If You’re Vegan, You Need These Four Supplements

1. Vegan Omega-3

One plant-based diet benefit you’re probably heard about is the variety of healthful fats you’ll be eating – olive oil, avocado, and walnuts, to name a few. Omega-3 polyunsaturated fats are one of these healthful fats that can be found in plant foods. Per the NIH, omega-3s are “important components of the membranes that surround each cell in your body… omega-3s also provide calories to give your body energy and have many functions in your heart, blood vessels, lungs, immune system, and endocrine system.”

Long story short – omega-3 fats are putting in a lot of work in our bodies, and it’s important that we’re getting the right amount in our diets!

Additionally, plant-based fats tend to be lower in saturated fats, the type of fat found in animal products. The exclusion of most or all animal fats is one of the big reasons that plant-centric diets are linked with better cardiovascular health and decreased mortality compared with non-vegetarians.

You’ve probably also heard that a vegan diet can help improve your lipid panel (cholesterol, triglyderides, LDL, HDL). Isn’t the food I’m eating enough to get all my omega-3s? Can’t I just eat a lot of walnuts?

Not quite. There are actually several different types of omega-3 fats, and we need all three of them. The one found in plant-foods at a high proportion is known as ALA – or alpha-linolenic acid. Our bodies can’t make this essential fatty acid – we have to get ALA from the diet. So the good news is, if you’re eating a well-balanced vegan diet, you’re more than likely consuming some good sources of ALA – things like soy, flaxseed, walnuts.  

There are two other types of omega-3 fats, however: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fats are naturally abundant in certain non-plant foods, such as salmon. People who eat salmon, omega-3-rich seafoods, or take a fish oil supplement get a greater proportion of EPA and DHA into their diet.

ALA – the one from plants – can actually be converted into EPA and DHA inside the human body! But only a small amount is converted to EPA and DHA. Thus, we need to take a vegan omega-3 supplement that contains EPA and DHA to obtain the correct amounts. Vegan omega-3s are derived from algae.

One additional point that I eluded to above – plenty of non-vegetarians likely need to be taking omega-3 supplements as well! It’s why fish oil and krill oil are such popular dietary supplements. Most non-vegetarian people aren’t getting enough omega-3 fats from their diet, so they’ll take a supplement to ensure their bases are covered. And that’s exactly what we’re trying to achieve in taking a vegan omega-3.

It is suggested to consume 250 to 500 milligrams of EPA and DHA (combined) per day.

2. Vitamin D

Surprise! This is another one that applies to both vegans and non-vegans. Did you know that sizable portion of the American population is deficient in vitamin D? Numbers ranging from 40% to 60% have been reported in research articles, with higher rates among certain groups, such as older adults or people with limited sun exposure. 

Now, why is vitamin D so important, and why is it a problem that so many of us are deficient?

Vitamin D is known to be an important player in bone health, in conjunction with calcium. It is necessary for bone growth and bone metabolism. Just like the rest of our cells, bone cells turnover and regenerate throughout our lives, and vitamin D is needed to ensure our bones stay strong. Inadequate vitamin D can increase risk for brittle bones, fractures, and osteoporosis.

Studies have also been conducted that indicate vitamin D may be an important vitamin to inhibit formation of certain cancers and slow tumor growth. Per the NIH, “further research is needed to determine whether vitamin D inadequacy increases cancer risk, whether greater exposure to the nutrient can prevent cancer, and whether some individuals could have an increased risk of cancer because of their vitamin D status over time.”

Vitamin D has also been linked to improved heart health and decreased risk for cardiovascular disease. 

So, you may ask … why can’t I just eat a lot of foods with vitamin D? Well, it’s true that is found naturally in some foods, and many other foods are fortified with vitamin D. We should aim to include a variety of foods containing vitamin D in our diets. But the foods naturally richest in vitamin D are animal-derived: items such as cod liver oil, trout, and salmon contain the greatest amounts.

Our bodies also synthesize vitamin D as a result of sun exposure. Some people don’t get enough sun exposure to promote this process: we literally just don’t spend enough time outside. Another group at risk are people living in colder climates who get less sunlight than people in other parts of the world. Additionally, Black people have greater amounts of melanin in their skin, which stymies the vitamin D synthesis process.

