Do Only Vegetarians Need Vitamin B12? Symptoms, Sources, Supplement Requirements Explained

Vitamin B12, also known as cobalamin, is an essential nutrient required for healthy nerve function, red blood cell production, DNA synthesis and energy metabolism. Because it is not produced by the body and is almost exclusively present in animal-sourced foods, its deficiency has long been associated with vegetarian and vegan diets. However, experts stress that vitamin B12 deficiency can occur regardless of eating pattern, influenced by age, absorption issues and gut health as well as dietary intake.

In India, where a significant portion of the population follows vegetarian diets for cultural, ethical and religious reasons, awareness of vitamin B12's role and sources is critical. According to reports, up to 47% of Indians may be deficient, with only about 26% having adequate levels, a public health concern that warrants broader education and screening.

But is it only vegetarians who suffer from vitamin B12 deficiency and need supplementation? Here's what you need to know.

What Vitamin B12 Does In The Body

Vitamin B12 plays several vital roles:

1. Red blood cell formation: It's necessary for preventing a type of anaemia called megaloblastic anaemia.
2. Nervous system health: B12 helps maintain the protective covering around nerves (myelin) and supports normal nerve signalling.
3. Energy and metabolism: It assists in converting food to energy, reducing fatigue and weakness.
4. Brain and DNA functions: B12 works with folate for DNA synthesis and may affect mood and cognition.

Because of its wide physiological importance, inadequate intake or poor absorption can have consequences beyond simple tiredness.

Also Read: 10 Signs And Symptoms Of Vitamin B12 Deficiency

Do Only Vegetarians Need B12?

A popular belief is that only vegetarians or vegans need to worry about B12 deficiency. While it's true that animal foods are the richest natural sources, deficiency is not exclusive to vegetarians.

B12 is naturally found in meat, fish, eggs and dairy but not in plant foods unless they are fortified. Therefore, strict vegetarians who consume dairy and eggs may still meet some needs, whereas vegans who avoid all animal products are at higher risk unless they rely on fortified foods and supplements.

However, non-vegetarians can also be deficient due to poor absorption (e.g., low stomach acid), medication use (e.g., proton pump inhibitors), digestive disorders (Crohn's, celiac disease) or ageing, which reduces intrinsic factor needed for B12 absorption.

Dietary Sources Of Vitamin B12: Animal-Derived Foods

According to the World Health Organization and dietary data:

• Milk and dairy: A cup of milk can provide around half of your daily needs.
• Yogurt and cheese: Rich vegetarian options supplying meaningful B12.
• Eggs: Especially for lacto-ovo vegetarians.
• Fish and meat: Strong B12 sources for non-vegetarians.
• Fortified foods: Plant milks, cereals and nutritional yeast enriched with B12 can help meet requirements.

While fortified foods improve intake, their effectiveness depends on stomach digestion and intrinsic factor, meaning they may not be sufficient for everyone.

Recognising Deficiency Symptoms

Vitamin B12 deficiency can develop slowly, and early symptoms are often subtle:

• Fatigue and weakness
• Memory issues or poor concentration
• Tingling or numbness (neuropathy)
• Mood changes (depression, irritability)
• Pale skin or anaemia symptoms
• Balance problems and coordination issues

If untreated, long-term deficiency can lead to irreversible nerve damage, impaired cognition and more serious anaemia. Regular screening through blood tests, including advanced markers like methylmalonic acid and homocysteine when indicated, can improve early detection.

How Supplements Work

Vitamin B12 supplements are available in different forms:

• Oral tablets and capsules: Useful for mild to moderate deficiency and maintenance.
• Sublingual (under-tongue) options: May benefit those with slight absorption issues.
• Injectable B12: Bypasses the gut and is used for severe deficiency or malabsorption conditions.

Supplement effectiveness varies based on form, dosage and absorption capacity. Not all supplements work the same way, and medical guidance ensures appropriate choice and dosing.

In India, vegetarian-friendly B12 supplements are widely available; the only factor that may make some non-vegetarian is the capsule shell rather than the vitamin itself.

Also Read: Can A Vegan Diet Cause Vitamin B12 Deficiency? Diet Expert Says Yes, Reveals Why

Who Should And Shouldn't Take Supplements

Should Consider B12 Supplements:

• Vegans and strict vegetarians with limited animal products.
• Older adults with decreased stomach acid.
• People with digestive disorders impacting absorption.
• Pregnant and breastfeeding women with limited B12 intake.

May Not Need Supplements:

• Individuals with adequate animal food intake and normal absorption.
• Those regularly consuming fortified foods and maintaining adequate blood levels.
• People without deficiency symptoms and verified normal biomarker levels.
• Medical testing is essential before starting any supplements rather than self-prescribing.

Vitamin B12 deficiency is common in India and globally, and while vegetarians and vegans are at higher risk due to dietary patterns, it is not exclusive to them. Adequate intake from animal foods, fortified foods or supplements, guided by blood testing and medical advice, is key to preventing fatigue, neurological issues and anaemia. Understanding where B12 comes from, recognising early deficiency signs and knowing when and how to supplement can help people across all diets maintain optimal health.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.