h and repair of tissues. This becomes especially important for tissues which are constantly reproducing such as red blood cells of which ten thousand need to be replaced every second. As important as this may seem, B-12 is required by the body in only the tiniest amounts. The Recommended Dietary Allowance for B-12 is only 2 mcg. daily. This figure is higher for pregnant women and children. The reason this poses a risk for the vegetarian is that b-12 can only be found in animal products including meat, milk, eggs and certain fermented products. Especially for a vegan this may pose a problem.
The signs and symptoms of Vitamin B-12 deficiency are insidious, and may take years to develop. It is important for vegetarians to note that green vegetables contain folic acid which may mask the symptoms of blood deficiency which may go unnoticed until irreparable nerve damage has occurred. Of course this implies blood deficiency in the western sense, however it is probable that the practitioner of TOM would be able to help the patient with earlier diagnosis utilizing energetic diagnostics. According to Pitchford the tongue of a vitamin B-12 patient will commonly present as red, shiny, smooth and occasionally ulcerated. B-12 deficiency has also been attributed to mental disorders and it is common for mental problems ranging all the way up the scale to acute psychosis to be among the first symptoms. Insanity, nervousness, and chronic fatigue have been attributed to borderline levels of B-12 deficiency. The view that Vitamin B-12 can only be obtained from meat is a debatable one. B-12 can be found in trace amounts in air, water, mushrooms, fermented products and even the herb Radix Angelica Sinensis (Dang Gui), a blood tonic coincidentally9 Some point to the successful primarily vegetarian diets of traditional cultures, or contend that there is enough natural bacteria in our digestive tract to provide B-12 as a byproduct. Still others claim that there is enough b-12 in a diet based primarily on whole grains and beans. Seaweed and micro-algaes have also been proclaimed to be significant sources of this essential vitamin. Yet, there are problems with all these alternative sources that deserve discussion.
In traditional cultures organically grown vegetables would have been eaten. There would have been less sanitation, chemicals and pesticides used in the production of crops. Also modern topsoils have been depleted from many nutrients essential to good nutrition. Bacteria and insects would have provided enough B-12 in these instances. 548.185 Other factors in our Modern culture also limit the uptake of vitamin B-12 are the widespread use of antibiotics and birth control pills. Stress from emotional factors or physical injury adversely affects B-12 absorption, as well as liver disease and chronic illnesses. A perception from a health perspective that traditional cultures were better off however is perhaps idealistic and simplistic.
In less industrialized cultures of the world it is more likely that fermented products provide an adequate supply of B-12. However, many of these products made for mass production are made in highly sanitized environments where bacteria have little chance to form cultures in quantities for significant amounts of B-12. For similar reasons it is unlikely that there is enough B-12 from flora in the digestive tract for human needs, and it has even yet to be proven that this is even being assimilated. Obviously antibiotics would be a significant factor here. It is helpful to include fermented products in a strictly vegetarian diet, however , as these seem to be beneficial in uptake of the vitamin.
By far the majority of sources I found on the subject insisted that B-12 must come from animal products. For the vegan , abstaining from even eggs or milk, it is therefore essential to be finding some supplementation. One plausible explanation for this overwhelming view is that B-12 is found only in the animal cell is that it helps to synthesize it's DNAC nucleic acid of which thymine is a base. Vegetable products are primarily sources of RNA structures which have no thymine as a base. In the case of red blood cell production folic acid will enable the cells to go through intermediate stages of growth, but can not bring them to their full growth. And this is why folic acid may mask symptoms of true blood deficiency for so long.
Seaweed's and micro-algaes have until recently been praised as being rich sources of vitamin B-12. Testing has shown however that much of the actual quantities of this vitamin are not available to by the human body as they are analogs. The analogs mimic B-12 but can not be utilized by the body, and furthermore may actually be blocking the uptake of usable b-12 by the body. It is probably not wise to rely on these sources given this information.
Pitchford recommends the use of a B-12 supplement for a healthy vegetarian diet. It is perhaps significant to note that this is the only vitamin supplement which he feels is absolutely necessary. B-12 supplements made from nutritional yeast gown in a B-12 solution preferably on molasses or sugar beets. The uptake of such supplements can be assisted by eating enzyme rich foods such as pickles, sauerkraut, or sprouts. It is not advisable to take a multivitamin version of B-12 as analogs similar to the case of sea vegetables are often present to block uptake. This method is probably not the best choice however, for those with problems involving yeast infections.
Regardless of the various ideas about B-12 absorption presented here. It is a simple and inexpensive procedure for a clinic to run a vitamin B-12 test. Perhaps this is an excellent idea to try first , before making radical alterations in a patients diet.
