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Home > Diet & Nutrition > Vegetarianism

Vegetarianism, Good Idea, or Not?

By Clark C. Casteel

Vegetarians & Chinese Nutrition

I would like to preface this article by stating that I am not a vegetarian. Yet not long ago, I experimented with an ovo-lacto vegetarianism discipline for over a year. After observing that I became mentally and physically weak, timid, susceptible to disease, and depressed, I decided to return to eating meat. Thereafter, I soon felt much better. Somehow, however, I have continued to feel drawn to adopting a vegetarian diet. My reasons for this are for ecological, health, and spiritual concerns.

Like so many of my colleagues, I began my journey as a practitioner of Oriental Medicine out of a deep interest in holistic medicine and improving my own health, as well as that of others. Now, after nearly four years of immersion in the intricacies of Traditional Oriental Medicine (TOM), I am realizing my goals. The prevailing view among most of my instructors during this time seems to be that a vegetarian lifestyle will ultimately lead to a deficiency condition; that as people it is necessary to eat meat. My own experience with vegetarianism, led me to unquestionably agree with this view. My dealings with many vegetarian patients, most of whom have had deficiencies, lent further confirmation. At the same time, there has been a growing realization of how little I really know about vegetarianism. I found myself advising patients to eat some meat based on my ignorance of their lifestyle, and my unclear understanding of TOM's stance on vegetarianism.

I have come to realize that vegetarianism is more than avoiding eating meat. It entails careful meal planning, and a good understanding of nutrition. Also, I feel it requires a good understanding of personal body energetics from an Oriental Medical standpoint. None of these things did I have when I, cold turkey, decided to become a vegetarian. I began to think that perhaps this is exactly what many of our patients are doing; choosing lifestyles they know little of. At the very least, I decided I should know as much about vegetarianism as possible, and where the bias against it in TOM came from.

Thus, this article is not an attempt to prove or disprove the validity of a vegetarian lifestyle. It has been my intention to explore the TOM viewpoint on vegetarianism, and to provide a general background for special concerns of vegetarianism that I feel as practitioners we should know. It is my intent to provide practitioners with information they need to know in order to obtain these goals. First, to have an appreciation for reasoning against a vegetarian diet from a traditional perspective. Secondly, to provide a framework for practitioners to resolve where they stand themselves on the subject. And finally, to be knowledgeable enough to evaluate a patients understanding of how to be a healthy vegetarian, as can be best determined. I have consulted various Eastern and Western holistic nutritional authors, practicing vegetarians, and non vegetarians in obtaining information for this article. There are both Eastern and Western nutritional concerns discussed , as I feel any complete discussion on this subject would lack for the other. It is my hope that the information provided will be a service to you and your patients.

In closing I would like to thank my Chinese friends J. Min Fan, L. Ac. and Mei-fang Wei, L. Ac., MD.. for their willingness to share their experience and insights, A. Gregory Bantick, L.Ac. for his wisdom and inspiration in writing this article, and Richard Warren, L.Ac., M.T.O.M. , who is an all but deficient vegetarian, for his guidance.


I doubt that I am the only practitioner who has advised a vegetarian patient to eat meat only to be met by raised eyebrows and wide eyes. Here is a person who considers themselves to be spiritual, holistically minded and generally healthy being told by their acupuncturist that they need to eat meat. Often times, horror of horrors, red meat.

I have until recently been one of these practitioners. We are indoctrinated into the fold of Traditional Oriental Medicine, which upholds the view that people should be eating meat. It occurs to me, however, that before we try to influence our patients to eat meat , we really should have a clear understanding of why this is so. We also need to have a sensitivity for why people have chosen a vegetarian lifestyle, and whether or not our patients are even practicing it wisely. There are some people who are simply not going to eat meat no matter what you tell them. Religious groups such as Buddhism, Brahmanism, Hinduism, Jainism, The Seventh Day Adventists and The Trappist Monks of the Roman Catholic Church all promote a vegetarian diet. Is it our place to try to change peoples religious or social beliefs? Can we not help people without insisting they eat meat.? Many of our patients and many of us come from the fold of holistically minded people who uphold vegetarianism as a healthy lifestyle. When so many of our patients eat poorly by anyone's standards, and seem to have attitudes that absolve themselves of any personal responsibility for their health, we should be embracing and supporting vegetarians, not chasing them away. In order to be of service to these people we need to know just as much about vegetarianism as they do. We need to have other strategies than just telling people to eat meat. If we really feel people need meat for any reason, we must be prepared to defend this position.

