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Eating a plant-based diet makes you miss out on some essential nutrients. For instance, only animal protein contains substantial amounts of vitamin B12, while plant sources don’t. The lack of vitamin B12 in the diet can have adverse effects on mental health, including panic attacks and depression. 

You may have thought turning vegan is a lifestyle decision without consequences. Think again after you learn that not eating animal protein might be behind some disturbing vegan mental health problems. 

In a 2017 study published in the International Journal of Clinical and Diagnostic Research (IJCDR), researchers found a link between vitamin B12 deficiency and psychiatric disorders. In one case, a 16-year-old was rushed to the hospital after experiencing panic attacks and other symptoms of severe anxiety for four hours. Tests showed a severe deficiency of vitamin B12 serum levels. The patient was treated with methylcobalamin, a form of vitamin B12, which reduced the patient’s Hamilton Anxiety Rating Scale from 17 to 4 after a week. 

B12-Related Anxiety And Depression

The Hamilton Anxiety Rating Scale, sometimes shortened as HAM-A, is an instrument for measuring the degree of anxiety symptoms a patient experiences at a given time. The 16-year-old patient, mentioned above, initially had moderate anxiety but improved to no or minimal anxiety after the treatment.

According to the International Journal of Methods in Psychiatric Research, a score of 7 or less means no or minimal anxiety, 8-14 represent mild anxiety, 15-23 represent moderate anxiety, and 24 and above represent severe anxiety. This means the patient suffered from moderate anxiety and had nonexistent or minimal anxiety when treated with B12 supplements. Doctors were able to help him knowing the connection between B12 deficiency and anxiety.

Another symptom of B12 deficiency is depression. A study in the IJCDR discusses the case of an 18-year-old vegetarian who reportedly suffered from depression. Additionally, showing symptoms like low mood, pessimism, and anhedonia — or the inability to feel pleasure. Doctors found that the patient had reduced sensations of pain and temperature during physical examinations. During mental tests, the patient exhibited predominant depressive cognition.

This alarming discovery paved the way to the discovery of his cobalamin deficiency. Since cobalamin regulates all neurological processes, low levels of this essential nutrient pose serious life-changing threats.

Oral supplements and parenteral vitamin B12 were used to regulate cobalamin levels. After one week of treatment, the anxiety of the patient declined from 28 to 7 in the HAM-A. The treatment resolved the patient’s severe anxiety. 

How Are B12 and Anxiety Connected With Vegan Mental Health?

Vitamin B12, or cobalamin, plays a vital role in the methylation cycle. The methylation cycle is a series of chemical reactions inside the body. Methylation regulates a variety of biological processes such as cell division, cellular energy metabolism, phospholipid synthesis, and DNA and RNA synthesis. Additionally, it regulates neurotransmitter generation, histamine clearance, hormone clearance, and genetic repairs. Methylation of DNA has epigenetic implications and plays a role in gene expression.

As a general rule, increased methylation turns the “off” switch to most genes, while decreased methylation capacity facilitates gene expression. Disruptions to the methylation cycle can lead to anxiety, depression, fatigue, infertility, hormone imbalance, and poor detox capacity. 

Also, cobalamin governs the metabolism of amino and fatty acids, which are important because the former helps the body break down food and repair tissue. At the same time, the latter is an essential source of energy. It is a crucial nutrient that helps keep the nerves healthy.

On a deeper level, cobalamin is mainly responsible for changing an amino acid called homocysteine into S-adenosylmethionine. The latter is responsible for other methylation processes like neurotransmitter metabolism. Therefore, the lack of vitamin B12 in the methylation cycle leads to an excess of unchanged homocysteine.

When there is an insufficient amount of vitamin B12 in the system, homocysteine remains unaltered. The unchanged homocysteine builds up inside the body when there is an insufficient amount of amino acids to convert it. The excess homocysteine has a neurotoxic effect on the body, which can manifest as anxiety and depression. A team of scientists from Alfaisal University have also linked homocysteine to an increased risk of heart attack or stroke.

Are You Eating Enough To Fight Deficiency?

Adults need approximately 1-2 μg of cobalamin intake daily. Vitamin B12 is naturally found in animal protein. It can come from either fish, poultry, eggs, or any other meat. People prone to vitamin B12 deficiency are usually vegans who don’t consume animal protein.

Plants have negligible amounts of vitamin B12. Even if you overfeed yourself to the point of indigestion, you won’t hit your daily vitamin B12 intake requirement. This makes vegan mental health more susceptible to B12 deficiency and anxiety. 

Gastrointestinal problems also threaten to disrupt the cobalamin levels by malabsorption, which makes the absorption of nutrients and other essential organic substances difficult. Malabsorption is a more troubling situation. In this case, you should be diagnosed first before commencing a particular treatment. Consulting a specialist is the best course of action. Proper diagnosis to determine the underlying causes for malabsorption is essential for understanding the root of the problem as well as assigning an individualized treatment plan. 

Vegan = B12 Deficiency? B12 Deficiency = Panic Attack?

With lifestyle choices like veganism, adults may unknowingly be setting themselves up for an increased risk of a panic attack, depression, and other effects. Although eating plant-based meals isn’t bad for your health, missing out on vitamin B12 can compromise your health in the process. 

Vegan brands are fortifying their products with cobalamin sourced from microorganisms to help consumers maintain a healthy diet. For vegetarians, the cobalamin in vitamin B12 fortified products is extracted from animal by-products like milk and eggs. There’s no health difference whether B12 is sourced from microorganisms or animal by-products except for the price. 

Think You Have B12 Deficiency? Check Your Knuckles

If your fingers appear like a zebra’s where hyperpigmentation is prominent in areas of connection like joints, you may want to get checked for cobalamin deficiency. 

The hyperpigmentation is prominent in areas where bones are connected by ligaments. The discoloration should be obvious with the hyperpigmented skin several shades darker than the patient’s usual skin color.

In a study by Mori in 2001, the researchers found a relationship between hyperpigmentation, particularly in the knuckles, and Vitamin B12 deficiency. Vitamin B12 helps to regulate melanin levels. Low vitamin B12 levels caused an increase in melanin synthesis, which caused hyperpigmentation.

There is no single test that can accurately determine B12 deficiency. Only a series of tests are capable of making a conclusive diagnosis. These tests typically include red blood cell count, homocysteine level, and mean corpuscular volume, among other lab tests. So if you suspect you are Vitamin B12 deficient, consult a health professional. 

The concentration of vitamin B12 in plants is too low to make it practical; extraction for the same amount in microorganisms and animals makes it exponentially cheaper. With that said, advocates of veganism should bear in mind that most vitamin B12 supplements and additives to food products are still sourced from animal protein since it is cheaper than cobalamin derived from microorganisms. For vegans, always buy supplements that explicitly state they are vegan. Otherwise, you might be buying vitamin B12 derived from animal sources.

Tristan Buenconsejo petroleum engineer who ditched his degree to do what he loves- the art of persuasive writing. He helps businesses in the health and wellness space write converting copy while stroking his imaginary chinchilla. He’s sad he can’t have one given his country’s temperature and humidity.

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