Vegetarians and Stroke Risk Factors—Vitamin B12 & Homocysteine?

NutritionFacts .org
NutritionFacts .org
28 Aug 2020

B12 deficiency and higher homocysteine levels factor into stroke risk. Not taking B12 supplements or regularly eating B12 fortified foods may explain the higher stroke risk found among vegetarians.

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I have updated my recommendation ( for B12 supplementation. I now suggest at least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach, or at least 50 mcg daily of supplemental cyanocobalamin (you needn’t worry about taking too much). You can also do servings of B12-fortified foods three times a day (at each meal), each containing at least 190% of the Daily Value listed on the nutrition facts label (based on the new labeling mandated to start January 1, 2020—the target is 4.5 mcg three times a day). Note that those over age 65 only have basically one option, taking 1000 micrograms a day.

We started this stroke series what to eat ( and not eat ( for stroke prevention, and whether vegetarians really have a higher stroke risk (

The last few videos have looked at specific factors:
• Vegetarians and Stroke Risk Factors—Vitamin D? (
• Vegetarians and Stroke Risk Factors—Omega 3s? (
• Vegetarians and Stroke Risk Factors—Vegan Junk Food? (
• Vegetarians and Stroke Risk Factors—Saturated Fat? (
• Vegetarians and Stroke Risk Factors—Animal Protein? (
• Vegetarians and Stroke Risk Factors—Vitamin B12 & Homocysteine? (

Stay tuned for:
• How to Test for Functional Vitamin B12 Deficiency (
• Should Vegetarians Take Creatine to Normalize Homocysteine? (
• The Efficacy and Safety of Creatine for High Homocysteine (

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-Michael Greger, MD FACLM

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