This article, therefore, is not intended to be an argument for or against vegetarianism. It is an exploration of reasons against abstaining from meat from a TOM perspective, to enable the practitioner to analyze this and find their own ground on this issue. Also it is an exploration of special dietary and lifestyle concerns that vegetarians and those treating them should be aware of. This information will provide a framework from which a practitioner can evaluate the role of vegetarianism in a patients health, and what adjustments can be made according to contemporary vegetarian living.

Vegetarianism and Oriental Medicine

In my experience the overwhelming majority of practitioners of Traditional Oriental Medicine, especially those from a Chinese background, hold that a strict vegetarian diet is unhealthy and will eventually lead to deficiency. This is certainly not true of all practitioners; I know several vegetarian practitioners of Oriental Medicine personally. It is perhaps simplistic to condense the entirety of this field into a single viewpoint on this subject. Yet, my own educational experience in Oriental Medicine has left me with the idea that vegetarianism is not a great idea. An opinion enforced by the numerous clinical cases I have seen of strict vegetarians with underlying deficiencies, in particular, blood deficiency. The Chinese practitioners I have been exposed to are emphatically against it. But the arguments, like so many concepts and methods we are exposed to in the holistic health field, to me were largely hearsay and opinion with little substance to back them up. I have heard such arguments as people have been eating meat for centuries to think that we can revert back to a vegetarian diet in one lifetime is foolhardy. This of course assuming the human race was ever completely vegetarian. Another practitioner explained that people in the city need more meat than those in the country, due to the stress of modern society. Still another said that being a vegetarian, based on his experience with patients, was simply "crazy." The prevailing view throughout has been that people on vegetarian diets just do not seem to do that well.

Though the clinical experience of others is always valuable, it seems awkward to me to walk around telling people to eat meat based solely on thinking like this. That, and who can deny the cultural background settings of which we are dealing. I do not want to diverge at great length into a cultural debate, but the attitude toward animal life seems to be greatly different in Oriental cultures than for the "New Age" American. One can not overlook the cultural biases that exist. The book Chinese foods for Longevity; The Art of Long Life discloses the health benefits of everything from pork brain, to frogs and eels. In looking for a more complete view on the subject of vegetarianism, contemporary Taoist writers and nutritionists seemed a logical place to seek more detailed information.

The prevailing view among Taoist sources is that one should eat meat. The most common reasoning being the high demands of living in a competitive industrialized society are too taxing on the body to subsist healthfully on a vegetarian diet. In his The Great Tao, Stephen Chan emphatically states in large bold letters "DO EAT MEAT", stating that only animal products can supply the high energy levels that we need, unless living in an isolated retreat. Ming-Dao Deng, in his book on a Taoist lifestyle, shares this view writing:

"It is unnecessary to become a complete vegetarian. Vegetarianism arouse out of economic necessity or for specific high meditations. Meat is too active for the quiescent activities of a meditator. Temple living a very specific activity in a protected environment. The scholar warrior considers pure vegetarianism to be impractical in a competitive society. " 1

Master Hua Ching Ni, a Taoist spiritual teacher and practitioner of Traditional Oriental Medicine in Los Angeles also cautions against a strict vegetarian diet, upholding that the nature of ones life should determine the amount of meat one eats.

"Vegetarianism is okay if you live in a religious institution, without doing extremely hard work, but in this high pressure society where most of you work hard, I do not recommend it, especially in the winter." 2

Hua Ching Ni wisely comments , however, that perhaps monastery living is idealized too much and is not as simple as one might presume. Western holistic nutritionists, also share the idea that meat is necessary to modern living. Bernard Jensen, Ph.D. claims that a competitive occupation uses up lots of adrenaline which will not be accommodated by an exclusively vegetable diet. He also reasons that the level of consciousness required to subsist as a strict vegetarian has not been attained by most people. According to his calculations the amino acids would be burned up so rapidly that most people in the United States would starve to death. This idea of varied diets is reflected in ancient Indian culture in which meat as an article of diet was traditionally prescribed for the rajpats caste of warriors and rulers. Brahmins, who did not engage in battle, but focused on study and spiritual development, were forbidden use of meat. This brings up the next point on meat eating, and how it effects us spiritually. This view is both disturbing and confusing. For, what these authors seem to be saying is that for ideal spiritual development one should eat as a vegetarian , but for most of us with little hope anyway, this is not appropriate. Perhaps this is a bit facetious, but in examining the energetic qualities in meat, it is not held in high regard by Taoists, and it would seem something of a necessary evil for those of us living in modern culture.

