Vitamins

 

Omega 3s

Currently, not everything is known about omega 3s. They are being researched and there are contradictory findings. We hope you find this summary useful
There are three important omega 3 fatty acids:

•     ALA‒alpha-linolenic acid; found in a wide range of foods.
•     EPA‒eicosapentaenoic acid; found mainly in fish.
•     DHA‒docosahexaenoic acid; found mainly in fish and seaweed.

    Our body can convert ALA into EPA and DHA. ALA is efficiently converted to EPA, but it may require large amounts of ALA to produce optimal amounts of DHA.
    Omega 3 fatty acids are produced by sea plants. Fish are a source of omega 3s because they eat plants or other fish that may have eaten plants. It may be possible to get sufficient omega 3s from plants.

What do omega 3 fatty acids do?

Omega 3 fatty acids may be useful in the prevention and treatment of heart disease, arrhythmias, and depression. DHA deficiency could cause neurological problems. There are various studies but it is difficult to be very sure of the effects as of now. One of the main things they do is reduce clotting which helps blood circulation to all organs. On the downside too much DHA can also cause bleeding disorders.

Balancing omega 3s and omega 6s

Omega 3s should be in balance with omega 6s. Omega 6 is found in higher quantities in most vegetable oils such as corn, soy, safflower, sunflower, and sesame. Therefore if one is consuming a lot of omega 6 oils, one needs even more omega 3s to balance them out. Vegans and vegetarians may have low omega 3 intakes and blood levels; this may be of special concern in older vegans.

Recommendations

•         Eat mainly fresh whole plant foods, and make sure whole plant foods are a major source of your fat intake. Avocados and coconut are good sources.        If using oils for cooking, favor those rich in monounsaturated fats like olive, canola or peanut. Oils rich in omega 3s may be used (flaxseed, hemp) but should never be heated.
•         Avoid fried foods and processed foods rich in trans fats and omega 6 fatty acids.
•         Avoid foods rich in saturated fats and cholesterol (animal fats).
•         Although there is not enough data on this, Dr. Joel Furhman has noticed clinical improvements in health by taking DHA. In case LDL levels are consistently high, you may want to try taking DHA supplements and see if there is an improvement in health. Excess DHA can be dangerous.

Supplementation

Recommendations for DHA supplementation are as follows:

•     Under 60 years old: 200 ‑ 300 mg every 2-3 days
•     60+ years old: 200 ‑ 300 mg per day

Vitamin B12

    B12 is manufactured by bacteria and yeast.  Meat and milk are full of bacteria because they are decaying substances and so these foods have plenty of B12.
    In a more natural world, vitamin B12 could be naturally available to vegans in the form of organic fruits and vegetables straight off the farm, pond water, river water or other natural drinking water etc. Nature always made provisions for us to get all nutrients. In fact, some raw vegans find that their B12 levels are good without supplementation due to the abundance of fermented foods and drinks that they consume.
    Vitamin B12 is so vital and the repercussions of low B12 are so huge that it's just not worth it. Whether you have a deficiency or not can be determined by a simple blood test. Even if vitamin B12 deficiency is not currently present, it is likely to occur in the future. You should keep checking or take a B12 supplement to be safe.
    Vitamin B12 is required in minute amounts and can be stored for up to 3 years.

Deficiency

    Both vegans and non-vegetarians can suffer from B12 deficiencies. Vegans may suffer because of low intake. Nonvegans, due to the inability to absorb B12.
    Vitamin B12 is absorbed by the intrinsic factor in the stomach. High protein from meat and milk force the stomach to produce more acid to digest them. (Proteins are digested mainly in the stomach.) This high acid secretion not only is one of the causes of acidity but also destroys the lining of the stomach so that the intrinsic factor is deficient. Thus vitamin B12 is not absorbed.
    When the deficiency is due to a lack of intrinsic factor, B12 tablets will not help, and injections are required. Deficiencies could also be the result of bacterial flora being destroyed by antibiotics or because of deficient intake of bacteria in our unnaturally sterile food.
    Vitamin B12 deficiency can occur in anyone at any age. In a random test on 21 diabetics conducted by us, we found that about half of them had B12 deficiency, and none of them were vegan. Of those who were not deficient, some were on B complex supplements, which included vitamin B12.

