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Fermented foods (such as tempeh), nori, spirulina, chlorella algae, and unfortified nutritional yeast cannot be relied upon as adequate or practical sources of B-12.39,40 Vegans must regularly consume reliable sourcesmeaning B-12 fortified foods or B-12 containing supplementsor they could become deficient, as shown in case studies of vegan infants, children, and adults

Diagnostic use under medical supervision remains permitted2026list_en_final_clean_septemb

Early warning signs of Vitamin B12 deficiency often include persistent fatigue and weakness, brain fog, memory and concentration issues, a smooth or sore tongue (glossitis), pale or yellowish skin, and tingling sensations in hands or feet

Other research shows that vitamin B12 might help treat chronic migraine