There is the psychological energetic aspect to this subject which follows that eating meat creates many disturbing desires. Those who consume meat are filling themselves with low energy foods producing a gross spirit producing animalistic tendencies and belligerent mentalities. On the other hand those who eat more vegetables will supposedly have a more harmonious spirit. As Hua Ching Ni recommends:

"The highest beings absorb pure energy...People trying to spiritualize their life eat only light subtle foods such as herbs and vegetables."

Pitchford notes that just as certain animals have certain attributes which may be beneficial to health, they also have negative attributes which are transmitted to the eater. The shyness of the rabbit or the desires of the pig are examples of this. He further argues that perhaps much of the stress that is attributed to a modern lifestyle may be the result of eating too much meat and its toxic by-products, obstructing the body's physical and therefore mental well being

Jensen has an interesting and contrasting view with regard to the different energetic aspects of meat and vegetables. He maintains that humans need the higher vibratory rates provided by animal products. The medulla portion of the brain, what he calls "the chest brain", regulates respiration and must be built with the highest evolved (meaning highest vibratory rate) phosphorus from animal products. This same phosphorus is required for well developed thought processing. For similar reasons he insists that only fresh vegetables can provide adequate vibratory rates necessary for good health.

Nonetheless, it should be noted that there have been Taoists who subsisted on strict vegetarian regimes. Though most caution against the practice of a strict vegetarian lifestyle, the practice of including meat in the diet is approached with caution among modern Taoist authors. Meat should represent only a fraction of the total diet. Eating too much meat in the diet creates a condition of Yin blood, or an acidic imbalance leading a person to become prone to illness. On the other hand a strict vegetarian diet may cause one to become too alkaline. A harmonious balance should be sought for. Maoshing Ni in The Tao of Nutrition recommends gradually moving to a mostly vegetarian diet, including meat as no more than 1/10 of all food consumed. So, on one hand we have the more spiritually minded side of our tradition which advocates a vegetarian practice, and on the other we have a more practically minded health perspective which cautions against it.

Special Concerns for Vegetarians

Before going on to the next section dealing the special nutritional concerns of vegetarians the comments of Dr. Stephen Chan In The Great Tao are worth looking at.

"It is said that we should have nutritionally "balanced" meals, such and such an amount each day of proteins, vitamins, minerals, and other "foods." If you ask me whether or not you need these, my answer would be "What are vitamins? What are minerals? What are proteins?" And "How much do we really know about them?" 4

This is significant because it gets into the whole question of supplementation in general. As Chang further explains, most scientists believe there are probably 2000 unknown components in an apple. If it were stated that herbal medicine and western pharmacology were one in the same, many practitioners would scoff at this notion. Most practitioners would support the notion that some synthesized active ingredient found in some herb are far removed from the actual organic equivalent. Why , then should we feel any different with regard to vitamins and minerals? On the other hand, completely disregarding known information about required nutrients in the body would be equally as ridiculous. For this reason exploration of nutritional aspects of vegetarianism in both Traditional Eastern and Western terms is valuable and at the same time incomplete. Perhaps at some point it will be discovered that some component of meat actually is required for proper body function. Where possible natural organic sources for common nutritional deficiencies will be included. It is important to consider, however, that many so called natural products are grown in soil that has been severely depleted of essential nutrients. Therefore a vegetarian must be very discriminating when it comes to food sources, as well as deciding whether or not to use supplementation. For example, given the present understanding of these complex issues those on a vegetarian diet Vitamins A and D, Calcium, and Riboflavin are frequently found in levels for what is considered safe. These substance are often found in many whole vegetable sources. Proper eating habits, involving balancing of foods and well rounded dietary choices should eliminate these problems.


