I'm a strict vegetarian. How can I get enough vitamin B12?

The only reliable food sources of active vitamin B12 are animal foods, such as meat, poultry, fish, shellfish, eggs, milk, yogurt, and cheese. While some plant foods in their fermented or otherwise processed versions (including sprouting, in some cases) contain vitamin B12, there are no known plant foods that provide consistent, dependable levels of this important nutrient.

Many soil bacteria can make vitamin B12; so can certain bacterial inhabitants of the human digestive tract. Yet, there is inadequate research to confirm that these potential B12 sources are reliable sources for a person who is strictly vegan and eats no animal foods of any kind, including dairy products.

It's important here to distinguish between a strict vegetarian — who might include eggs and dairy products in his or her meal plan — and a strict vegan, who would not include these foods. All of those non-flesh yet animal-derived foods can contain B12. Strict vegans should therefore do one or more of the following:

• Regularly consume foods that have been fortified with active vitamin B12, such as fortified breakfast cereals or bread products, fortified soy products (like soy burgers, hotdogs, or breakfast patties), nutritional yeast, and yeast extracts
• Take an oral, nasal, or sublingual vitamin B12 supplement
• Receive vitamin B12 injections from their doctor.

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