Vegan and vegetarian diet: B12
First line
Vegan and long-term vegetarian diets without fortified foods are a major indication for preventive B12 intake. Without supplementation deficiency develops in some people within 1-2 years and in others over 5-10 years. NIH ODS 2024 and SEEN recommend 25-100 mcg of cyanocobalamin per day or 2000 mcg once weekly in vegans. Any iHerb form works; cyanocobalamin is cheaper and has the longest evidence base. Annual or biannual monitoring of B12, homocysteine and methylmalonic acid is appropriate. If you are vegan and not taking B12, discuss testing and a regimen with a clinician.