Prevalence of Vitamin B12 Deficiency among Exclusively Breast Fed Term Infants in South India

Author(s):  
Apurva Kadiyala ◽  
Anitha Palani ◽  
Sasitharan Rajendraprasath ◽  
Padmasani Venkatramanan

Abstract Objective Vitamin B12 is not synthesized in the body and its only dietary sources are non-vegetarian. The breast milk of mothers in resource poor countries who are on predominantly vegetarian diets is deficient in vitamin B12. Hence exclusive breast feeding (EBF) may result in B12 deficiency in the infant, which can affect the neurodevelopmental outcome. Our aim was to study the serum vitamin B12 levels among EBF infants and identify the risk factors for B12 deficiency. Method This cross-sectional study was done among EBF, term, otherwise healthy infants, 1–6 month of age in the well-baby clinic .The sociodemographic data of mother and the infants’ anthropometric measurements were noted and blood samples were sent for complete blood count and serum vitamin B12 levels. The data were analysed using SPSS software version 16. Results We enrolled 149 EBF infants, aged 1–6 months and the mean age was 3.1 (±1.03) months. The mean serum vitamin B12 level was 199.91 (±112.523) pg/ml. Low serum vitamin B12 levels (<200 pg/ml) was seen in 95 (63.7%) infants. On multivariate analysis, there were no other significant risk factors for B12 deficiency in the infants. Conclusion The prevalence of vitamin B12 deficiency among EBF infants is 63.7%. Because of its importance in neurological development during infancy, there is an urgent need to address this issue while promoting exclusive breast feeding.

2018 ◽  
Vol 25 (05) ◽  
pp. 753-758
Author(s):  
Arshad Sattar Lakho ◽  
Aqeel Ahmed Channa ◽  
Abdul Ghaffar Dars ◽  
Syed Zulfiquar Ali Shah ◽  
Muhammad Iqbal

Objectives: To determine the frequency of vitamin B12 deficiency in patientswith hypothyroidism. Study Design: Cross sectional descriptive study. Period: 12-05-2016to 11-11-2016. Setting: Liaquat University Hospital Jamshoro / Hyderabad. Patients andMethods: All the patients of known hypothyroid patients for ≥01month duration, 20-50 yearsof age, either gender were explored for serum vitamin B12 level. The SPSS was used tomanipulate the data in relation to mean ±SD, frequencies and percentages and through chisquaretest to get the p-values and its level of significance (≤0.05). Results: Total 145 patientswith hypothyroidism were evaluated for B12 deficiency, of which 97 (66.8%) were males and48 (33.1%) were females respectively. Ninety patients (62%) were from urban areas while 55(37.9%) was rural population. The mean ±SD for age of overall population was 41.83±8.93years while the mean age ±SD for vitamin B12 deficient and non deficient was 39.96±7.82and 40.74±8.54 years respectively. The vitamin B12 deficiency was observed in one hundredand five patients (72%), of which 69 (65.7%) males and 36 (34.3%) females. The mean ± SDfor duration of infection in overall population was 5.32±1.53 months while it was 5.81±1.43 invitamin B12 deficient individuals. Conclusion: The vitamin B12 deficiency is more pronouncedin hypothyroid patients. In present series vitamin B12 deficiency was observed in 105 (72%)individuals with male predominance 69 (65.7%).


1973 ◽  
Vol 19 (9) ◽  
pp. 1049-1052 ◽  
Author(s):  
J W Harrison ◽  
B A Slade ◽  
W Shaw

Abstract Urinary aminoimidazolecarboxamide (AIC), serum folate, and serum vitamin B12 values were determined in 84 apparently healthy individuals. An automated system for determination of AIC in urine is described. Despite claims to the contrary, we found no evidence of a strong relationship between elevated (e.g., >1.3 µg/mg of creatinine) AIC excretion as reflected in a casual sample of urine and folate or vitamin B12 deficiency. Urinary AIC values ranged from 0.10 to 5.20 µg/mg of creatinine. The mean for the population examined was 1.36 ± 1.02 µg/mg of creatinine.