It is a commonly held belief that vegetarians have trouble getting enough protein. A quick walk through any health food store will reveal numerous protein supplement products for those on vegetarian diets and otherwise. The fact of the matter is that most people in the United States far exceed the amount of protein necessary in terms of quantity. Protein is highly present in many vegetable as well as animal products. In fact, dietitians who prepare meatless diets find it difficult not to exceed protein allowances when caloric needs are met. According to international health groups .8g per kilograms of body weight is required daily by the average man, which is about 48g per day. The USRDA it is 70g daily for men and 60g for women. Infants may require up to 3 times as much. Yet in one experiment done at The Massachusetts Institute of Technology, 100 men on regulated diets showed 30 g per day was sufficient.5 At any rate, protein from vegetable sources is in no short supply. 2 cups of dried uncooked peas or beans and 40 ounces of uncooked rice has the same protein amounts as a 7 ounce steak. 1/2 cup of cooked protein is equal to a 20 ounce steak, and 1 cup of hulled sunflower seeds is the same as an unbelievable 40 ounce steak. 6 Consider also these figures for a moment. One cup of broccoli has 40 calories and 4 grams of protein. Eating only broccoli for a day providing 2000 calories would be the equivalent of over 200 grams of protein, more than double the daily recommended amount.7 It should not be hard for any vegetarian to obtain enough protein.

What is very important for the vegetarian is the proper balance of biologically available protein. Vegetable sources of protein are less complete and therefore less efficiently utilized by the body than animal sources. There are 24 identifiable amino acids used in the body. Of these 8-10 are considered essential amino acids because they can not be synthesized by the body on it's own; they must be obtained from food. The essential amino acids are phenylaline, leusine, isoleusine, methionine, valine, lysine, threonine, and tyrptophane. Though controversial, histadine and argenine may also be essential, especially during times of injury and disease. In addition, all the essential amino acids must be eaten at the same time in order to insure the proper absorption of a complete protein requirement. The other 14 amino acids can then be produced by the body. Therefore, various food products are discussed in terms of their limiting amino acids, or those which they are low in. The body can only absorb proteins at the level of the lowest essential amino acid at any given meal. The extent to which an essential amino acid is low, is the extent to which the body can effectively absorb the proper protein requirements.

In order to account for this problem, the proper combining of foods provides a solution to the vegetarian. In fact, when the proper foods are combined, vegetable sources of protein can actually exceed meat in terms of protein values. In terms of biologically available proteins eggs are by far the most complete, followed by milk, cheese, fish, whole rice, red meat, and poultry. There is a greater difference between eggs and meat than between meat and vegetables in terms of limiting amino acids. It is also interesting to note that whole rice ranks higher than red meat. Nevertheless, only some seeds and nuts, very few grains, and even fewer vegetables fulfill complete protein requirements. Micro-algaes such as spirulina, chorella, and wild blue green algae are considered to be among the world's richest supplies of protein. Some varieties are thought to contain every nutrient required for the human body. When compared to beef, for example, the digestive absorption of spirulina and chorella is four times greater. Any strict vegetarian would do well to include these foods in their diet.

There are numerous books that provide guidelines and complete recipes for well balanced protein diets. Generally, plants tend to be deficient in lysine, tryptophan, and methionine. Grains and cereals are often lacking in lysine. Corn and rice are often found with low amounts of tryptophan and threonine. The following guidelines should be followed. Always combine grains with legumes, seeds and nuts with legumes, or for those who eat them eggs and dairy with any vegetable protein. According to Maoshing Ni, a balanced vegetarian diet should consist of 2/5 grains, 2/5 vegetables and fruit, and 1/5 nuts and legumes. Carbohydrates should always be eaten with proteins, and it is important to provide the body with a good protein carbohydrate ratio. Certain important organs such as the brain require carbohydrates to function. If no carbohydrates are eaten, protein will be converted by the body into carbohydrates. In this regard, vegetables are preferable to meat as they often contain both protein and carbohydrates. Meat is composed of protein and fat, and fat can not be converted into carbohydrates. Eating a well rounded diet should provide the vegetarian with more than enough available protein.

