Vitamin B12 for Indian Vegetarians: Foods, Myths, and Deficiency
Expert-reviewed guide for Indian diets
Vitamin B12 is one of the most poorly understood nutrients in Indian nutrition discussions, and the misinformation around it has real consequences for people's health. Let me state the critical fact clearly: vitamin B12 is produced exclusively by bacteria and archaea. It is found in meaningful quantities only in animal-sourced foods — meat, poultry, fish, eggs, and dairy — because these animals either produce B12-synthesising bacteria in their gut or consume bacteria directly. There is no plant food that contains true, bioavailable vitamin B12. None. This is not a controversial statement — it is textbook biochemistry.
Why does this matter specifically in India? Because India has one of the world's highest proportions of vegetarian population — an estimated 30–40% of Indians are vegetarian, and a significant proportion of non-vegetarians eat meat very infrequently. Dairy and eggs are the only animal-sourced B12 that vegetarians consume, and the quantities required are significant: you need two to three serves of dairy or eggs daily to reliably meet your B12 requirement of 2.4 mcg per day. Many Indian vegetarians eat curd and drink milk but in quantities that provide perhaps 0.8–1.2 mcg of B12 — not enough for adequate status long-term.
The most dangerous B12 myths I encounter repeatedly: (1) "Fermented foods like idli, dosa, and curd contain B12." Partially true — bacterial fermentation does produce some B12 analogues, but multiple studies have shown these are largely inactive cobalamin analogues that do not function as true B12 in human metabolism. You cannot rely on idli and dosa for your B12. (2) "Spirulina and chlorella contain B12." Also partially true in the worst way — these algae contain B12-like compounds that are actually B12 analogues that block true B12 absorption. Consuming spirulina can worsen B12 deficiency rather than helping it. (3) "My traditional Indian ancestors were fine without supplements." Many were not — B12 deficiency causing neurological symptoms was common and often attributed to other causes. And traditional diets included more dairy and less processed food than current urban vegetarian diets.
B12 deficiency is particularly insidious because it takes years to deplete stores (the liver stores 2–5 years' worth), and symptoms appear gradually. By the time neurological symptoms develop — tingling hands and feet, memory problems, balance issues — significant and sometimes irreversible nerve damage may already have occurred. This is not a minor nutritional issue. For strict vegetarians and vegans, B12 supplementation is not optional — it is a medical necessity.
Foods to Eat
Eggs — Best Vegetarian Source at 0.6 mcg Per Egg
For people who eat eggs, this is the most reliable vegetarian B12 source. One egg provides approximately 0.6 mcg of B12 — a quarter of the daily requirement. Three eggs daily provides 1.8 mcg, which combined with dairy gets most people close to the 2.4 mcg requirement. The B12 in eggs is primarily in the yolk, which is another reason eating whole eggs rather than only whites is nutritionally superior. If you identify as vegetarian but eat eggs, please do so regularly — your B12 and iron status will be meaningfully better than strict vegetarians who don't.
Milk (Doodh) — 0.9 mcg per 250ml Glass
One glass of milk provides about 0.9 mcg of B12 — roughly 37% of the daily requirement. Two glasses daily provides nearly 80% of daily needs from milk alone. The B12 in milk is well-absorbed because it travels bound to a protein (haptocorrin) that aids absorption. Full-fat and skim milk have similar B12 contents — the vitamin D difference is the main nutritional distinction between them. For vegetarians, making two glasses of milk a daily non-negotiable habit (not just in tea, but as a standalone drink or in curd) is the simplest dietary B12 strategy.
Dahi (Curd) — 0.3–0.6 mcg per Katori
Curd contains B12 produced by the lactic acid bacteria of fermentation — about 0.3–0.6 mcg per katori, varying with fermentation time and bacterial strains. The B12 in curd appears to be genuine and bioavailable, unlike the analogues in non-dairy fermented foods. Having a substantial katori of curd daily contributes meaningfully to B12 intake for lacto-vegetarians. Homemade curd set with active starter culture (not UHT-treated curd) has better B12 content. The longer the curd is set (especially in slightly warmer conditions), the more bacterial fermentation and B12 production occurs.
Paneer — 0.8 mcg per 100g
Paneer provides approximately 0.8 mcg of B12 per 100g serving. As a concentrated dairy product, it delivers B12 alongside protein and calcium — a nutritionally useful combination for vegetarians. Eating 100–150g of paneer three to four times per week adds meaningfully to cumulative B12 intake. Fresh homemade paneer has similar B12 content to commercial paneer. As with milk, it's a complement to — not a replacement for — a complete B12 strategy.