Deficiency due to low intake

Vegans may be able to absorb vitamin B12 but are unlikely to get enough of it on a plant-based diet. This is because of our present day lives which are unnaturally hygienic. Microorganisms naturally available in our food are destroyed or removed due to many reasons like:

•         Irradiation of fruits and vegetables
•         Pesticides used in farming
•         Chlorine or other forms of sanitizing drinking water
•         Washing fruits and vegetables well
•         Preservatives used in packaged food
•         High hygiene levels in our lifestyles
•         Modern day toothpaste with Triclosan which destroy oral bacteria
•         Alcohol consumption
•         Use of the microwave

Hence, even fermented foods found in almost every culture (eg. idli, dosa, miso, kimchi, sauerkraut, relevel, vegan yogurt, tempeh, natto etc) are not enough to provide vegans with required vitamin B12 levels.
Vitamin B12 deficiency may be less common in the West, especially in the US, where soya milk and other ready-made foods are fortified with vitamin B12. Sometimes people who have come back or are visiting India from the West may develop symptoms after a few months, which they never had in the West. Many people who want to live naturally, are averse to taking vitamin B12 supplements and this may not cause a problem for a number of years since vitamin B12 is stored in our body, but sooner or later this problem can catch up. Therefore it is important that everybody keeps a check.

Symptoms of B12 deficiency

Symptoms can range widely and may not manifest themselves at all because vitamin B12 is required by all cells of the body. Some of the common symptoms of vitamin B12 deficiency are a weakness, apathy, memory loss, acidity, loss of weight, nausea, and vomiting, anemia, mental confusion, delusions, paranoia, respiratory symptoms, hives and other symptoms of allergy. A long-term deficiency can lead to heart attacks or stroke‒the very problems that a healthy vegan diet can prevent. Long-term vitamin B12 deficiency can cause irreversible damage to the brain and nervous system.

How to test for the deficiency?

There are 4 main tests for vitamin B12

•     Serum B12 ‑ The normal range is 200 to 900 pg/ml. (Please note that your B12 may have been measured by another system ‑ pmol/l so you should see the normal range described in your report.) If your B12 is less than 150 it is very low. A good level is around 400. If a cyanocobalmin source (like spirulina or chlorella) is consumed these levels may be high but the B12 is still not usable by the body. In this case, its better to rely on one of the other two tests
•     Homocysteine level ‑ High homocysteine levels are an indicator that the usable vitamin B12 is low, and should be supplemented. If Serum B12 levels are normal but homocysteine is high (common in people taking cyanocobalmin supplements), a methylcobalamin supplement is necessary.
•     MMA ‑ Methylmalonic Acid, serum: MMA, along with homocysteine, helps diagnose an early or mild B12 deficiency. If MMA and homocysteine levels are increased, then vitamin B12 deficiency may be present, indicating less available B12 at the tissue level. If only homocysteine is elevated, then folic acid may be low or not being metabolism properly. If MMA and homocysteine levels are normal, it is unlikely that there is a B12 deficiency.
•     Holotranscobalamin‑ this test is not done everywhere and is expensive but it’s the best test because it measures usable B12. Under normal circumstances It's alright to rely on Serum B12 if cyanocobalmin supplements are not being taken. Otherwise, homocysteine levels are more reliable. Alternatively, both serum vitamin B12 and homocysteine levels can be tested.

Ways to supplement

It is important to take supplements or at least check levels regularly so that supplementation is not delayed. It is better to take just B12 instead of B complex. There are two kinds of vitamin B12 ‑ methylcobalamin and cyanocobalmin. Methylcobalamin is the kind which is used by our body. Our body cannot efficiently use cyanocobalmin. Spirulina and Chlorella contain cyanocobalamin and not methylcobalamin, and hence are not good sources of vitamin B12. Some vitamin B complex supplements also contain cyanocobalamin rather than methylcobalamin!

Tablets

If the deficiency is low and the absorption of vitamin B12 is not yet affected, you could opt to take B12 orally. There are many preparations available in India. Methycobal 500Mcg by Wockhardt is recommended. Other options are Nurokind by Mankind, and Folinext by Otsira genetics. Folinext contains both Folic acid and methylcobalamin. Take one tablet daily initially when the deficiency is detected. After 3 months, get your blood levels checked again and see if levels are normal. Once your blood levels reach normal to take one tablet every alternate day for life. In case you are not vegan and your B12 levels are low, it means you are not absorbing B12. In this case, the only option is injections.

