B12 is only available in foods that are either fortified with it or in animal products. Vegans are most at risk but they are not the only ones.
Natto: https://www.eatthismuch.com/food/nutrition/natto,3608/
Has -0- B12 despite what some say to the contrary.
Tempeh: http://www.dietandfitnesstoday.com/vitamin-b12-in-tempeh.php
Has a very low amount of B12 at 1 - 2% of the government recommended daily amount.
https://veganhealth.org/vitamin-b12/ A more complete article.
Many people who eat meat are being found to be B12 deficient. Tuft University researchers, analyzing data from the large-scale Framingham Offspring Study, found that nearly 40 % of the participants aged twenty-six to eighty-three had plasma B12 levels in the “Low normal” range- a level at which many people begin to experience neurological problems.1 Smaller studies report that 15-20 percent of seniors have a vitamin B12 deficiency.2 A recent study found that 40 percent of hospitalized elderly patients had low or borderline serum B12 levels.3
Over 80 percent of long-term vegans who do not adequately supplement their diet with B12 and over 50 percent of long-term vegetarians, show evidence suggestive of B12 deficiency.4
The CDC reported that B12 deficiency is present in every 1 out of 31 people over the age of 50 but this is underreported because the baseline level used is too low.
Here are some symptoms of B12 deficiency: Early signs are unusual fatigue, faulty digestion, no appetite, nausea and loss of menstruation. Later signs include numbness and tingling of the hands and feet, nervousness and diarrhea.
There are two common tests, a blood test for B12 and a urine test. The urine test, while not completely accurate is better. You can have a false high B12 reading if you eat leafy greens, drink green drinks or take folic acid. High homocysteine levels in the blood may indicate a B12 deficiency as does enlarged red blood cells.
B12 is only present in animal products and is highest in organ meats and sardines. If you are deficient or are vegan or vegetarian, you can take a 5000-microgram sublingual tablet of the methyl cobalamin B12 under your tongue daily or get shots. When food is fortified with B12 or is in supplements, it is not well absorbed if you are B12 deficient because adequate stomach acid is necessary for absorbing B12 through the digestive tract. Adequate stomach acid requires B12. Some people don’t respond to the B12 under the tongue and need to get shots. If you need shots, ask the doctor for shots that don’t have as many preservatives.
People eating meat who are B12 deficient may have poor digestion from eating a too rich modern diet. They are not absorbing the B12 from food.
There are no vegan sources of B12 in foods. The B12 in shots and pills is appropriate for vegans because it has no animal products.
A good idea is for everyone over 60 is to take B12 weekly or daily even if you eat natural meats.
1 Judy McBride, Agricultural Research Service website, U. S Department of Agriculture, August 2, 2000. http://www.ars.usda.gov/is/pr/2000/000802.htm
2 Shahar, A., Feiglin, L., Shahar D, R., Levy, S., and Seligsohn, U. Journal of Nutrition, Health and Aging (2001) 5:124-7
3 Could It Be B12 by Sally Pacholok and Jeffery Stuart. You can find more information about B12 in this excellent book,
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933506/ This study shows that many people including non-vegetarians are at very low levels of B12 because what they think is sufficient is not.
https://www.nature.com/articles/ejcn201446 more information