Another important aspect to protein is the maintenance of the calorie protein ratio. On one hand if a person does not eat enough calories, protein will be absorbed to maintain body weight. On the other it is also important not to consume an excess of calories. The average daily calorie intake should be around 1900-2700 and protein 46-70g. This comes out to about 1 gram for every 40 calories eaten. Thus vegetarians must be careful not to eat to many sugars, starches fats and oils. It is impossible to be a healthy junk food vegetarian. Fudge, for example, has 150 calories to 1 gram of protein. When something like this is eaten an immediate protein debt is incurred and requires eating protein dense foods like eggs cheese and meat. Strict vegetarianism when combine with sugar or even honey is considered very damaging as it will incur an immediate protein deficiency. Also sugar and honey contribute to de-mineralizing the body. A diet consisting of a veggie burger and a soda will not cut it. In order to maintain their health as a vegetarian people must be very disciplined not to eat too many sweets.

Finally the popular notion that vegetarians are somehow weak should be dispelled. This is an idea that seems to be held by Master Ni as well when he refers to the type of work one does when considering vegetarianism. Muscles require carbohydrates and fats for fuel, not protein. Even those who are trying to stimulate muscle growth should do fine on a normal diet which typically supplies more than enough proteins for the average American. In one study in 1904 students were compared to vegetarian students to see how many times they could squeeze a grip meter in quick succession. The vegetarian average was 69 as compared to 38.9 for non-vegetarians. Swedish athletes tested for endurance on a bicycle lasted three times longer after a three day diet consisting of grains and proteins than three days eating high meat content.8 There is no reason to assume that vegetarians, eating a well balanced diet, will somehow become reduced in strength or stamina. We can look to the awesome power of a Clydesdale horse which eats largely hay and oats.

Vitamins and Minerals

There are a number of vitamins and minerals which, although they are found in vegetables seem to be lacking in many vegetarian diets, or are issues of common concern. These are Vitamin A, Vitamin D, Calcium, Zinc, Riboflavin, Iron and lastly Vitamin B-12 which is an extensive topic and deserves it's own discussion. Before exploring each of these it is important to understand the effect a well balanced vegetarian on the uptake of certain nutrients. A well planed vegetarian diet should consist of ample amounts of beans, legumes and grains. These products , however are rich in phyates which become biochemically bound up with zinc calcium and other elements. The phyates therefore reduce amounts of uptake of these nutrients, and can even leach them out of the body. Sprouted beans, and grain seeds are not similarly effected and should therefore also be included. Fermented products help offset the effect of phyates as well. Foods such as leaven bread and adding yeast to bread can help. One method to reduce the effect of phyates in beans is to soak them overnight. For the greatest effect it is necessary to soak the beans at least 12 hours changing the water at least once. Grains, beans, and legumes are of course very important and should not be avoided for fear of phyates.

Vitamin A also known as Beta Carotene is well known for it's benefit to the eyes, but it is used in a whole range of body functions. It is needed for maintenance and repair of epithelial tissue. It aids in fat storage and is involved in the immune system protecting against external attacks and infections. It is an antioxidant, thought to slow the aging process, and is considered to be useful against cancer and pollution. Most importantly for the vegetarian, protein can not be used by the body without Vitamin A. From a TOM perspective a lack of Vitamin A in the diet seems to be related to wei qi and liver deficiency. Symptoms of Vitamin A deficiency can include skin diseases, dandruff loss of smell, allergies, night blindness, eye inflammation, and dryness of the mucous membranes, respiratory system, and reproductive systems. It is interesting to note that Liver meat is considered to be an excellent source of Vitamin A and that green leafy vegetables are associated with the wood element in five phase energetics. My experience has shown that vegetarians often do present with liver deficiencies. Generally vitamin A can be found especially in dark green and deep yellow vegetables. Dunaliella, spirulina, wild blue green algae, wheat and barley grass, chorella, carrot, sweet potato, kale, parsley, and spinach are excellent sources of Vitamin A, listed in order of highest content.

Vitamin D is required for the assimilation of calcium and phosphorus in the body. It is essential for development of bones and teeth and is considered helpful for the prevention of such disorders as osteoporosis and rickets. Perhaps interesting a correlation can be made between the TOM idea of the Kidney influence on bone development. Vitamin D is converted first by the liver and then the kidney. 3315.9 Despite the fact that we hear much about how too much fat is unhealthy, it is required for the assimilation of vitamin D by the body. This is important for those on strict vegetarian diets which can be low in fats. Many of the food sources of vitamin D are oily and damp in nature; milk, cod liver oil and butter. Fortunately, the body is able to convert exposure to sunlight into vitamin D. This is somewhat difficult in colder climates and for those who working indoors. The amount of sunshine required for adequate Vitamin D absorption is at least 20% of the skin on the body for 30 minutes a day at sea level. Vegetarian sources of vitamin D include alfalfa, oatmeal, sweet potatoes, and vegetable oils.