B12-Fortified Foods
Several foods available in India are now fortified with B12: certain breakfast cereals, nutritional yeast (available in health food stores and online), some plant milks (soya milk, oat milk), and certain energy drinks. Nutritional yeast — not baker's yeast — is often heavily fortified with B12 and has a savoury, cheese-like flavour that can be sprinkled on food. If you're a strict vegetarian or vegan, fortified foods alongside a B12 supplement are the necessary strategy. Check labels for B12 content — not all fortified foods have the same level.
Vitamin B12 Supplements (Essential for Vegans and Many Vegetarians)
I include this because it's the honest, evidence-based recommendation: if you are a vegan, or a vegetarian eating less than two servings of dairy and one egg daily, you likely need a B12 supplement. Cyanocobalamin (the most common supplement form) is stable and effective. The recommended supplemental dose for adults is 25–100 mcg daily, or 1,000 mcg two to three times per week — higher doses are used to compensate for the decreasing absorption efficiency at larger doses (B12 absorption is saturable). Sublingual B12 tablets (dissolved under the tongue) have excellent absorption. Methylcobalamin is the active form but has similar long-term efficacy to cyanocobalamin in supplementation.
Foods to Avoid
Spirulina and Chlorella as B12 Sources
This is a specific, potentially harmful mistake: spirulina and chlorella are marketed as plant-based B12 sources, and they do contain compounds that resemble B12 — called corrinoids or B12 analogues. However, these analogues are not only non-functional as B12 in human metabolism, they actively compete with true B12 for absorption receptors in the gut, potentially worsening B12 status in people who consume them while believing they're meeting their B12 needs. Studies on vegans consuming spirulina have shown unchanged or worsened B12 functional markers despite the spirulina "B12" content. Do not use spirulina for B12 — it is ineffective at best and counterproductive at worst.
Depending on Idli, Dosa, and Fermented Foods for B12
The idea that traditional South Indian fermented foods (idli, dosa, dhokla, kanji) provide meaningful B12 comes from the fact that bacterial fermentation can produce B12. However, studies that have directly measured the B12 content and bioavailability of these foods consistently show the B12 analogues produced are not bioavailable in humans. A 1994 study found that vegans consuming fermented foods had no improvement in B12 status compared to those who didn't. Traditional vegetarian diets in India were protected by dairy and, in many communities, occasional eggs — not by fermented grains.
Waiting for Symptoms to Check B12
The neurological damage from severe B12 deficiency — peripheral neuropathy causing tingling and numbness, subacute combined degeneration of the spinal cord, and cognitive impairment — can be irreversible if treatment is delayed. The insidious part is that symptoms develop slowly over years as liver stores deplete, and are often attributed to other causes (stress, diabetes, age-related changes). For any Indian vegetarian who has been strict about avoiding eggs and consuming limited dairy for five or more years, getting a serum B12 test is urgent — don't wait for symptoms.
B12 Injections Unnecessarily Over Oral Supplements
Many people believe that B12 injections are superior to oral supplements and required for absorption. This is true for a specific condition — pernicious anaemia — in which the intrinsic factor required for B12 absorption is absent. For most vegetarians with dietary B12 deficiency and normal gut function, oral cyanocobalamin at high doses (1,000 mcg daily or 2,000 mcg weekly) is absorbed adequately through passive diffusion — even without intrinsic factor — and corrects deficiency as effectively as injections. Injections are more expensive, require a clinic visit, and cause discomfort unnecessarily for most people. Ask your doctor specifically whether your situation requires injections or whether oral supplementation is appropriate.
Practical Tips for the Indian Kitchen
Get Your B12 Tested — Especially If Vegetarian for Years
A serum vitamin B12 test is inexpensive (200–400 rupees) and widely available. Normal range is typically 200–900 pg/mL, but functional deficiency symptoms can occur at levels between 200–350 pg/mL — what labs label "normal" may not be optimal. Ask your doctor to also check methylmalonic acid (MMA) and homocysteine levels if B12 is borderline — these are more sensitive functional markers of B12 adequacy. Test once, know your baseline, and retest 6 months after any dietary or supplement change.
Two Glasses of Milk Daily If You Don't Eat Eggs
For lacto-vegetarians who don't eat eggs, two glasses of milk plus a katori of curd daily provides approximately 1.5–2 mcg of B12 — close to but often slightly below the 2.4 mcg daily requirement. This is borderline sufficient for many people, which is why even dairy-consuming vegetarians frequently show low-normal B12. Adding paneer two to three times weekly and ensuring generous curd intake rounds out dietary B12. If your levels are still low despite this, supplementation is the appropriate next step.
