If you have gone vegan or plant-based, there are some nutrients you should keep an eye on.

First, a good quality vegan or plant-based diet with plenty of fresh unprocessed whole foods, is important, and shows excellent health outcomes and longevity in studies. However, a poor quality vegan diet full of processed foods, of which there are plenty nowadays directed to vegans, is associated with poorer outcomes than an omnivorous diet.

B12

B12 is not very available in plant foods, although it is abundant in animal foods. There may be traces in mushrooms, in algae, and plants that are contaminated with soil. Some soy or nutmilks are B12-supplemented- check the label.

B12 is important for the myelin that insulates nerves, neurotransmitters and for making red blood cells, and deficiency can be serious. You can get tested for B12 levels ....it is stored in the liver so you probably won't be deficient in the first months of being vegan but after a while, your stores may run dangerously low. It is easily supplemented and highly recommended to do so.

An addendum to this- the normal range of B12 is 200-700pg/ml……however, the optimum range is 500-1300pg/ml, and that is the standard range in Japan. So when a doctor tells you your B12 is fine and it is 220 or even 350pg/ml……it is actually not. You may not have clinical B12 deficiency, but you will not feel as good as you can. Higher B12 is associated with better cognitive health and decreased brain atrophy, dementia and depression. It is also better for our nervous systems.

Zinc

Zinc is an essential mineral that even omnivores are frequently short in, because there is not a lot in our soils. It is needed for the nervous system, for making sure you have enough stomach acid to digest your food well, for fighting infection and all sorts of enzymatic reactions in the body. While there is zinc in many plant foods, such as nuts, seed, chickpeas, bread and leafy greens....it is often poorly absorbed compared to animal sources, because phytates in plants can block absorption. To be on the safe side, I recommend most people- omnivores and plant based- to supplement zinc, because it is so crucial for our bodies.

Iron

Iron is another essential mineral. Again, it is available in many plant-based foods, but often poorly absorbed. We don’t want too much, as high iron is associated with shorter life span, but too little can also be a problem for many women. Some people seem to have no trouble absorbing iron, and others have a lot of trouble. This may be because of low stomach acid (which needs good amounts of zinc to improve!), or possibly viral infections feeding on the iron.

It is the ferritin that is most useful to track- the amount of iron our body is storing- and if your ferritin is low you will likely have cold hands and feet and feel low in energy. You may feel like you are running on adrenalin (aka coffee!) because that’s what it takes to keep you going. Getting your iron levels up can make a big difference to your sense of wellbeing, and also help with other health issues such as with your thyroid.

There are a variety of iron supplements available, both pharmacy (eg Maltofer), which can sometimes be harsh on the tummy and constipating, and Naturopathic (eg Bioceuticals Iron Sustain). Sometimes larger amounts are needed- this warrants discussion with your health professional.

I recommend taking 1000mg of Vit C with every iron tablet, to significantly increase the absorption. The amount they add to the tablets is not sufficient and more will help.

Spirulina, 1 tsp or 6 tablets 2x a day, might be enough to top up or maintain healthy iron levels for many women. Eating the equivalent of 1 bunch of leafy greens such as spinach a day also has so many health benefits, and iron is one. Again, taking some Vit C can help with iron absorption.

Iodine

Another vital nutrient is iodine, which is needed for the thyroid, which governs the metabolic rate..but is also needed by every cell in the body. It is protective against breast cancer for women. Iodine is available in seafood for omnivores, but for vegans, the main source is seaweed, although iodised salt alone or in products may also help a little. If you eat plenty of seaweed- you are probably fine. If not, or you haven't for a long time, it may be worth getting your iodine levels checked and to supplement for a while. It is also easy enough to add seaweed to soups and stews, even smoothies, and it is available at Asian food stores.

Calcium, Bone health

A good quality vegan diet can sustain healthy bone density, according to some studies. There are other studies that raise concerns about lower bone density and higher rates of fractures. It is thought that the higher potassium intake and lower acid load of a healthy vegan diet is somewhat protective against lower bone density- it is more complex than just getting enough calcium. The body can upregulate calcium absorption if calcium intake is low, however if it is too low, it is an issue.

It is worth being aware of your calcium intake if you are vegan and making sure your other bone cofactors are plentiful as well (such as silica, Vit D and boron). Quality sources of calcium are: beans, peas, lentils, leafy greens, almonds, chia, flaxseeds, and tahini. A supplement may be helpful, but many on the market are low quality supplements.

Omega-3 Fatty Acids

Levels of omega 3 (EPA, DHA) fatty acids do tend to be lower in plant based people, however there is no evidence that this negatively affects their cardiovascular or brain function. In vegetarians and vegans, alpha linolenic acids (ALA) from plants are transformed into EPA and to a lesser extent, DHA, and if levels are low, again, the body will upregulate this process.

Flaxseeds, chia seeds, walnuts and hemp, are all good sources of ALA, especially flax and chia. There are algae-based omega-3 supplements readily available, and I would recommend these particularly to pregnant women, as their needs are higher.

Vegans…please listen to your body

There are enough studies out now to prove that it is possible to thrive on a high-quality plant based diet. It can clearly be protective against the metabolic diseases such as cardiovascular disease, and T2 diabetes. But if you lead a busy lifestyle and fall back on less-than-ideal food such as too much bread, white rice, cakes and biscuits, vegan raw sweets and not enough fruit and vegetables, you may need to supplement and/or reconsider. Being vegan alone is not enough to protect your health long term, and can lead to significant deficiencies. Superfoods can be a good way to supplement, such as spirulina and dulse, but it needs to be regular, not occasional.

I believe that the Whole Food Plant Based approach to eating, which is to all intents and purposed vegan, is a well-balanced approach that is helping many people heal.

In my experience, plant-based eating, particularly low fat, high raw whole food plant-based eating, can be a very healing diet for some people- particularly people who have signs of excess and heat in their body. However, I have seen many people feel very good on it for the first few months, as the body lightens up, cleanses and heals. Long term, deficiencies are possible unless the diet is very high quality. To be honest, the same can be said for any way of eating.

Many vegans gravitate back to animal foods after a year or 2, because they recognise their body is no longer thriving as it did in the beginning. Just being vegan or plant-based is no guarantee of good health, and in our busy modern lives it can be difficult to keep up a high quality diet long term. However, many others have found a way to thrive longer term, by maintaining a high-quality diet. There are many good resources nowadays.

I support people to thrive on whatever diet they wish, but to most importantly, listen to their own body.