Calcium is of course strongly involved with the growth of bones, but also muscle and nerve health. Symptoms of Calcium deficiency can result in muscle cramps, brittle nails and aching joints, and numbness of the arms and legs. If we consider many of the calcium rich substances in the Oriental materia medica such as Concha Ostrea (Mu Li), Os Draconis (Long Gu), or Fluoritum (Zi Shi Ying), we can see that it has an energetic property of anchoring the yin and is useful in symptoms of nervousness and insomnia. A calcium supplement taken before bedtime is useful for a sound nights sleep. For the vegetarian who chooses not to eat dairy products there are a wide variety of vegetable sources of this mineral, especially the green leafy vegetables. These would include; collards, dandelion greens, Kale, mustard greens, turnip greens, broccoli, bok choy, okra rutabaga, soybeans, black strap molasses, dried fruit, almonds.

Unfortunately for the vegetarian meat is an excellent source of zinc. The availability of zinc in vegetable products is questionable due to soil exhaustion, and use of nitrogen and phosphorus fertilizer's. Due to it's involvement in the reproductive organs, especially the prostrate and protein synthesis, it has been suggested by some practitioners that it is related to the Jing. Symptoms of zinc deficiency can cause light headedness and a feeling of disattachment that can be found in some vegetarians. Good sources of Zinc would include; lima beans, whole grains, mushrooms, pecans, soybeans, and pumpkin and squash seeds are reported to be excellent sources of this mineral.

Riboflavin, or Vitamin B2 is necessary for the formation of red blood cells, production of antibodies , and cell growth and respiration. Lack of this vitamin is important to a pregnant woman as it can cause damage to the fetus, even without obvious symptoms to the mother. It is also interesting to note that inclusion of Vitamin B2 and B6 together are helpful in the treatment of carpal tunnel syndrome. The seaweed Hijiki is a rich source of riboflavin. Other sources include mostly green leafy vegetables, asparagus, broccoli, brussle sprouts, okra, and winter squash.

Iron is the single largest mineral found in the blood. It is essential to the production of hemoglobin and the oxygenation of red blood cells. Low levels of Iron correspond largely with some of what would be blood deficiency in Oriental Medicine. These symptoms include, brittle nails, hair loss, pallor, dizziness and fatigue. If too much iron , as in a supplement is taken, with a protein deficient diet there can be a system overload which may damage the muscles of the heart and liver. Good sources of Iron for the vegetarian are largely in whole grain foods. Also, beets, avocados, dates, raisins peaches, pears, and pumpkins are good sources. Micro-algaes such as spirulina, seaweed, are also an excellent source.

Vitamin B-12

It is a widely held view that vegetarians must be cautious to obtain enough Vitamin B-12 in the diet. The B-12 vitamin is especially influential in the reproduction of new cells, and though the exact relationship is unclear it interacts with folic acid. It is involved with development, growth and repair of tissues. This becomes especially important for tissues which are constantly reproducing such as red blood cells of which ten thousand need to be replaced every second. As important as this may seem, B-12 is required by the body in only the tiniest amounts. The Recommended Dietary Allowance for B-12 is only 2 mcg. daily. This figure is higher for pregnant women and children. The reason this poses a risk for the vegetarian is that b-12 can only be found in animal products including meat, milk, eggs and certain fermented products. Especially for a vegan this may pose a problem.

The signs and symptoms of Vitamin B-12 deficiency are insidious, and may take years to develop. It is important for vegetarians to note that green vegetables contain folic acid which may mask the symptoms of blood deficiency which may go unnoticed until irreparable nerve damage has occurred. Of course this implies blood deficiency in the western sense, however it is probable that the practitioner of TOM would be able to help the patient with earlier diagnosis utilizing energetic diagnostics. According to Pitchford the tongue of a vitamin B-12 patient will commonly present as red, shiny, smooth and occasionally ulcerated. B-12 deficiency has also been attributed to mental disorders and it is common for mental problems ranging all the way up the scale to acute psychosis to be among the first symptoms. Insanity, nervousness, and chronic fatigue have been attributed to borderline levels of B-12 deficiency.

