scholarly journals Perspective: Practical Approach to Preventing Subclinical B12 Deficiency in Elderly Population

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1913
Author(s):  
Alessandra Vincenti ◽  
Laura Bertuzzo ◽  
Antonio Limitone ◽  
Giuseppe D’Antona ◽  
Hellas Cena
Keyword(s):  
Vitamin B12 ◽  
Elderly Population ◽  
Vitamin B12 Deficiency ◽  
Water Soluble ◽  
Health Issues ◽  
Animal Products ◽  
Water Soluble Vitamin ◽  
Age Dependent ◽  
B12 Deficiency ◽  
Inadequate Dietary Intake

Vitamin B12 (also known as cobalamin) is an essential water-soluble vitamin that plays a pivotal role for several physiologic functions during one’s lifespan. Only certain microorganisms are able to synthetize B12, thus humans obtain cobalamin exclusively from their diet, specifically from animal-derived foods. Specific sub-group populations are at risk of vitamin B12 subclinical deficiency due to different factors including poor intake of animal source foods and age-dependent decrease in the capacity of intestinal B12 uptake. Consumption of animal products produces some negative health issues and negatively impacts sustainability while a plant-based diet increases the risk of B12 deficiency. Taking a cue from the aforementioned considerations, this narrative review aims to summarize facts about B12 deficiency and the burden of inadequate dietary intake in elderly population, as well as to discuss sustainable approaches to vitamin B12 deficiency in aging population.

Vitamin B12 Deficiency and West Syndrome: An Uncommon but Preventable Cause of Neurological Disorder. Report on Three Cases, One of Them with Late Onset during Vitamin B12 Treatment

2021 ◽  
Author(s):  
Piero Pavone ◽  
Federica Sullo ◽  
Raffaele Falsaperla ◽  
Filippo Greco ◽  
Agustina Crespo ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Late Onset ◽  
Vitamin B12 Deficiency ◽  
West Syndrome ◽  
Water Soluble ◽  
Vegan Diet ◽  
Inborn Errors ◽  
Water Soluble Vitamin ◽  
B12 Deficiency ◽  
Somatic Diseases

AbstractVitamin B12 is a water-soluble vitamin that plays a fundamental role as an essential cofactor for two enzymes responsible for the production of succinyl-CoA and methionine. Vitamin B12 deficiency can occur in infants and may be related to the breastfeeding mother's adherence to a vegan diet or somatic diseases in the mother. It should be differentiated from inborn errors of vitamin B12 metabolism. Herein, we report the cases of three infants with West syndrome; all three were breastfed by mothers who followed a strict vegan diet. In one of the three infants, West syndrome developed during treatment with vitamin B12 and normalization of the vitamin B12 level. Early treatment and replacement therapy are worthwhile to prevent serious neurological problems and to improve the patient's clinical course.

scholarly journals A case report on hyperpigmentation in vitamin B12 deficiency

2019 ◽  
Vol 7 (5) ◽  
pp. 1944
Author(s):  
Vivek Kumar Verma ◽  
V. Vijayavarman
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Water Soluble ◽  
Animal Origin ◽  
Adequate Treatment ◽  
Cutaneous Manifestations ◽  
Food Of Animal Origin ◽  
Water Soluble Vitamin ◽  
B12 Deficiency

Cobalamin (Vitamin B12) is a water-soluble vitamin. Cobalamin is synthesized only by microorganisms. The only source of vitamin B12 for humans is food of animal origin. Hyperpigmentation of skin has been reported only rarely as the presenting manifestation of vitamin B12 deficiency. We report a patient who had hyperpigmentation as her presenting medical complaint and in whom Vitamin B12 deficiency was the cause.  A 36-year-old female presented with generalised weakness and progressive and asymptomatic hyperpigmentation of hand and feet for 5 months. She is vegetarian by diet. On examination, hyperpigmentation was present over dorsal aspect of metacarpophalangeal, proximal and distal interphalangeal joints. Hyperpigmentation were present over dorsum of the foot and over the joints. The tongue was depaillated, and hyperpigmentation was present. Her serum level of vitamin B12 was diminished (83pg/ml). Megaloblastic anemia presents with protean manifestations. The association between vitamin B12 deficiency and hyperpigmentation, although unusual, has been described. Cutaneous manifestations associated with B12 deficiency include characteristic mucocutaneous hyperpigmentation (most common), vitiligo, angular cheilitis, and hair-nail changes. It mainly affects knuckle pads and oral mucosa. It is an under-recognized sign of megaloblastic anemia and should always be looked for in the setting of pallor. Hyperpigmentation could be the earliest manifestation of vitamin B12 deficiency before anemia sets in. It is worthwhile to consider the possibility of vitamin B12 or folate deficiency in a patient with unexplained pigmentary changes. Early detection and adequate treatment will prevent anemia and various neurological manifestations.

