Doctors often rely on serum B12 levels in the blood to test for vitamin B12 deficiency, but this may not be sufficient. Two cases of young vegetarians experiencing strokes emphasize the importance of B12 supplements in preventing cardiovascular issues. While vegetarians have lower overall heart disease risk, inadequate B12 levels may increase the risk of stroke. Testing for functional B12 deficiency is crucial, as symptoms can be subtle and easily missed. In many cases, a normal serum B12 level may not accurately reflect B12 status at the cellular level. Measuring levels of methylmalonic acid or homocysteine provides a more accurate assessment. Subclinical functional B12 deficiency is more widespread than previously assumed, especially among vegetarians and vegans. Regular B12 supplementation is recommended to maintain optimal levels. In cases of persistently high homocysteine levels despite supplementation, alternative approaches may be necessary.
Regular monitoring of B12 status, especially among plant-based individuals, is essential to prevent deficiencies. Ensuring adequate B12 levels through supplementation is key to maintaining optimal health and reducing the risk of cardiovascular issues. Further research is needed to better understand the impact of B12 deficiency and the importance of regular testing for at-risk populations.
