The Supplements I Recommend To All My Plant-Based Patients

Beyond highly processed junk food, another trap some vegans fall into is ignoring the need to supplement intelligently. This is not a limitation of the vegan diet but represents the state of the world with depleted soil and indoor lifestyles resulting in uniformly low vitamin intake. Most of the adults I seen in the clinic, whether their diet is vegan or otherwise, lack important nutrients that show up on the advanced testing I perform. The following list is what I add to my plant-based diet to maximize results (hint: The first three are the most important).

By some estimates, 50 percent of vegans and 10 percent of vegetarians are deficient in vitamin B12. I recommend taking about 2,500 ug once a week, ideally as a liquid, sublingual, or chewable form for better absorption or 250 ug daily if that schedule works better for you. There is no known risk to taking larger amounts of B12.

Direct sunshine on exposed skin for 20 to 30 minutes a day can provide adequate vitamin D, but, for many of us, oral supplementation is necessary. Vitamin D3 is the form most commonly recommended but is usually derived from animal sources such as lanolin. There are vegan versions of D3 now available and the standard recommendation is to supplement with 800 IU a day, but I start routinely with 2,000 IU a day and titrate up to reach blood levels of 50 to 70 ng/mL.

I can check blood levels for low omega-3 in my clinic and deficiencies are common regardless of diet. However, as fish isn't an option for vegans, I often recommend supplementing with omega-3 in the form of a combined DHA and EPA (the fatty acids that are great for heart and brain health) supplement sourced from algae. I suggest that most patients on a vegan diet take 250 mg each day and at the same time limit foods rich in omega-6, which may contribute to inflammation. These are mainly in the forms of oils such as corn, soy, safflower, sunflower, and vegetable oil blends. Overall, go easy or skip oils for cooking. Finally, adding whole foods rich in ALA, the precursor to EPA and DHA, is encouraged. This is easy using 1 to 2 tablespoons a day of ground flaxseeds, a small handful of English walnuts, chia seeds, and leafy greens.

L-carnitine plays an important role in shuttling fatty acids across membranes to fuel the production of energy in the heart and other muscles. L-carnitine is found mainly in meat (think carne) and vegetarians have lower levels of L-carnitine in their muscles. There are rare reports of heart disease in patients lacking this amino acid. Although long-term studies of L-carnitine supplementation in vegans are not available, I consider supplementing vegans with 500 mg a day as a recommendation for optimal health—particularly in those who are athletic or who have heart disease. Recently, L-carnitine in red meat has been shown1 to be capable of leading to the creation of TMAO, a molecule I measure in the blood of patients, and that is unfavorable for artery health. I advise patients eating meat, and those taking L-carnitine supplements, to stop both habits if the level of TMAO1 is elevated.

Taurine is the most abundant amino acid in the body, and you've probably never heard of it beyond the world of energy drinks. Taurine is important for proper functioning of cardiac immune systems, insulin action, hearing, and electrolyte balance. It is typically found in meat and seafood. Vegans can have low levels of taurine. Supplementation with 500 mg a day is an option.

Vegan diets are an amazing choice for health, promoting a clean planet and being mindful of the life of animals farmed for human consumption. Moving to a vegan diet is not only supported by thousands of medical research studies, but it is also endorsed by the United Nations, Oxford University, the USDA Food Guidelines, and the Association of Nutrition and Dietitians3. Although it may seem a bit of a hassle to add these six supplements to your plant-based routine, it's important to be a "smart vegan" and make sure you're giving your body everything it needs to function optimally.