scholarly journals Methylcobalamine (Vitamin B12): Water Soluble Vitamin with Various Pharmacological Aspect

2021 ◽  
Vol 11 (1) ◽  
pp. 130-137
Author(s):  
Roopesh Kumar Yadav ◽  
Sudhanshu Mishra ◽  
Deepti Jain
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Intrinsic Factor ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Water Soluble ◽  
Oral Dosage ◽  
Therapeutic Effects ◽  
Water Soluble Vitamin ◽  
B12 Deficiency

Vitamin B12 is a water-soluble vitamin that plays a key role in the brain's proper functioning and nervous system, in blood flow, and in reducing weakness and tiredness. In their food, most people get adequate vitamin B12, but in some health conditions (e.g. inadequate sleep, stomach/intestinal disorders, inflammation, cancer), there could be a shortage. If left unchecked, severe Vitamin B12 deficiency results in anemia and nerve damage. Vitamin B12 deficiency is typically treated using parenteral and oral dosage formulations, but absorption and compliance problems are involved with these routes of administration. Most significantly, the function of this missing intrinsic factor has been shown to assist in vitamin B12 absorption and a deficiency known as pernicious anaemia. Vitamin B12 is only partially absorbed when delivered by mouth to patients with pernicious anemia, but hematologically re-absorbed in patients with pernicious anemia. Parenteral administration of the extrinsic element will treat pernicious anaemia satisfactorily. There are several roles and advantages of vitamin B 12 in the human body with therapeutic effects also. Keywords: Water Soluble Vitamins, Methylcobalamine, Vitamin B12, Pernicious Anaemia.

scholarly journals Vitamin B12 deficiency: metabolic effects, clinical evaluation, and treatment

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
Keyword(s):  
Insulin Resistance ◽  
Vitamin B12 ◽  
Neurological Disorders ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Water Soluble ◽  
Metabolic Effects ◽  
Pharmacological Treatments ◽  
B12 Deficiency ◽  
Composition Changes

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.

scholarly journals Anaemia in the Hospitalized Elderly in Tanzania: Prevalence, Severity, and Micronutrient Deficiency Status

Anemia ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Clara Chamba ◽  
Ahlam Nasser ◽  
William F. Mawalla ◽  
Upendo Masamu ◽  
Neema Budodi Lubuva ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Elderly Population ◽  
Vitamin B12 Deficiency ◽  
The Elderly ◽  
Micronutrient Deficiency ◽  
Sub Saharan Africa ◽  
Serum Folate ◽  
Deficiency Anaemia ◽  
Hospitalized Elderly ◽  
B12 Deficiency

Introduction. Anaemia is a common problem in sub-Saharan Africa. While most literature has focused on children, women of childbearing age, and pregnant women, data for the elderly population are relatively scarce. Anaemia exhorts negative consequences to functional ability of elderly patients, both physically and cognitively. The purpose of this study was to determine the prevalence of anaemia, severity, and micronutrient deficiency status in the elderly hospitalized patients in Tanzania. Methods. A total of 156 hospitalized adults aged 60 years and above were enrolled in this study. A structured questionnaire was used to capture sociodemographic and clinical characteristics. Blood samples were collected, and a complete blood count, serum cobalamin, serum ferritin, and serum folate levels were measured to assess anaemia and micronutrient deficiency status in all participants who had anaemia. Results. The prevalence of anaemia was 79.5% (124/156) with severe anaemia in 33.9% (42/124) of participants, moderate anaemia in 42.7% (53/124) of participants, and 23.4% (29/124) of all participants had mild anaemia. Micronutrient deficiency was found in 14.5% (18/124) of all participants with anaemia. Combined deficiency (either iron and vitamin B12 deficiency or iron and folate deficiency) was the most common micronutrient deficiency anaemia with a frequency of 33.3% (6/18), followed by isolated iron and folate deficiencies at equal frequency of 27.8% (5/18) and vitamin B12 deficiency at 11.1% (2/18). Conclusion. The prevalence of anaemia in the hospitalized elderly population is high warranting public health attention and mostly present in moderate and severe forms. Micro-nutrient deficiency anaemia is common in this age group and is mostly due to combined micronutrient deficiency.

