Evidence-Based Nutrient Recommendations

B12 Status of Lacto-Ovo Vegetarians

In general, lacto-ovo vegetarians (LOV) whose diets are not supplemented with B12 have lower serum B12 levels and higher homocysteine levels than non-vegetarians—see Homocysteine and Mild B12 Deficiency in Vegans.

Though B12 is less of a concern for LOV than vegans, if B12 supplements or fortified foods are available, they should be used regularly to ensure optimal B12 status.

A 2017 study of mainly Hindu lacto-vegetarians from Pakistan, who didn’t consume much dairy, found that about half of the vegetarians had B12 deficiency (Kapoor, 2017). Of the 100 vegetarians, 44% had elevated methylmalonic acid levels indicating a functional B12 deficiency. The frequency of depression was 31% compared with 12% in the omnivores (p=0.002), paresthesias was 11% compared with 3% in the omnivores (p=0.04), peripheral neuropathy was 9% compared with 2% in the omnivores (p=0.05), and psychosis was found in 11% subjects compared with 3% in the omnivores (p=0.04).


Kapoor, 2017. Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among Vitamin B12 deficient young vegetarians. Neurosciences (Riyadh). 2017 Jul;22(3):228-232.

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  • If you have a question about whether it's okay to cut supplements in half or combine supplements to achieve the dose we recommend, the answer is “Yes.” Be aware that nutrient recommendations are only estimates—it's not necessary to consume the exact amount we recommend every single day.
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