Body Energetics
An area where many vegetarians seem to get in trouble is the nature of the foods they are eating. With no regard or understanding to their own state of body tendencies, many uphold a cold raw foods diet as the healthy way to go. Many women decide to try to loose weight by eating only cold salads, and thereby destroy the digestive fire, and the spleen's strength in the process. Another example is vegetarians who only eat fish, which by nature is a cooling food and depletes the internal warmth. This ,it seems is an area where the practitioner of Oriental Medicine can be particularly useful to the vegetarian. With our understanding of body energetics, as well as that of the climatic environment, it should be easy for us to assess the eating habits of vegetarians and make suggestions based on that. In order to get the right amount of nutrients, we would say qi, from the foods, it is important for the strict vegetarian to be eating based on foods in season that grow in the local environment, which are fresh and in season. This idea is also upheld by western nutritionists. Another important consideration is the racial or ethnic background of a person. For example many Native Americans do not fare very well on the rich modern American Diet. By returning back to a more traditional diet they become healthier and stronger. Finally, the methods in which foods are cooked should be consistent with these same parameters. In general however, it is recommended by Taoist nutritionists that most food should be cooked a little bit in order to keep the digestive fire in good health. Cooking food, even just a little maintains the digestive fire, and allows better digestion of needed nutrients. According to the Western view on this subject, uncooked and raw foods enzymes and vitamins are destroyed by cooking. The amount of nutrients measured however is before digestion and not after. This it seems reflects one of the fundamental differences between Western and Eastern. In the West the focus has been largely on the breakdown of systems into their fundamental parts. Eastern thinking provides a more macro view in which important things, such as taste and temperature of foods, is also important to good dietary balance. One need not be a nutritionist , but be firmly established in the basic diagnostic methods and sensitivity to climatic factors to help a patient make wise decisions in this regard. It is my experience that this simple information is largely overlooked by many vegetarians, who know nothing of the subject.
Becoming Vegetarian
It seems to be a sort of trendy cultural thing these days to say at the coffee shop that we have made the decision to become vegetarian. As mentioned earlier, many people seem to be just switching to vegetarianism without the slightest idea about what this means for their health and how to do it nutritionally. I myself, have been guilty of this. For those making the decision to become a vegetarian all the sources agree that this should be a slow process, not overnight. Pitchford's whole book is geared toward a gradual transition from the typical American diet. Even Taoist author's who do not advocate a total vegetarian regime, recommend moving slowly to a mostly vegetarian diet.
Vegetarians who return to eating meat experience the same digestive difficulties, so it makes sense that it would work in the reverse. Perhaps the best thing we can do for the vegetarian patient is point this fact out to them, and get an understanding of what level of maturity the decision to become a vegetarian is at. Getting the patient involved in understanding their nutrition is essential to their being a healthy vegetarian. It can not be done on a whim.
A Final Word
It should be clear at this point that being a vegetarian is not merely a diet choice, but a way of life. A vegetarian lifestyle requires discipline, planning, and a conscious effort to maintain a well rounded diet. It requires becoming actively involved, and personal responsibility. One must mature beyond eating things simply because they taste good and develop an attitude of eating for health preservation and personal cultivation. In addition to merely changing the way one eats, it is necessary to work towards a more harmonious existence in all facets of one's life. For these reasons, it could be argued that for the majority of Americans, living healthfully as a vegetarian is a monumental task. On the other hand, it does not mean it is impossible. Given the state of disharmony in our modern culture, the devastation of the environment, and the degree to which untampered meat and animal products is hard to come by, vegetarianism is a lifestyle worthy of considering and encouraging.
As practitioners of Oriental Medicine it behooves us to remember that we are instruments of influencing body, mind and spirit. In our Western materialistic society it is often easy for us to focus on ailments of the body, ignoring the rest. We need to be sensitive and understanding of others who are seeking a more spiritual existence, and be prepared to work with them within the parameters of the lifestyle choices of others. In our own tradition there are precedents for including at least a little meat in the diet. There is also a tradition for forgoing this for spiritual purposes. If a patient who has chosen a vegetarian lifestyle is having health difficulties, assessment of their particular regime, and alterations to the diet can be made. This should be attempted and encourage first, before insisting that meat should be eaten. According to our own tradition meat should only be a very small part of the diet anyway. If it appears that meat is, in our opinion, absolutely necessary, we must be prepared to counsel patients and provide them with a very clear understanding of their health and allow them to make an informed decision. This strategy should be approached with knowledge and compassion for our vegetarian patients.
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