 What's the best way to stay healthy in the face of so much conflicting nutrition information? Well, ideally you would go to the source, the gold standard, the peer-reviewed medical literature, and read through the stacks of the latest medical journals. But who's got time for that? I do. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. If you had a plant-based diet, you may wonder, do we really need to take supplements like vitamin B12? Let's find out. Hello from Jonathan. How do you recommend navigating supplements, multivitamins, protein powders? I'm not sure what to trust. Give me the lax regulation. Absolutely. Well, certainly this regulation is indeed lax. So what protein powder to get? No protein powder. Why would anyone need protein powder to get protein? Same way, you get carbs. Same way, you get fat from whole foods, ideally whole plant foods. And no reason to take a multivitamin. There are some things that people may need in supplement form. For example, vitamin D for getting an adequate sunshine, vitamin B12, vitamin B12, 45 foods. So how do you get supplements that aren't contaminated with something or actually have what they say they have? Probably the best way to do it is to get one that is USP certified. So that's a third-party certification entity that makes sure that whatever says on the label is what is actually in the bottle. It doesn't mean it's good for you or anything. I mean, the USP certification of snake oil, but at least it would be actual snake oil at the dose that they say on the package. So it's kind of true than advertised. Okay, this is from Heidi Newton, a plant-based mostly fruit diet. Okay, for anyone to take vitamin B12 supplement, absolutely. Or even vitamin B12 fortified foods. One of those two critically important for anyone eating a plant-centered diet, even if it's not strictly plant-based, critically important to do. Okay, Gabrielle or Gabriel, what can cause tingling sensation in a whole food plant-based diet besides B12 deficiency? I presume you mean tingling sensation kind of fingers and toes. That's a sign of a peripheral, typically a sign of peripheral neuropathy. So let's say you have a problem with your nerves. Why would it show up as tingling in your fingers and toes? Well, those are the longest nerves in your body. So the nerve in your toe actually goes all the way up to your spinal cord, from your toe all the way up to spinal cord. One nerve, like one long, skinny, teeny little string of spaghetti, but like almost microscopic, actually microscopic, all the way up. Isn't that amazing? One, you know, you think of cells as being microscopic. This cell is like, you know, three feet long. So you can imagine if there's any problems with your nerves. Those are the nerves that are gonna really show it first, right? As ones that are so long and vulnerable. And so you get this kind of, that typical thing. But it can be caused of all sorts of things. There's all sorts of toxins, medications that can do it. And so you just really need to go to a neurologist and they go through the differential diagnosis, all the various things that can cause it. There are other nutritional deficiencies that can do it. And you just, some heavy metal tuxesies can do it. All of those autoimmune diseases, all sorts of things. So you just gotta get checked out. We got mechanic curcatsy. Do you have short-term effects with insufficient B12 rules? So I presume clinical effects. Do you actually feel differently in the short term from insufficient B12? You may not, which makes it so insidious, but you can start showing these subclinical issues in terms of rising, homocysteine or something, which you wouldn't really feel, but may have negative consequences. So a regular, reliable source of vitamin B12 is critically important. And so for those eating plant-based diets, for example, I would recommend either sufficient vitamin B12, 45 foods, or taking one, 2,000 microgram B12 tablet once a week. Get all the B12 you need. Super cheap, safe, easy, convenient, and critically important. Can you synthesize enough vitamin D during the warm months to last you throughout winter? Yes, in terms of enough vitamin D to live. I mean, that's the whole point, is that during the summer months, you have high latitudes. You build up enough and it's stored in your fat and you kind of live through the winter and then you get more. The next year. But do you have enough in your body for optimal health? That we don't know the answer. And we suspect that it's probably dipped too low. And indeed you see that study, the Oxford study on vegans in the UK, high latitude, vitamin D perfect in the summer, dips too low during the winter months. And so it's probably good when you're going to insufficiency sunshine to supplement your diet with vitamin D. And I would recommend 2,000 international units of vitamin D three a day for anyone getting insufficient sun. It doesn't matter where you live. Even in the warmer months, if you're inside all day, it doesn't matter how much sun there is outside, you're not going to make enough because it actually relies on cutaneous exposure without sunblock, without clothes. But we have next, this is from Stephanie. I don't know if vitamin D three is okay for a hopeful plant-based because I read vitamin D two is vegan rather than vitamin D three. Okay, there are vegan sources of both vitamin D two which is sourced predominantly from fungi, from mushrooms. And vitamin D three, which is sourced predominantly from sheep's wool, but is also from lichen, which is kind of an algae-based multi-cellular organism, but not an animal. Yeah, you can get vegan vitamin D three. All D two is vegan, but D three is probably preferable just because the studies showing increased longevity with vitamin D supplementation were all done on vitamin D three. And so since that's what the studies were done on, we don't know if that necessarily translates to D two. So I would just use D three if you have a choice. And if it's important for you to be vegan, you can get a vegan D three. No problem. We would love it if you could share with us your stories about reinventing your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials. We may be able to share it on our social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the nutrition facts podcast landing page. There you'll find all the detailed information you need plus links to all the sources we cite for each of these topics. 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