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doi: 10.1056/NEJM199601043340103

I wouldnt count on sources like seaweed, spirulina, or soil. I hear people that likely do need to supplement with B12 say that theyre OK because they eat foods that may include B12, but they can be unreliable sources, such as sea vegetables or nutritional yeast, says Ginger Hultin, MS, RDN, CSO, a lifelong vegetarian, chair of the VNDPG, and spokesperson for the Academy

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The most often causes include lifestyle (poor dietary intake, especially in vegans), pernicious anaemia, GI disorders such as Crohns disease or celiac disease, medications, and age-associated absorption difficulties

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