus on whole foods and don’t rely too much on processed stuff, Azarcon says. “Eating a plant-based diet does not necessarily put you at risk for a vitamin B6 deficiency,” agrees Pelitera. The key is to eat different plant foods that provide B6, such as whole grains, vegetables, nuts, and seeds, she says.

Read More: 6 Signs Your Plant-Based Diet Isn’t Working For You

Another important thing to note: absorption of B6 can be affected by alcohol use and certain medications (like some antibiotics and epileptic drugs), so keep your consumption in check and speak to your doctor about your risk for deficiency if you take daily prescriptions. 

How to Get Enough B6

The RDA for vitamin B6 for adults is between 1.3 and 1.7 milligrams per day, depending on age. The best plant-based sources of B6 include:

• Legumes: chickpeas
• Fruits: Bananas, avocados, prunes
• Vegetables: Spinach, potatoes, sweet potatoes, carrots, Brussels sprouts
• Whole grains: Brown rice, oats, fortified cereals
• Nuts and seeds: Sunflower seeds, pistachios, sesame seeds

To meet their B6 needs, a plant-based eater might incorporate a banana, a cup of fortified cereal, and half a cup of chickpeas into their eats throughout the day. If they don’t consume a variety of B6-containing foods, have gut issues that interfere with absorption, or take certain medications, a supplement that includes ample amounts of B6 (like a B complex) can help support energy, cognitive function, and metabolic health, the experts agree.

Folate: Key for Fertility, Pregnancy, and Cell Growth

Folate (vitamin B9) is another B vitamin that plant-based eaters—especially women of reproductive age—need to prioritize. Folate helps form DNA and RNA, supports red blood cell production, and is critical for fetal neural tube development during pregnancy.

“The recommended daily dose for the average adult is 400 micrograms, while 600 micrograms per day is recommended for pregnant women,” says Pelitera. 

The tricky thing about missing out on folate? Deficiency symptoms mimic B12 deficiency, which can mask the true problem. Low folate can cause symptoms like:

• Fatigue
• Headaches
• Dizziness or faintness
• Irregular heartbeat
• Anemia

How to Get Enough Folate

It’s possible to meet your needs for folate by eating enough different plant foods, such as legumes, grains, nuts, and seeds. Unfortunately, cooking can destroy up to 50 percent of the folate found in these foods, Pelitera says. Some of the best sources include:

• Dark leafy greens: Spinach, kale, Swiss chard, collards, romaine
• Legumes: Lentils, black beans, pinto beans, chickpeas
• Nuts and seeds: Sunflower seeds, peanuts, flaxseeds
• Fruits: Oranges, papaya, avocado
• Whole grains: Quinoa, barley, fortified cereals
• Fortified foods: Some breads, cereals, and pasta

Most prenatal and multivitamin supplements contain adequate folate, but it’s still important to eat a folate-rich diet, especially during pregnancy and lactation, Pelitera says.

Smart Supplement Tips for Plant-Based B Vitamins

If you’re going to supplement (and if you’re not eating animal foods, you likely should, according to Azarcon), keep a few tips in mind.

First, choose methylated forms like methylcobalamin (B12) and methylfolate (B9/folate) for better absorption, advises Azarcon. Methylated folate may be particularly important for pregnant and lactating women who have MTHFR gene variants, as they may not absorb the synthetic form of folate, called folic acid (which is found in most supplements and fortified foods), well, she says. Since individual needs can vary, it’s best to check in with your healthcare provider if you’re in that phase of life.

Otherwise, look for third-party testing to ensure label accuracy and potency. “Third-party testing helps ensure supplements are honestly reporting on their labels,” Pelitera advises. Stick to trusted brands (who are typically very transparent about third-party testing) and avoid products with unnecessary additives or fillers.

Final Thoughts: With a Plan, You Can Thrive on Plants

If you’re eating a vegetarian, vegan, or plant-forward diet, it’s absolutely possible to meet your B vitamin needs—but it probably won’t happen by accident. Among all nutrients, B12 is the biggest priority, but B6 and folate deserve attention, too—especially if you’re struggling with fatigue, mood issues, or fertility concerns. Thankfully, a little planning and the right supplement strategy can go a long way toward helping you feel your best. As always, consult your doctor or a dietitian if you have any concerns and before starting any new supplement routine.

This article was reviewed by Brian Tanzer, nutritionist and Director of Scientific and Regulatory Affairs at The Vitamin Shoppe.