When it comes to to vegan diet – vitamin D supplementation is recommended due to the limited amounts we may get from our diet, as well as the likelihood our bodies may not be synthesizing enough from sunlight.

This is especially critical for people with kidney disease to be aware of, as the kidneys take part in the process of converting sunlight to vitamin D in the body. If the kidneys are damaged, this process cannot take place efficiently. A supplement will more that likely be required to maintain adequate blood levels.

The daily recommended amount of vitamin D is generally 1,000 to 2,000 IU. It is wise to have your labs drawn to see what your current level is before starting to take a vitamin D supplement.

3. Iron

Not all vegans will need to take iron if they are eating a well-planned diet, plentiful in iron-rich foods, but some might.

Plant-based iron rich foods include beans, lentils, chickpeas, soybeans (including tofu), spinach, and broccoli. These are all great foods to include in your well-rounded plan-based diet! The type of iron found in plant-based foods is called non-heme iron. In contrast, the iron found in animal foods is called heme iron. Heme iron is better absorbed by the body.

This doesn’t mean it’s impossible to get adequate iron on a plant-based diet. But certain people following plant-based diets are at a greater risk for iron deficiency. This includes people who are highly active, or people who menstruate.

Adequate iron helps to ensure we have enough healthy red blood cells to transport oxygen to the muscle tissue in our body. People who are highly active such as athletes or runners will need adequate iron to ensure their cells get the oxygen necessary to support their physical activity levels. Additionally, in runners, the heel strike that occurs while running can actually cause red blood cells to rupture. As a runner – it was fascinating for me to learn about this the first time I heard it! Who knew my healthy running habit could be causing anemia?

Others at risk include the following:

• People who menstruate experience loss of blood during their monthly cycle, thus putting them at a greater risk for iron deficiency anemia.
• People who regularly donate blood may also need to take an iron supplement to maintain the levels required to donate.
• People with kidney disease are at a greater risk for anemia as well, due to the role of the kidneys in red blood cell production. In addition to adequate iron, people with CKD may need certain B-vitamins or even medications to help correct the type of anemia related to kidney disease.

It is best to get a blood test to see what your current iron levels look like before starting a supplement.

4. Vitamin B-12

The above supplements mentioned are not 100% mandatory for everyone. They depend upon your personal lab results and should be initiated in consultation with your healthcare team.

Vitamin B-12 is a different story.

You MUST supplement with vitamin B-12 if you are following a 100% vegan diet. B-12 is only found naturally in animal foods. According to The Vegetarian Society, “B12 is synthesized in nature by micro-organisms. Animal-derived foods are a primary source because animals eat other animal food, they produce B12 internally due to the intestinal bacteria (not present in humans), and they eat food contaminated with bacteria.”

Although many plant-based foods are fortified with B-12 (such as non-dairy milks or nutritional yeast) the best way to reliably get the amount you need on a plant-based diet is to take a supplement.

B-12 is one of the B-vitamins noted above that’s crucial for production of red blood cells. It is also needed to form DNA and to support brain and nerve cells. Those are all pretty darn important processes that we’d like to keep running smoothly, wouldn’t you agree?!

An ideal starting dose of vitamin B-12 is 2,000 mcg weekly. It can be found in preparations such as tablets or liquids. It has been suggested that vitamin B-12 taken sublingually (under the tongue) is better absorbed than traditional tablets, but studies have shown that there is not a meaningful difference between the sublingual or oral route, according to the Harvard School of Public Health. Your physician can check your vitamin B-12 levels to determine if a different or greater dose is required to meet your needs.

The best way to take B-12 is the way that’s easiest for you! Tablet, liquid, or spray – it’s your call. Personally, I enjoy taking it in a spray form.

In Summary

If you are following a plant-based diet, it’s important that you pay mind to these vitamins and minerals. Not every vegan will need to take all four, but given that vegans and vegetarians are at a higher risk for deficiencies in these areas, it would be beneficial to get your labs drawn, discuss them with your physician, and ensure they’re aware that you follow a plant-based diet.

If nothing else, make sure to take that vitamin B-12. Everyone has their own reasons for pursuing a vegan diet, but if you’ve found me – a dietitian – it’s likely you’re interested in it for health reasons. So make sure you’re the healthiest vegan you can possibly be. Don’t be a silly vegan. Take those supplements! — Kate, Your Kidney Dietitian