Author(s):  
Sanem Kayhan ◽  
Nazli Gulsoy Kirnap ◽  
Mercan Tastemur

Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.


2018 ◽  
Vol 7 (10) ◽  
pp. 304 ◽  
Author(s):  
Emmanuel Andrès ◽  
Abrar-Ahmad Zulfiqar ◽  
Khalid Serraj ◽  
Thomas Vogel ◽  
Georges Kaltenbach

The objective of this review is to provide an update on the effectiveness of oral and nasal vitamin B12 (cobalamin) treatment in gastrointestinal (GI) disorders. Relevant articles were identified by PubMed and Google Scholar systematic search, from January 2010 and June 2018, and through hand search of relevant reference articles. Additional studies were obtained from references of identified studies, the Cochrane Library and the ISI Web of Knowledge. Data gleaned from reference textbooks and international meetings were also used, as was information gleaned from commercial sites on the web and data from CARE B12 research group. For oral vitamin B12 treatment, 4 randomized controlled trials (vs. intramuscular), 4 narrative and 4 systematic reviews, and 13 prospective studies fulfilled our inclusion criteria. These studies concerned patients with vitamin B12 deficiency related to: food-cobalamin malabsorption (n = 6), Biermer’s disease (n = 3), veganism or vegetarianism (n = 1), total gastrectomy after Roux-en-Y gastric bypass (n = 2) and Crohn’s disease (n = 1). Four prospective studies include patients with vitamin B12 deficiency related to the aforementioned etiologies, except veganism or vegetarianism. The systematic present review documents that oral vitamin B12 replacement, at a daily dose of 1000 μg (1 mg), was adequate to normalize serum vitamin B12 levels and cure main clinical manifestations related to vitamin B12 deficiency, in GI disorders, and thus, with safety profile. For nasal vitamin B12 treatment, only one preliminary study was available. We conclude that oral vitamin B12 is an effective alternative to intramuscular vitamin B12 (except in patients presenting with severe neurological manifestations). Oral vitamin B12 treatment avoids the discomfort, contraindication (in patients with anticoagulation), and cost of monthly injections.


Blood ◽  
1977 ◽  
Vol 49 (6) ◽  
pp. 987-1000 ◽  
Author(s):  
R Carmel ◽  
B Tatsis ◽  
L Baril

A patient with recurrent pulmonary abscess, weight loss, and alcoholism was found to have extremely high serum vitamin B12 and unsaturated vitamin B12-binding capacity (UBBC) levels. While transcobalamin (TC) II was also increased, most of his UBBC was due to an abnormal binding protein which carried greater than 80% of the endogenous vitamin B12 and was not found in his saliva, granulocytes, or urine. This protein was shown to be a complex of TC II and a circulating immunoglobulin (IgGkappa and IgGlambda). Each IgG molecule appeared to bind two TC II molecules. The reacting site did not interfere with the ability of TC II to bind vitamin B12, but did interfere with its ability to transfer the vitamin to cells in vitro. The site was not identical to that reacting with anti-human TC II antibody produced in rabbits. Because of this abnormal complex, 57Co-vitamin B12 injected intravenously was cleared slowly by the patient. However, no metabolic evidence for vitamin B12 deficiency was demonstrable, although the patient initially had megaloblastic anemia apparently due to folate deficiency. The course of the vitamin B12-binding abnormalities was followed over 4 yr and appeared to fluctuate with the status of the patient's illness. The IgG-TC II complex resembled one induced in some patients with pernicious anemia by intensive treatment with long-acting vitamin B12 preparations. The mechanism of induction of the antibody formation in our patient is unknown.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
John Rolshoven ◽  
Katelyn Fellows ◽  
Rolando Ania ◽  
Burton J. Tabaac