Vitamin B12 deficiency is associated with coronary artery disease in an Indian population

2009 ◽  
Vol 47 (3) ◽  
Author(s):  
Jitender Kumar ◽  
Gaurav Garg ◽  
Elayanambi Sundaramoorthy ◽  
P. Veerendra Prasad ◽  
Ganesan Karthikeyan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vitamin B12 ◽  
Care Center ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Animal Products ◽  
Transsulfuration Pathway ◽  
B12 Deficiency ◽  
Artery Disease

Abstract: The incidence of coronary artery disease (CAD) is increasing at an alarming rate, especially in developing countries, such as India. It is often advocated that a vegetarian lifestyle could reduce the burden of CAD. However, in spite of a majority of Indians being vegetarians, the incidence of CAD is highest in this population. This may be due to deficiency of vitamin B12, a micronutrient, sourced only from animal products.: Herein, we assessed the effect of vitamin B12 with respect to CAD in 816 individuals (368 CAD patients and 448 controls) recruited from a tertiary care center in New Delhi, India.: We found that vitamin B12 levels were significantly lower in CAD patients than in controls (p<0.0001). Also, vegetarians were found to have significantly lower vitamin B12 concentrations (p=0.0001) and higher incidence of CAD (p=0.01). Interestingly, elevated homocysteine levels, a hallmark of vitamin B12 deficiency, was not associated with CAD. In contrast, cysteine levels were significantly higher in CAD patients than in controls (p=0.004).: We believe that, when vitamin B12 is deficient, homocysteine is rapidly metabolized via the transsulfuration pathway leading to increased cysteine levels.Clin Chem Lab Med 2009;47:334–8.

scholarly journals VITAMIN DEFICIENCY AND FOOD SUPPLEMENTS

2021 ◽  
Vol 9 (12) ◽  
pp. 540-552
Author(s):  
Saad Fahad Aldaihani
Keyword(s):  
Vitamin B12 ◽  
Human Body ◽  
Vitamin B12 Deficiency ◽  
Vitamin Deficiency ◽  
Megaloblastic Anaemia ◽  
Water Soluble ◽  
Vitamin B ◽  
B12 Deficiency ◽  
And Function ◽  
Harmful Effects

Vitamins are a heterogeneous group of organic compounds that help ensure the human bodys wellbeing and function. This paper introduces the importance of all vitamins, both water-soluble and fat-soluble, as well as problems deriving from their deficiency. Additionally, vitamin supplements as part of treating vitamin deficiency, and possible harmful effects on the human body areshowcased. The main focus of the paper is on the vitamin B complex, and vitamin B12 specifically. The benefits of vitamin B12, as well as its action in the human body and the noxious effects of any lack of vitamin B12 in the human body, are also discussed. Some of the health conditionsan individual may need to face when they have vitamin B12 deficiency include neural tube defects, Alzheimers disease, depression, and megaloblastic anaemia, which are also introduced and further discussed, in terms of symptomatology, causes and suggested treatment. The toxicity of vitamin B12 is also introduced, and possible causes for vitamin B12 deficiency are showcased.

scholarly journals Neurological disorders in vitamin B12 deficiency

2019 ◽  
Vol 91 (4) ◽  
pp. 122-129 ◽  
Author(s):  
Ch S Pavlov ◽  
I V Damulin ◽  
Yu O Shulpekova ◽  
E A Andreev
Keyword(s):  
Vitamin B12 ◽  
Pancreatic Insufficiency ◽  
Clinical Manifestations ◽  
Bacterial Overgrowth ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Cobalamin Deficiency ◽  
Animal Products ◽  
B12 Deficiency ◽  
Transcobalamin I

