Eating well to prevent vitamin B12 deficiency Te kainga pai e ārai ai i te korenga huaora B12

If you have been diagnosed with a vitamin B12 deficiency, your treatment will depend on why your level is low. You may need vitamin B12 injections or to take tablets. You may also be advised to boost your vitamin B12 intake in your diet.

Vitamin B12 deficiency

Vitamin B12 deficiency can happen if you do not eat enough foods with vitamin B12, or your body does not absorb B12 properly.

Most people in Aotearoa New Zealand get plenty of vitamin B12 from food. But some people might not get enough including:

• vegans
• pēpi who are breastfed by mothers who are vegan
• older people who have a poor appetite and eat very small meals.

All animal foods contain vitamin B12 including:

• meat, chicken, fish and seafood
• eggs
• animal milks and milk products such as yoghurt, cheese and ice cream.

Some foods have vitamin B12 added, which are also called fortified or enriched foods. To see if vitamin B12 has been added, check the nutrition information panel and the ingredient list on the food packet. These foods may be fortified:

• yeast extracts such as Marmite and Vegemite
• savoury yeast flakes
• breakfast cereals
• soy milks and soy products such as vegetarian sausages
• almond, oat and rice milks
• powdered drinks such as Milo, Vitaplan and Complan.

Mushrooms have a small amount of vitamin B12. One serve of mushrooms (about a cup) only has 5% of daily vitamin B12 needs.

Other plant foods including grains, fruit and vegetables do not contain vitamin B12. Some people claim that seaweed, algae and fermented food such as tempeh contain vitamin B12. But these foods usually contain a form of vitamin B12 that our bodies cannot absorb.

If you are 65 or older, your body will absorb the vitamin B12 added to fortified foods more easily than the vitamin B12 found in foods naturally.

Eat a variety of foods every day.

• At least one serving of meat, chicken, fish or eggs. A serving is the size and thickness of the palm of your hand, or 2 eggs.
• At least 2 to 3 servings of animal milk or milk products. A serving is 1 cup (250 ml) of milk, 1 pottle (150 g) of yoghurt or 2 slices (40 grams) of cheese.
• If you are vegetarian, cow's milk and milk products can provide enough vitamin B12. If you eat eggs, include them regularly.
• If you are vegan, have vitamin B12 fortified soy, almond, oat or rice milk every day. One cup (250ml) provides almost 50% of your daily vitamin B12 needs. Include mushrooms and other plant-based fortified foods such as soy sausages and yeast extract. If you do not regularly eat vitamin B12 fortified foods, you may need a vitamin B12 supplement.

Vegetables, fruit, breads and cereals do not contain vitamin B12. But you should still eat these foods every day as they provide a range of other important nutrients to keep you healthy.

Most multivitamins contain vitamin B12, or you can find it in supplements with other nutrients such as folic acid and other B vitamins. You can also get supplements that contain only vitamin B12. 

Vitamin B12 supplements are not made from animal products so they are suitable if you are on a vegan diet.

Some people claim that Spirulina is a good source of vitamin B12. But it is in a form that is inactive or your body cannot absorb.
Your healthcare provider or pharmacist can tell you what the most appropriate supplement is for you.