Vitamin B12 deficiency in India

Update May 2024:
Data from a study in northern India (2014-2016) show that >90% of lacto-vegetarian women were categorized as being vitamin B12-deficient [Ganie et al. 2024].

More details:
  • Data are from a "hospital based, twin-center, cross-sectional observational study enrolled subjects from two Northern Indian cities between January 2014 and December 2016".
  • Diet definitions: "The women (PCOS n = 112; healthy, n = 186) who strictly consumed plant-based diets with no egg, fish, poultry, and meat were considered vegetarian while as women (PCOS, n = 104; healthy, n = 148) who consumed meat/chicken/fish/egg at last 5 days a week in the preceding 1 year were considered as nonvegetarian".
  • "Using 4cB12 [combined biomarker including vitamin B12, homocysteine, MMA, and holo-transcobalamin], prevalence of VB12D [vitamin B12 deficiency] is discerned in 54.4% (PCOS: 72.1%; healthy 36.5%) and 93.4% (PCOS: 95.9%; healthy: 91.9%) among nonvegetarians and vegetarians, respectively.
  • "

A new study from New Delhi shows that „[t]here is a high prevalence of vitamin B12 deficiency in Indian infants and their mothers. There is an urgent need to supplement our population with vitamin B12, and the best time to do this would be antenatal.“

[For vegetarians the best time to do this would be during all stages of the life cycle, I would say.]


  • Background: „Vitamin B12 deficiency in early life can adversely affect the growth of developing brain with myriad of neurodevelopmental manifestations. At this age, the deficiency is usually the result of low maternal levels.“
  • Study participants: „exclusively breast-fed Indian infants aged 1 to 6 months and their mothers“ (n = 100)
  • Results: 57% of the babies and 46 % of the mothers had B12 deficiency.
  • „Normal“ serum B12 levels were defined as 200–700 pg/mL in this study.
  • More info: „In an infant born to deficient mother, not only are the blood levels of B12 low, but the liver stores of the vitamin are also inadequate. Further, a [vitamin B12] deficient mother is likely to produce breast milk having low levels of the vitamin. Even though a deficient mother may not exhibit any hematological or neurological symptoms of B12 deficiency for several years, her exclusively breast-fed infant may develop symptoms as early as 3 weeks of age. These are often subtle and difficult to detect because of the wide variation in the normal development in this age group. Such infants may have failure to thrive, irritability, apathy, anorexia [don’t want to eat], refusal to solid feeds, delay and regression of neurological development, hypotonia [baby apears weak and „floppy“], seizures, and pancytopenia [~anemia].“
  • Of the babies <3 months old 62 % had B12 deficiency.
  • „Two infants had levels less than 50 pg/mL with the lowest being 6.6 pg/mL [!]“
  • 10% of the mothers were vegans* (or ~vegans) [!], 19 % lacto-vegetarians, 17 % lacto-ovo-vegetarians, and 54 % nonvegetarians (= 100 women in total)
  • 69% of the babies with vegetarian mothers, and 52 % of the babies with nonvegetarian mothers were B12 deficient.
  • „Of the 100 mothers, 46 % were deficient in B12 and all were asymptomatic.“
*I asked the corresponding author. 

The authors of this new study have also listed severeal other studies on the topic. I didn’t check the original sources. This table summarizes the studies:

Studies on vitamin B12 deficiency in India
Prevalence of vitamin B12 deficiency
New Delhi
(this study here, by Mittal et al.)
- exclusively breast-fed babies (1–6 months old)
- their mothers
(each: n = 100)

babies: 57 %
mothers: 46 %
Pune (Pune maternal nutrition study)
pregnant mothers (at 28 weeks of pregnancy)

71 % low serum B12
(>90 % had high urinary MMA)

42 %
pregnant women (before 14-weeks of pregnancy)
50 %
Vellore, South India
women (n = 1000)
52 %
rural area of Haryana, North India
pregnant women
74 %


adults (n = 224)
47 %
(73 % had high MMA)
middle-aged men (n = 441)
67 % had low serum B12
New Delhi

infants (6–30 months old) (n = 2261)
28 %
toddlers (Ø 2.4 years) (n = 51)
(urban slum population)
14 %

Mittal M, Bansal V, Jain R, Kumar Dabla P: Perturbing status of vitamin B12 in Indian infants and their mothers. Food and Nutrition Bulletin 38(2): 209–215 (2017)