Getting the nutrients we need

by Dr Paul Palmer

In this article I will be discussing the role of supplementing certain key nutrients and vitamins as a vegan. Should we supplement or should we go ‘natural’? Unfortunately with the world being as complicated as it is and so vastly different from our ‘caveman’ days I believe that a simple answer is not possible, but I can give you an uncomplicated recommendation.

From the research I have done and from my experience with patients our lives are just so crammed full of things to do and tasks to complete that balancing our responsibilities often supersedes the need to balance ones diet. Convenience foods creep into the diet and make it difficult to juggle our nutrient balances and so I have identified the 4 problem nutrients I believe we should be supplementing.

VITAMIN D – Now ideally I would advise anyone in South Africa to get their Vitamin D from the sun by spending 15-30 minutes daily in the sun with at least half the body exposed. If this is not possible the research suggests that 2,000 IU supplemental vitamin D is advisable on a daily basis to maintain good bone health. I base most of my recommendations on the work done by Dr Michael Gregor ( who has compiled the most convincing interpretation of global nutritional research in my opinion. While supplementing with vitamin D is still somewhat debatable the bottom line is this; if you can’t get into the sun regularly a vitamin D supplement is a safer bet and covers your bases.

VITAMIN B12 – Health risks associated with B12 deficiency include neurological and psychiatric disorders, including Alzheimer’s disease, and an increased risk of heart disease. It’s very important to keep your levels up as a vegan and there are a few foods like nori seaweed and tempeh which naturally containsmall amounts of bioactive B12 but if you don’t eat these foods very regularly, you need to take a vitamin B12 supplement. I recommend an injectable supplement of 2500mcg every week , taking a daily oral B12 supplement or using B12 transdermal patches. It is advisable to take a liquid oral B12 if available as some oral capsules and pills have been found to be ineffective. In my opinion B12 should rather be taken in excess as you cannot overdose on B12 and the benefits of good B12 levels are numerous. The injectable form we get in South Africa is CYANOcobalamin;”A common synthetic form of the vitamin, cyanocobalamin, does not occur in nature, but is used in many pharmaceuticals and supplements, and as a food additive, because of its lower cost. In the body it is converted to the physiological forms, methylcobalamin and adenosylcobalamin, leaving behind the cyanide…” ( While this injectable version does help with B12 levels it is advisable to find B12 in the form of METHYLcobalamin which is the form that exists in nature, and it is pre-methylated, meaning it’s ready for your biochemistry to put to immediate use. I would use the liquid oralmethylcobalamin drops or the popular B12 patches that deliver methylcobalamintransdermally, but if your only option is the injectable cyanocobalamin then go for it- B12 deficiency is of greater concern then the injectable biproducts.

Omega 3- So there are actually three important omega-3 fatty acids (ALA – alpha-linolenic acid; EPA – eicosapentaenoic acid; DHA – docosahexaenoic acid) but don’t try remembering the names just try remembering the acronyms ALA, EPA and DHA. The body can convert ALA into EPA and into DHA but while ALA is very efficiently converted to EPA, it may require large amounts of ALA to produce optimal amounts of DHA. Here is the problem, it would take extreme diligence to obtain enough natural ALA (eg Flaxseed)through the diet to produce the optimum level of DHA and a deficiency can result in fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation. I recommend 250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (DHA) to keep levels optimal and prevent problems.

Iodine- Most people get their iodine from iodized salt and a 1/4 tsp of iodized salt gives about 45% of the Recommended Dietary Allowance (RDA) for iodine, but it has loads of sodium and is not the best choice as your source of iodine. According to sea vegetables such as nori, dulse, and alaria are excellent sources of iodine and do not appear to be polluted but I just can’t see South Africans eating enough of these foods to keep our levels healthy. As I mentioned above these recommendations are about being smart with what is available in our modern age and I would say that supplementing with an iodine supplement is one of the smartest choices a vegan can make. With an important role to play in thyroid functioning this is not a deficiency to be taken lightly but it must be noted that too much iodine is not healthy either- a 150 mcg daily supplement is sufficient and will help insure a healthy metabolism.
What about calcium supplements?
Researchers have found that taking calcium supplements offers no reduction in hip fracture risk; in fact an increased risk is possible. The randomized controlled trials showed a 64% greater risk of hip fractures with calcium supplementation compared to just getting a placebo sugar pill.More recent calcium balance studies suggest that the calcium requirement for men and women is lower than previously estimated. They found calcium balance was highly resistant to change across a broad range of intakes, meaning our body is clever. If we eat less calcium, our body absorbs more and excretes less, and if we eat more calcium, we absorb less and excrete more to stay in balance. So the current evidence suggests that dietary calcium intake is not something most people need to worry about.
But then why are both Vegans and Omnivores deficient in calcium?
Because neither Vegans nor Omnivores include enough whole plant foods like beans, legumes and leafy greens in their diet. Calcium, it seems, is only effective if eaten in food, not supplements.
At the moment these 5 nutrients were on my watch list and I would say that these are the most notable deficiencies that vegans exhibit and most of these deficiencies seem to start occurring after about 18-24months of going vegan. Obviously with correct supplementation this would not occur and I fear that some vegans may be sacrificing their health trying to be too ‘purest’ or ‘natural’ and unfortunately some of these nutrients in particular are very hard to obtain without supplementing. Just being a vegan and avoiding animal foods does not guarantee health, there are certain fundamentals that need to be adopted by the vegan community so we can be the greatest example of a healthy lifestyle. These fundamentals include eating a predominantly whole foods diet, limiting oils, getting enough exercise, staying hydrated and using supplementation to acquire important nutrients that are scarce in a vegan diet.
Recommendations quick summary:
Vitamin B12- 2,500 mcg (µg) every week, or at least 250 mcg (µg) a day orally
Vitamin D- 15-30 minutes daily sunlight (at least half body exposed) or 2,000 IU supplemental vitamin D
Omega 3- 250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA)
Iodine- For those who don’t eat seaweed often or use iodized salt, a 150 mcg daily supplement
Calcium- Variety of whole foods including beans, legumes and leafy greens.


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