Background. The term cytotoxic lesions of the corpus callosum (CLOCCs) encompasses the entity reversible splenial lesion syndrome (RESLES). RESLES typically presents with altered levels of consciousness, seizures, and delirium and is distinguished radiographically by reversible focal lesions of the splenium of the corpus callosum. This disease pathology is associated with withdrawal of antiepileptic medications, infections, metabolic disturbance, or high-altitude cerebral edema. Methods. We presented an otherwise healthy 72-year-old female that was consulted for an episode of isolated vertigo lasting four hours. Initial workup included CT head without contrast, CT angiogram head and neck, and MRI brain with and without contrast. The patient experienced recurrent episodes of vertigo at one and four months after initial presentation. An extensive workup at one month included a wide spectrum of laboratory tests and repeat imaging. Results. Noncontrast CT of the head and CT angiogram of the head and neck were reassuring. MRI brain with and without contrast demonstrated hyperintensity in the splenium of the corpus callosum on FLAIR sequencing. A follow-up visit at one month revealed vitamin B12 deficiency and unchanged hyperintensity of the splenium of the corpus callosum. History and workup were negative for typical risk factors associated with RESLES. Conclusion. An otherwise healthy patient who presented with an isolated episode of vertigo was discovered to demonstrate radiographic features consistent with RESLES but lacked the common risk factors and typical presentation of RESLES. This case expands the possible clinical presentation of RESLES and highlights the possible relationship between vitamin B12 deficiency and radiographic features of RESLES.


2019 ◽  
Vol 59 (2) ◽  
pp. 40 ◽  
Author(s):  
Synara Cavalcante Lopes ◽  
Daniel Duarte Gadelha ◽  
Manuela Dias de Carvalho ◽  
Virgínia Oliveira Fernandes ◽  
Renan Magalhães Montenegro Junior

Vitamin B12 is a water-soluble essential micronutrient, required by all the body cells. Its deficiency has been implicated not only in hematological and neurological disorders, but also in many metabolic processes, such as insulin resistance and body composition changes, which have aroused particular interest in recent years. This study reviews the physiology of vitamin B12 from its digestion and absorption to its distribution in tissues, metabolic effects and controversies regarding the diagnosis of deficiency, and to dietary and pharmacological treatments.


2020 ◽  
Vol 11 (1) ◽  
pp. 114-120
Author(s):  
Susianto Susianto

Introduction: Vegetarians consume plant-based foods with or without eggs and milk. Vegetarians are at risk of vitamin B12 deficiency, as natural sources of vitamin B12 are limited to animal-based foods. Vitamin B12 deficiency can lead to megaloblastic anemia, nerve damage and increase homocysteine level. Higher homocysteine level can increase the risk of coronary heart disease and stroke. The objective of this study was to investigate the effect of vitamin B12 fortification on the level of serum vitamin B12 and homocysteine in vegetarian. Method: The research design was an experimental study, community trial. The samples were 42 vegetarians with vitamin B12 deficiency (< 156 pmol/L) selected from 118 vegetarians as members of Indonesia Vegetarian Society (IVS) Pekanbaru, treated by vitamin B12 fortified oatmeal for three months from March to June 2010.  Serum vitamin B12 and homocysteine were measured by electrochemiluminescent immunoassay and microparticle enzyme immunoassay method respectively. Result: Prevalence of vitamin B12 deficiency in vegetarian was 35.6%. Statistical analysis showed a significant increase of serum vitamin B12 from 124.6 to 284.6 pmol/L (p=0.001) and significant decrease of serum homocysteine from 20.1 to 15.1 µmol/L (p=0.001). Conclusion: Consumption of vitamin B12 fortified oatmeal increases the level of serum vitamin B12 and decreases the level of serum homocysteine significantly in vegetarian with vitamin B12 deficiency.


2020 ◽  
pp. 32-38
Author(s):  
VICTORIA LAZAROVA SPASOVA ◽  
LILIA IVANOVA KOLEVA ◽  
MARIETA ANTONOVA POPOVA ◽  
VALENTINA BOYANOVA PETKOVA ◽  
MILEN VENTZISLAVOV DIMITROV

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.


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