Original Article VITAMIN B12 AND NON-VEGETARIANISM: MYTH vs REALITY

VITAMIN B12 AND NON-VEGETARIANISM: MYTH vs REALITY

Authors

  • Dr. Jaswant Saluja CMPH Medical College Irla Vile Parle West
  • Dr. Nishtha Nagral Kokilaben Dhirubhai Ambani hospital, Rao Saheb Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra 400053
  • Dr Sanjeev S. Khanna Holy spirit hospital, Mahakali Caves Rd, Sher E Punjab Colony, Andheri East, Mumbai, Maharashtra 400093

DOI:

https://doi.org/10.15713/ins.bhj.179

Keywords:

B12 deficiency, anemia, vegetarian, non-vegetarian.

Abstract

Background: Vitamin B12 deficiency has traditionally been linked to a vegetarian diet in medical texts, for decades. This alone, is probably only the tip of the iceberg. Hence, there is a dire need to know the other possible causes of this deficiency in our country. The number of such studies so far is rather scant.

Objective: Our study aims to measure the prevalence of Vitamin B12 deficiency in healthy volunteers and to compare the levels between vegetarians and non-vegetarians, for statistical significance.

Materials and Method: We carried out a comparative, single-centre study to analyse the levels of B12 in vegetarians and non-vegetarians. This was done at a Local Medical College in Mumbai, India, from March 2018. Data was collected over a period of one year. A sample size of 102 healthy volunteers were screened. We included students from the college between the ages of 18-22 years. They were divided into two groups, viz vegetarian and non-vegetarian based on their dietary patterns.

Results: 50 subjects were on a vegetarian diet and 52 were on a non-vegetarian diet. 75 individuals (73.5%) were found to be B12 deficient. 78% of vegetarians and 59.3% of non-vegetarians were deficient. However, statistical analysis showed no significant difference between the mean and median serum B12 levels between vegetarian (148.46) and non-vegetarian (172.02) groups (p>0.05).

Conclusion: Vitamin B12 deficiency is rampant amongst both vegetarian and non-vegetarian Indians. Clinicians should have a high index of suspicion in not only vegetarian but also non-vegetarian populations.

References

Green R, Allen LH, Bjørke-Monsen AL, Brito A, Guéant JL, Miller JW et al. Vitamin B12 deficiency. Nat Rev Dis Primers. 2017;3:1-20. doi: 10.1038/nrdp.2017.

Malik A, Trilok-Kumar G. Status of Vitamin B12 among Healthy Adult and Elderly Population in India: A Review. J Nutr Sci Vitaminol. 2020;66:S361-68. doi: 10.3177/jnsv.66.S361

Watanabe F. Vitamin B12 sources and bioavailability. Exp Biol Med. 2007;232:1266-74. doi: 10.3181/0703-MR-67.

Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine. 20th ed. New York: McGraw Hill; 2018. 567p.

Světnička M, Sigal A, Selinger E, Heniková M, El-Lababidi E, Gojda J. Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic. Nutrients. 2022;14:535. doi: 10.3390/nu14030535.

Dinu M, Pagliai G, Cesari F, Giusti B, Gori AM, Marcucci R et al. Effects of a 3-month dietary intervention with a lacto-ovo-vegetarian diet on vitamin B12 levels in a group of omnivores: results from the CARDIVEG (Cardiovascular Prevention with Vegetarian Diet) study. Br J Nutr. 2019;121:756-62. doi: 10.1017/S0007114518003835.

fdc.nal.usda.gov

Watanabe F, Bito T. Vitamin B12 sources and microbial interaction. Exp Biol Med. 2018;243:148-58. doi: 10.1177/1535370217746612.

Nishioka M, Kanosue F, Yabuta Y, Watanabe F. Loss of vitamin B(12) in fish (round herring) meats during various cooking treatments. J Nutr Sci Vitaminol. 2011;57:432-6. doi: 10.3177/jnsv.57.432.

Guéant JL, Guéant-Rodriguez RM, Alpers DH. Vitamin B12 absorption and malabsorption. Vitam Horm. 2022;119:241-74. doi: 10.1016/bs.vh.2022.01.016.

Nexo E, Christensen AL, Hvas AM, Petersen TE, Fedosov SN. Quantification of holo-transcobalamin, a marker of vitamin B12 deficiency. Clin Chem. 2002;48:561-2.