Injections

    Vitamin B 12 injections should be taken if the deficiency is very severe, or you are not vegan but deficient. If you are vegan and deficient, you may be able to absorb, so after the initial injections you could switch to tablets and continue for life or you may choose to take regular injections (about once in two months).  In case you experience some side effects after the injection they should not last for long. Injections should be given to you by a doctor after a test dose for the first time.
    Injection Eldervit from Elder Company is recommended. It comes as a combo pack of two vials. No.1. the vial contains vitamin B12, 2500mcg with Folic acid 0.7mg, and Niacinamide 12 mg. No.2 vial contains Vitamin C, 150 mg. No. 1 vial can be taken as it is or mixed with no. 2 vials. Mixed is better for absorption of vitamin B12. About 10 injections may be required initially in one month depending on the severity of deficiency. Later one injection every two months is good as a maintenance dose.
    Injection Vitcofol contains B12 and Folic acid. Take a total of 2 vials (each vial 10 ml) in the following way: Take 2ml twice a week of Vitcofol for 15 days. After that, 2ml each week. This should be enough to lift the B12 levels. The second vial would last for one month and one week.
    Injection Methylcobalamin contains only vitamin B12 but is in the same dosage as the Vitcofol injection and comes in similar sized vials of 10ml each. This can be taken in exactly the same way as you would take Vitcofol. This is not painful. The other one is a little painful.

Vitamin D

Vitamin D is known as the sunshine vitamin because our bodies create this important vitamin when the skin is exposed to the sun. The deficiency of this vitamin is becoming more common in cities all over the world. This is because many people spend most of their time living and working indoors and avoid the sun or use sunscreen because of the fear of skin cancer or damaging their complexion. Smog and pollution in cities can also block the sun’s rays. In a random study of people from Indian metro cities, we found that 50% had vitamin D deficiency.

The importance of Vitamin D

Vitamin D is very important for calcium absorption. It also helps boost immunity by fortifying the white blood cells, which defend against bacteria. In addition, it has anti-inflammatory properties. A link has been made between influenza and vitamin D deficiency in countries which experience long winters with low levels of sunlight (source). Depression, mental health problems, and Seasonal Affective Disorder have also been linked to low vitamin D levels in patients (Source). Other diseases which can be caused by a deficiency in Vitamin D include high blood pressure, diabetes, autoimmune diseases, excess fat accumulation around vital organs, different types of cancer, atherosclerosis (thickening of arteries), osteoporosis (deterioration of bone mass) and osteopenia (thinning of bones).

Getting Vitamin D naturally

    There are two types of Vitamin D. Ergocalciferol (Vitamin D2) is found in a few foods like fatty fish. In some countries, fruit juices, milk or cereals are often fortified with this vitamin. Cholecalciferol (Vitamin D3) is what is produced by the body when the skin is exposed to sunlight. It is difficult to get enough Vitamin D through food sources. This is why the sunshine is the best option. And it’s free!
    The best way to get Vitamin D is from the sun. Spend 15 to 20 minutes a day in direct sunlight, 3 to 5 times a week. Do not wear sunscreen during this time as this will prevent your skin from absorbing the vitamin.
    Taking vitamin D supplements can cause hypervitaminosis D, which can be dangerous. However, you can never get too much vitamin D from the sun.
    Do avoid sunburn by limiting exposure. If you are eating plenty of raw fruits and vegetables, the anti-oxidants in these will help prevent sunburn and also reduce the risk of skin and other cancers.
    Vitamin D is stored by the body. If you have enough stores you can get by on cloudy days without any problems. If you’re concerned that you may be Vitamin D deficient, and have symptoms of depression, chronic fatigue, weight loss and muscle ache get a test done to determine your level of Vitamin D. In places with long winters, or cloudy or smoggy weather, it’s very important to get Vitamin D levels checked. In the case of deficiency, supplementation is required but even then levels should be checked to avoid overdosage.

Testing for Vitamin

    A blood test can be done to check vitamin D3 levels. 15 to 50 ng/ml is the normal range. Less than 15 is too low. In this case, one should take supplements. Once the level reaches around 30+ sunlight will be the best source.
    In India commercially available vitamin D3 is not vegan since it is usually made from lanolin fat from sheep’s wool. Vegan Vitamin D2 is made from vegan sources like yeast and mushrooms and has been available but there is some debate on the virtues of D2 over D3. Many say vitamin D3 is more easily used than vitamin D2. Luckily now some vegan Vitamin D3 is available in India. Please scroll down for information on this.
    Supplementation can be oral or by injection. If the values are very low, injections may be best...