The view that Vitamin B-12 can only be obtained from meat is a debatable one. B-12 can be found in trace amounts in air, water, mushrooms, fermented products and even the herb Radix Angelica Sinensis (Dang Gui), a blood tonic coincidentally9 Some point to the successful primarily vegetarian diets of traditional cultures, or contend that there is enough natural bacteria in our digestive tract to provide B-12 as a byproduct. Still others claim that there is enough b-12 in a diet based primarily on whole grains and beans. Seaweed and micro-algaes have also been proclaimed to be significant sources of this essential vitamin. Yet, there are problems with all these alternative sources that deserve discussion.

In traditional cultures organically grown vegetables would have been eaten. There would have been less sanitation, chemicals and pesticides used in the production of crops. Also modern topsoils have been depleted from many nutrients essential to good nutrition. Bacteria and insects would have provided enough B-12 in these instances. 548.185 Other factors in our Modern culture also limit the uptake of vitamin B-12 are the widespread use of antibiotics and birth control pills. Stress from emotional factors or physical injury adversely affects B-12 absorption, as well as liver disease and chronic illnesses. A perception from a health perspective that traditional cultures were better off however is perhaps idealistic and simplistic.

In less industrialized cultures of the world it is more likely that fermented products provide an adequate supply of B-12. However, many of these products made for mass production are made in highly sanitized environments where bacteria have little chance to form cultures in quantities for significant amounts of B-12. For similar reasons it is unlikely that there is enough B-12 from flora in the digestive tract for human needs, and it has even yet to be proven that this is even being assimilated. Obviously antibiotics would be a significant factor here. It is helpful to include fermented products in a strictly vegetarian diet, however , as these seem to be beneficial in uptake of the vitamin.

By far the majority of sources I found on the subject insisted that B-12 must come from animal products. For the vegan , abstaining from even eggs or milk, it is therefore essential to be finding some supplementation. One plausible explanation for this overwhelming view is that B-12 is found only in the animal cell is that it helps to synthesize it's DNAC nucleic acid of which thymine is a base. Vegetable products are primarily sources of RNA structures which have no thymine as a base. In the case of red blood cell production folic acid will enable the cells to go through intermediate stages of growth, but can not bring them to their full growth. And this is why folic acid may mask symptoms of true blood deficiency for so long.

Seaweed's and micro-algaes have until recently been praised as being rich sources of vitamin B-12. Testing has shown however that much of the actual quantities of this vitamin are not available to by the human body as they are analogs. The analogs mimic B-12 but can not be utilized by the body, and furthermore may actually be blocking the uptake of usable b-12 by the body. It is probably not wise to rely on these sources given this information.

Pitchford recommends the use of a B-12 supplement for a healthy vegetarian diet. It is perhaps significant to note that this is the only vitamin supplement which he feels is absolutely necessary. B-12 supplements made from nutritional yeast gown in a B-12 solution preferably on molasses or sugar beets. The uptake of such supplements can be assisted by eating enzyme rich foods such as pickles, sauerkraut, or sprouts. It is not advisable to take a multivitamin version of B-12 as analogs similar to the case of sea vegetables are often present to block uptake. This method is probably not the best choice however, for those with problems involving yeast infections.

Regardless of the various ideas about B-12 absorption presented here. It is a simple and inexpensive procedure for a clinic to run a vitamin B-12 test. Perhaps this is an excellent idea to try first , before making radical alterations in a patients diet.

Body Energetics

An area where many vegetarians seem to get in trouble is the nature of the foods they are eating. With no regard or understanding to their own state of body tendencies, many uphold a cold raw foods diet as the healthy way to go. Many women decide to try to loose weight by eating only cold salads, and thereby destroy the digestive fire, and the spleen's strength in the process. Another example is vegetarians who only eat fish, which by nature is a cooling food and depletes the internal warmth. This ,it seems is an area where the practitioner of Oriental Medicine can be particularly useful to the vegetarian. With our understanding of body energetics, as well as that of the climatic environment, it should be easy for us to assess the eating habits of vegetarians and make suggestions based on that. In order to get the right amount of nutrients, we would say qi, from the foods, it is important for the strict vegetarian to be eating based on foods in season that grow in the local environment, which are fresh and in season. This idea is also upheld by western nutritionists. Another important consideration is the racial or ethnic background of a person. For example many Native Americans do not fare very well on the rich modern American Diet. By returning back to a more traditional diet they become healthier and stronger. Finally, the methods in which foods are cooked should be consistent with these same parameters. In general however, it is recommended by Taoist nutritionists that most food should be cooked a little bit in order to keep the digestive fire in good health. Cooking food, even just a little maintains the digestive fire, and allows better digestion of needed nutrients. According to the Western view on this subject, uncooked and raw foods enzymes and vitamins are destroyed by cooking. The amount of nutrients measured however is before digestion and not after. This it seems reflects one of the fundamental differences between Western and Eastern. In the West the focus has been largely on the breakdown of systems into their fundamental parts. Eastern thinking provides a more macro view in which important things, such as taste and temperature of foods, is also important to good dietary balance. One need not be a nutritionist , but be firmly established in the basic diagnostic methods and sensitivity to climatic factors to help a patient make wise decisions in this regard. It is my experience that this simple information is largely overlooked by many vegetarians, who know nothing of the subject.

