Causes of Vitamin B12 deficiency:
• Inadequate dietary B12 (rare, usually only in strict vegans)
• B12 Malabsorption
Pernicious Anaemia (PA), commonly associated with other
Autoimmune conditions (especially vitiligo and thyroid disease)
Long term use of PPI or H2-antagonist drugs
Coeliac disease (more commonly causes iron and/or folate deficiency
but up to 30% of patients can have B12 deficiency)
Small bowel (especially terminal ileal) surgery
Drugs – Biguanide (eg Metformin) therapy, Cholestyramine, Slow K
Foods containing vitamin B12
The following foods are good sources of vitamin B12. Including these foods regularly
in the diet should help to prevent vitamin B12 deficiency:
•Liver/liver pâté (note that pregnant women should avoid liver/liver pâté).
•Meat – for example, beef, lamb and pork.
•Fortified breakfast cereals.
•Fortified oat, rice and soya milks.
•Fortified soya yoghurts.
•Fortified yeast extract.
People who are vegan should aim to include foods that are fortified with vitamin B12,
at least three times a day. If these foods are not consumed in adequate amounts, the
Vegan Society recommends a vitamin B12 supplement which can be purchased
from a pharmacy or health food shop