Sobczyńska-Malefora A, Delvin E, McCaddon A, Ahmadi KR, Harrington DJ. Vitamin B12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency – clinical and laboratory pitfalls. Crit Rev Clin Lab Sci. 2021;58:399-429. doi:10.1080/10408363.2021.1885339

Shipton MJ, Thachil J. Vitamin B12 deficiency – A 21st century perspective. Clin Med. 2015;15:145-150; DOI: 10.7861/clinmedicine.15-2-145

Dukowicz AC, Lacy BE, Levine GM. Small Intestinal Bacterial Overgrowth: a comprehensive review. Gastroenterol Hepatol (N Y). 2007;3:112–22.

Dickey W. Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis. Eur J Gastroenterol Hepatol. 2002;14:425-7. doi: 10.1097/00042737-200204000-00016.

Pan Y, Liu Y, Guo H, Jabir MS, Liu X, Cui W et al. Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis. Nutrients. 2017;9:382. doi: 10.3390/nu9040382.

Pannu AK, Palanisamy DR. Ileocaecal tuberculosis: an under-recognised cause of vitamin B12 deficiency. Trop Doct. 2019;49:143-44. doi: 10.1177/0049475518816590.

Degnan PH, Barry NA, Mok KC, Taga ME, Goodman AL. Human gut microbes use multiple transporters to distinguish vitamin B₁₂ analogs and compete in the gut. Cell Host Microbe. 2014;15:47-57. doi: 10.1016/j.chom.2013.12.007.

Poddighe D, Kushugulova A. Salivary Microbiome in Pediatric and Adult Celiac Disease. Front Cell Infect Microbiol. 2021;11:625162. doi: 10.3389/fcimb.2021.625162.

Gorbach SL. Microbiology of the Gastrointestinal Tract. Medical Microbiology. 4th ed. Galveston: University of Texas Medical Branch at Galveston; 1996. Chapter 95.

Al-Thubiani ASA, Maher YA, Fathi A, Abourehab MAS, Alarjah M, Khan MSA, et al. Identification and characterization of a novel antimicrobial peptide compound produced by Bacillus megaterium strain isolated from oral microflora. Saudi Pharm J. 2018;26:1089-97. doi: 10.1016/j.jsps.2018.05.019.

Tett A, Pasolli E, Masetti G, Ercolini D, Segata N. Prevotella diversity, niches and interactions with the human host. Nat Rev Microbiol. 2021;19:585-99. doi: 10.1038/s41579-021-00559-y.

Beighton D, Gilbert SC, Clark D, Mantzourani M, Al-Haboubi M, Ali F, et al. Isolation and identification of bifidobacteriaceae from human saliva. Appl Environ Microbiol. 2008;74:6457–60.

Ramirez J, Guarner F, Bustos Fernandez L, Maruy A, Sdepanian VL, Cohen H. Antibiotics as Major Disruptors of Gut Microbiota. Front Cell Infect Microbiol. 2020;10:572912. doi: 10.3389/fcimb.2020.572912.

Elvers KT, Wilson VJ, Hammond A, Duncan L, Huntley AL, Hay AD, van der Werf ET. Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: a systematic review. BMJ Open. 2020;10:e035677. doi: 10.1136/bmjopen-2019-035677.

Gupta ES, Sheth SP, Ganjiwale JD. Association of Vitamin B12 Deficiency and Use of Reverse Osmosis Processed Water for Drinking: A Cross-Sectional Study from Western India. J Clin Diagn Res. 2016;10:OC37-40. doi: 10.7860/JCDR/2016/19621.7864.

Ingole JR, Patel RD, Ingole SJ, Pandave HT. Opportunistic Screening of Vitamin B12 Deficiency in IT Professionals Presenting for Routine Health Check-up. J Clin Diagn Res. 2015;9:OC01-2. doi: 10.7860/JCDR/2015/16191.6866.

Author details

Nishtha Nagral

DNB MED

Resident DNB Gastroenterology- Kokilaben Dhirubhai Ambani Hospital, Mumbai, India

Dr.J.G Saluja

MB (Cal) Phd.(Med. Bioch) Phd.(Micro)DND

Ex HOD & Prof Pathology CMPH Medical College Irla Vile Parle West

Dr. Sanjeev S. Khanna

MD: MNAMS, MACG

Consulting Gastroenterologist- Holy Spirit, Max Nanavati, Criticare Hospital, Mumbai, India

Downloads

Published

09-02-2026

Issue

Section

Regular Issue Articles

How to Cite

Original Article VITAMIN B12 AND NON-VEGETARIANISM: MYTH vs REALITY: VITAMIN B12 AND NON-VEGETARIANISM: MYTH vs REALITY. (2026). Bombay Hospital Journal, 66(3). https://doi.org/10.15713/ins.bhj.179

Similar Articles

You may also start an advanced similarity search for this article.