Eat Eggs If You're Open to It
Many Indian vegetarians are flexible about eggs (the term "eggetarian" exists for a reason). Three eggs daily provides approximately 1.8 mcg of B12 alongside excellent protein, iron, and vitamin D. Combined with dairy, this easily meets the daily 2.4 mcg requirement. If your primary concern is B12 deficiency and you're not ethically opposed to eggs, incorporating them is the most nutritionally complete solution. I mention this not to undermine individual choices but because I see people struggling with B12 deficiency who would easily resolve it with one dietary change they hadn't considered.
For Vegans: Supplement, Don't Gamble
If you follow a vegan diet — no eggs, no dairy — please do not gamble on dietary B12 sources. Supplement with 1,000 mcg of cyanocobalamin daily (or 2,000 mcg two to three times weekly). This is unambiguous medical advice, not a suggestion. The neurological damage from untreated B12 deficiency can be permanent. B12 supplementation is safe at these doses, inexpensive, and the one non-negotiable for vegan nutrition. Everything else in a well-planned vegan diet can be obtained from food — B12 cannot.
If You're Pregnant — This Is Urgent
B12 deficiency during pregnancy is associated with neural tube defects, intrauterine growth restriction, and — critically — severe B12 deficiency in the breastfed infant (whose only B12 source is breast milk). Indian studies have documented cases of infants of vegetarian mothers developing serious neurological damage from B12 deficiency in the first year of life. Any vegetarian or vegan woman planning pregnancy or currently pregnant should have B12 tested immediately and supplement under medical guidance.
Frequently Asked Questions
Q: Can I get enough B12 from curd and milk without supplements?
A: For most lacto-vegetarians consuming generous amounts of dairy — two glasses of milk, a katori of curd, and some paneer or cheese daily — it is theoretically possible to meet the 2.4 mcg daily requirement. However, actual intake studies show most vegetarian Indians fall below this, and B12 from food has variable absorption depending on stomach acid levels (which decline with age). People over 50 have significantly reduced B12 absorption from food due to reduced stomach acid, making supplementation advisable regardless of dairy intake. Monitor your levels with annual testing rather than assuming dietary intake is sufficient.
Q: What are the early signs of B12 deficiency?
A: Early signs are often subtle and non-specific: persistent fatigue not explained by poor sleep, tingling or numbness in hands and feet (peripheral neuropathy), slightly elevated homocysteine (detected on blood tests, associated with heart disease risk), unusual forgetfulness or difficulty concentrating, and mood changes including low mood and irritability. Later signs include macrocytic anaemia (large red blood cells that carry oxygen poorly), more severe neurological symptoms, and in advanced cases, difficulty with balance and walking. Early detection through blood testing prevents progression to the irreversible neurological stages.
Q: Is methylcobalamin better than cyanocobalamin?
A: Methylcobalamin is the active, ready-to-use form of B12 that doesn't require conversion in the body. Cyanocobalamin is a synthetic form that the body converts to methylcobalamin after absorption. For most healthy adults, both forms are equally effective for correcting B12 deficiency and maintaining adequate status. Methylcobalamin may be preferable for people with certain genetic variants that affect B12 metabolism (MTHFR polymorphisms, for example). Cyanocobalamin is cheaper, more stable, and has a longer track record in research. Either is appropriate for supplementation — don't overthink this if cost is a factor.
Q: If I've been vegetarian my whole life, doesn't my body adapt to need less B12?
A: No — the body does not adapt to require less B12. B12 is essential for DNA synthesis, red blood cell formation, myelin sheath maintenance (the insulating layer of nerves), and homocysteine metabolism. These functions cannot be downregulated. What happens instead is that lifelong vegetarians deplete their liver B12 stores gradually over years or decades, and then deficiency develops. The liver can store 2–5 years of B12, which is why strict vegetarians can remain asymptomatic for a long time before deficiency becomes clinically apparent. The absence of symptoms does not mean adequate B12 status.
Q: Can high folate intake hide B12 deficiency?
A: Yes — this is an important clinical point. High folate intake (from a diet rich in dal, green vegetables, and fortified grains) can correct the anaemia component of B12 deficiency without correcting the neurological damage. This means someone eating a folate-rich vegetarian diet may have normal haemoglobin and a normal blood count but progressive nerve damage from B12 deficiency occurring silently. This is why B12 testing should include serum B12 and ideally homocysteine or methylmalonic acid — not just haemoglobin. Don't be reassured by a normal blood count if you're a long-term vegetarian with inadequate B12 sources.
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