Becoming Vegetarian

It seems to be a sort of trendy cultural thing these days to say at the coffee shop that we have made the decision to become vegetarian. As mentioned earlier, many people seem to be just switching to vegetarianism without the slightest idea about what this means for their health and how to do it nutritionally. I myself, have been guilty of this. For those making the decision to become a vegetarian all the sources agree that this should be a slow process, not overnight. Pitchford's whole book is geared toward a gradual transition from the typical American diet. Even Taoist author's who do not advocate a total vegetarian regime, recommend moving slowly to a mostly vegetarian diet.

Vegetarians who return to eating meat experience the same digestive difficulties, so it makes sense that it would work in the reverse. Perhaps the best thing we can do for the vegetarian patient is point this fact out to them, and get an understanding of what level of maturity the decision to become a vegetarian is at. Getting the patient involved in understanding their nutrition is essential to their being a healthy vegetarian. It can not be done on a whim.

A Final Word

It should be clear at this point that being a vegetarian is not merely a diet choice, but a way of life. A vegetarian lifestyle requires discipline, planning, and a conscious effort to maintain a well rounded diet. It requires becoming actively involved, and personal responsibility. One must mature beyond eating things simply because they taste good and develop an attitude of eating for health preservation and personal cultivation. In addition to merely changing the way one eats, it is necessary to work towards a more harmonious existence in all facets of one's life. For these reasons, it could be argued that for the majority of Americans, living healthfully as a vegetarian is a monumental task. On the other hand, it does not mean it is impossible. Given the state of disharmony in our modern culture, the devastation of the environment, and the degree to which untampered meat and animal products is hard to come by, vegetarianism is a lifestyle worthy of considering and encouraging.

As practitioners of Oriental Medicine it behooves us to remember that we are instruments of influencing body, mind and spirit. In our Western materialistic society it is often easy for us to focus on ailments of the body, ignoring the rest. We need to be sensitive and understanding of others who are seeking a more spiritual existence, and be prepared to work with them within the parameters of the lifestyle choices of others. In our own tradition there are precedents for including at least a little meat in the diet. There is also a tradition for forgoing this for spiritual purposes. If a patient who has chosen a vegetarian lifestyle is having health difficulties, assessment of their particular regime, and alterations to the diet can be made. This should be attempted and encourage first, before insisting that meat should be eaten. According to our own tradition meat should only be a very small part of the diet anyway. If it appears that meat is, in our opinion, absolutely necessary, we must be prepared to counsel patients and provide them with a very clear understanding of their health and allow them to make an informed decision. This strategy should be approached with knowledge and compassion for our vegetarian patients.


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  8. Brody, Jane. Jane Brody's Nutrition Book. New York: W.W. Norton and Co., Inc. 1981. p. 442.
  9. Pitchford, Paul Healing with Whole Foods. Berkeley: North Atlantic Books. 1993. p. 96.


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Biographical Notes

Clark C. Casteel was a senior intern at the Pacific College of Oriental Medicine in San Diego, California at the time he wrote this article. In addition he has studied under several practitioners of Oriental Medicine in various clinics in San Diego including; the Pacific Center of Health, The Park Boulevard Health Center, and the East West Center for Health. He received a BA in History specializing in Asian cultures from the University of New Hampshire, Durham, New Hampshire in 1989.

He is currently practicing at "Eastern Healing Arts" in Gainesville, Georgia. His e-mail address is:

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