What You Should Know About Supplements If You Follow A Vegan Diet

I was vegetarian for almost 10 years and vegan for two (now I follow a plant-based diet approach that works best for me). Some people are vegan to help the environment, some wish to bring no harm to animals, some for health reasons...there are many great reasons to be vegan! There are a few things that I wish I had known before I started this journey that would have improved my health.

Studies show that eating a lot of red and processed meats (lunch meat/cold cuts, hot dogs, etc.) can put you at greater risk for cancer and heart disease. There’s also evidence that people who are vegetarian or vegan have lower rates of heart disease, diabetes, high blood pressure, and obesity. Cutting out meat can be a good idea for many people!

No matter what your reason for following a vegan diet is, it is important that you take your health and potentially missing nutrients seriously. I had a few people tell me early on that I needed to take supplements, but I ignored that advice. I believed they didn’t have the most up to date information or were trying to lure me back to eating dairy or meat. And I didn’t want to take pills every day! I couldn’t have been more wrong to ignore them.

Adding supplements to a vegan diet, even a well-balanced one, may help prevent deficiencies in essential vitamins that your body needs to function daily.

To stay healthy with a vegan diet, eat a balanced diet with lots of colorful vegetables and fruits. Get vitamin B12 from food sources and a vitamin supplement. Take a daily multivitamin with iron. Consider a vitamin D supplement, especially if you don’t get much sun exposure. Ask your doctor if you should get any lab tests to check for vitamin deficiencies.

Do I really have to take a supplement? Can’t I just get it from the food I eat?

A small percentage of people might be able to get all their nutrients from foods, but the most recent studies recommend that vegans supplement their diet with vitamins. Since many foods that are high in B12, iron, and vitamin D are eliminated from the diet (eggs, meat, milk, fish), it can be difficult to get enough of these vitamins, even with fortified cereals and vegan milks.

*Please remember that you should talk to your doctor or APRN before you start taking supplements. The below data assumes that you are greater than 14 years old.

Why is B12 important?

B12 is a vitamin that is needed for your body to make blood cells and for your nervous system (your brain, spinal cord, and nerves in your body) to work normally.

What happens if I don’t have enough B12 for a long time?

You can have low amount of blood cells – also called anemia. You may have low red blood cells, which can make you tired or weak, and cause headaches and problems breathing. You may have low white cells, which makes you more at risk for getting sick or getting an infection. Finally, you may also have low platelets, which can increase your chances of bleeding or bruising easily. Being deficient in B12 for a long period of time can also cause tingling or numbness in the hands and feet, problems walking, mood changes, and issues with memory.

How much B12 do I need to take?

Current studies suggest taking 2.4 – 10 mcgs/day. Many B12 supplements will have much more than your daily recommended amount, but since the vitamin is water-soluble, any extra that your body can not absorb will be excreted in your urine.

What non-vegan foods are rich in B12?

Eggs, dairy, fish

What vegan food sources are rich in B12?

Fortified cereals, milks, and soy products, nutritional yeast, mushrooms

Look for fortified cereals that have vitamin B12

Why is iron important?

Iron is an important part of red blood cells. Iron helps blood cells produce a substance that allows them to carry oxygen throughout your body. Without iron, your body can’t get enough oxygenated blood cells – also called anemia (see B12 details on anemia).

What happens if I don’t have enough iron for a long time?

Many people do not have symptoms if they are anemic. Others can be irritable, tired, weak, have headaches, or have trouble breathing.

How much iron do I need to take?

It depends on how deficient you are, but typically 325 mg of ferrous sulfate per day.

What non-vegan foods are rich in iron?

Beef, pork, liver, lamb, scallops, turkey

What vegan food sources are rich in iron?

Beans, cream of wheat, prunes, spinach, raisins, bran cereal, and nuts. See this table for a complete list.

Spinach is high in iron

Why is vitamin D important?

Vitamin D increases bone density, reduces the chance of fracturing or breaking a bone, improves the immune system and promotes heart health, and helps absorb calcium into the body.

What happens if I don’t have enough Vitamin D for a long time?

The density or thickness of your bones can decrease, which can increase your chances of breaking a bone after falling.

How much vitamin D do I need to take?

Vitamin D dosage depends on whether you are proactively trying to avoid a deficiency or if you are already deficient - but typically 20 mcg per day.

What non-vegan foods are rich in vitamin D?

Dairy products, fish, eggs

What vegan food sources are rich in vitamin D?

Mushrooms, fortified milks and juices, and 15 minutes/day of exposure to sunshine!

Get 15 minutes of sunlight a day for vitamin D absorption!

Honorable mention:

Calcium is another vitamin to be aware of when following a vegan diet, as high calcium sources include milk and other dairy products. Calcium plays a big part in making your teeth and bones strong and healthy. Vegan foods that are high in calcium include almonds, figs, tofu, beans, sweet potatoes, and broccoli. Most adults should take about 1,000 mgs a day.

When should I ask my doctor if I need a lab draw?

When you see your doctor for a routine appointment, tell him/her that you have started or are considering a vegan diet. Also tell them why you are doing this, so they can best support you. Ask them what lab draws you might need and tell them what your typical daily food choices are. If you don’t have an upcoming appointment, use functions like MyChart or other online messaging systems to let your doctor know that you have started a vegan diet. Ask them if there’s anything you need to do or know.

Depending on your physician, they might order lab draws for some or all the above vitamins. Personally, I did not know that I was iron or B12 deficient until my doctor suggested getting a lab draw. I’m thankful that I didn’t have deficiencies for a long period of time, which would have led to devastating symptoms. Some symptoms are reversible, such as irritable mood or shortness of breath with iron deficiency. Other deficiencies, such as vitamin D, can slowly be rebuilt – though meanwhile, it’s possible that you could fracture or break a bone while deficient.

Iron and B12 lab draws are more commonly ordered than vitamin D. Many health fairs offer free bone density scans, which offer quality information to share with your doctor about how thick and healthy your bones are. Vitamin D tests can be routinely done for people who have abnormal bone density scans, people who live in places that have little sunlight, elderly, and anyone with a history of osteoporosis or frequently broken bones.

To be tested for iron deficiency, your doctor or APRN will order a lab draw to see how much iron you have in your blood. They may also order something called Ferritin, which shows how much iron you have reserved in your body and available for use if your body needs it. They can also order something called a CBC, or complete blood count. This can usually show if you’re anemic.

Generally, all lab draws are very straightforward. Once you receive results, you will know if you are low or deficient in these vitamins.

In summary, the best way to stay healthy as a vegan long term is to get a wide variety of fruits and vegetables into your diet. Also include beans, soy-products, and protein-rich grains (seitan, quinoa, millet, and amaranth). Ask your doctor if you should take supplements and be sure to mention the above vitamins. You might be getting enough nutrients and vitamins from your current food intake. If not, it’s important to stay well by including a supplement in your diet. Always talk to your doctor about what vitamins you should take if you’re planning on getting pregnant, vegan or not!