The review discusses thesteps of vitamin B12 metabolism and its role in maintaining of neurological functions. The term "vitamin B12 (cobalamin)" refers to several substances (cobalamins) of a very similar structure. Cobalamin enters the body with animal products. On the peripherу cobalamin circulates only in binding with proteins transcobalamin I and II (complex cobalamin-transcobalamin II is designated as “holotranscobalamin”). Holotranscobalamin is absorbed by different cells, whereas transcobalamin I-binded vitamin B12 - only by liver and kidneys. Two forms of cobalamin were identified as coenzymes of cellular reactions which are methylcobalamin (in cytoplasm) and hydroxyadenosylcobalamin (in mitochondria). The main causes of cobalamin deficiency are related to inadequate intake of animal products, autoimmune gastritis, pancreatic insufficiency, terminal ileum disease, syndrome of intestinal bacterial overgrowth. Relative deficiency may be seen in excessive binding of vitamin B12 to transcobalamin I. Cobalamin deficiency most significantly affects functions of blood, nervous system and inflammatory response. Anemia occurs in 13-15% of cases; macrocytosis is an early sign. The average size of neutrophils and monocytes is the most sensitive marker of megaloblastic hematopoiesis. The demands in vitamin B12 are particularly high in nervous tissue. Hypovitaminosis is accompanied by pathological lesions both in white and gray brain matter. Several types of neurological manifestations are described: subacute combined degeneration of spinal cord (funicular myelinosis), sensomotor polyneuropathy, optic nerve neuropathy, cognitive disorders. The whole range of neuropsychiatric disorders with vitamin B12 deficiency has not been studied well enough. Due to certain diagnostic difficulties they are often regarded as "cryptogenic", "reactive", "vascular» origin. Normal or decreased total plasma cobalamin level could not a reliable marker of vitamin deficiency. In difficult cases the content of holotranscobalamin, methylmalonic acid / homocysteine, and folate in the blood serum should be investigated besides carefully analysis of clinical manifestations.

scholarly journals Total Homocysteine, Vitamin B12, and Total Antioxidant Status in Vegetarians

2001 ◽  
Vol 47 (6) ◽  
pp. 1094-1101 ◽  
Author(s):  
Wolfgang Herrmann ◽  
Heike Schorr ◽  
Kathrin Purschwitz ◽  
Fausi Rassoul ◽  
Volker Richter
Keyword(s):  
Vitamin B12 ◽  
Antioxidant Status ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Total Antioxidant Status ◽  
Serum Folate ◽  
Gas Chromatography Mass Spectrometry ◽  
Animal Products ◽  
Total Antioxidant ◽  
B12 Deficiency

Abstract Background: Decreasing or eliminating animal products from the diet decreases the intake of some essential nutrients, such as vitamin B12, which may lead to hyperhomocysteinemia. We investigated vitamin B12-dependent metabolism and oxidative stress in groups with various or no intake of meat or animal products. Methods: We investigated 44 high meat eaters, 19 low meat eaters, 34 lacto-ovo/lacto vegetarians, and 7 vegan vegetarians. Homocysteine (HCY) was assayed by HPLC, methylmalonic acid (MMA) by capillary gas chromatography–mass spectrometry, serum folate and vitamin B12 with a chemiluminescence immunoassay, and total antioxidant status (TAS) by a Randox method. Results: The mean serum HCY concentration of vegetarians was significantly increased, and in vegans the median concentration exceeded 15 μmol/L. Vegetarians had a higher serum concentration of MMA but a lower TAS. Vitamin B12 and folate did not differ significantly between vegetarian and omnivorous subjects. Overall, HCY and MMA were significantly correlated. Vitamin B12 correlated negatively with MMA, HCY, and folate, whereas the correlation with TAS was positive. Backward regression analysis revealed an independent influence of MMA on HCY, of HCY and vitamin B12 on MMA, and of vitamin B12 on TAS. The increased MMA concentration suggested a 25% frequency of functional vitamin B12 deficiency in all vegetarians. Serum vitamin B12 was below the lower reference limit in only five subjects. Conclusions: Functional vitamin B12 deficiency in vegetarians may contribute to hyperhomocysteinemia and decreased TAS, which may partly counteract the beneficial lifestyle of vegetarians. However, increased serum HCY is most likely not responsible for the lower TAS values in vegetarians. We recommend assaying of MMA and HCY to investigate functional vitamin B12 status.

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