From the Research
A ketogenic diet alone cannot effectively treat vitamin B12 or folate deficiencies and may potentially worsen these conditions if not properly managed. The most recent and highest quality study, 1, published in 2024, emphasizes the importance of proper diagnosis and treatment of vitamin B12 deficiency, which may not be adequately addressed by a ketogenic diet. While a ketogenic diet can include some B12-rich foods like meat, eggs, and fish, it often restricts folate-rich foods like legumes, fruits, and certain vegetables. The high fat content of ketogenic diets can also potentially interfere with B vitamin absorption.
For effective treatment of these deficiencies, direct supplementation under medical supervision is necessary, regardless of your dietary pattern. According to 1, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency, and the use of high-dose oral B12 at different frequencies may be considered for long-term treatment. If you have a confirmed deficiency, you should take specific supplements: for B12 deficiency, cyanocobalamin or methylcobalamin supplements (1000-2000 mcg daily); for folate deficiency, folic acid supplements (400-1000 mcg daily). Regular blood testing is important to monitor your levels and adjust treatment accordingly. If you're following a ketogenic diet and concerned about these nutrients, work with a healthcare provider to ensure proper supplementation and monitoring.
Some key points to consider:
- Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner 1.
- The consequences and severity of B12 deficiency are variable depending on the degree of deficiency and its duration, and can affect major organ systems including the blood, bone marrow, and nervous system 2.
- Diagnosis of B12 deficiency rests on clinical suspicion followed by laboratory testing, which consists of a panel of tests, that together provide clinically reliable predictive indices 2.
- B12 metabolism and deficiency is closely intertwined with folate, another B-vitamin 2.