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Vitamin B12 Deficiency

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3. Vitamin B12 deficiency

Vitamin B12 deficiency Vitamin B12 deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Vitamin B12 deficiency Last reviewed: February 2019 Last updated: June 2018 Summary Classically presents with megaloblastic anaemia, but can also present with peripheral neuropathy and neuropsychiatric complaints. Older people, patients with chronic malabsorption, patients with a history of gastric resection or bypass (...) , and those taking certain medicines (metformin, proton-pump inhibitors) are at risk. Early diagnosis is critical in preventing and halting the progression of neurological disorders such as peripheral neuropathy and dementia. Methylmalonic acid and homocysteine levels may help to diagnose vitamin B12 deficiency at an early, asymptomatic state. Cause of vitamin B12 deficiency should be searched for once a diagnosis is confirmed. Treatment with high-dose oral vitamin B12 therapy may be as effective

2018 BMJ Best Practice

4. Systematic Review and Pragmatic Clinical Approach to Oral and Nasal Vitamin B12 (Cobalamin) Treatment in Patients with Vitamin B12 Deficiency Related to Gastrointestinal Disorders (PubMed)

Systematic Review and Pragmatic Clinical Approach to Oral and Nasal Vitamin B12 (Cobalamin) Treatment in Patients with Vitamin B12 Deficiency Related to Gastrointestinal Disorders 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 (...) . 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

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2018 Journal of clinical medicine

5. How should severe vitamin B12 deficiency in pregnancy be managed?

How should severe vitamin B12 deficiency in pregnancy be managed? How should severe vitamin B12 deficiency in pregnancy be managed? – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Menu · · Published 13th December 2017, updated 13th December 2017 · UKMi This updated Medicines Q&A evaluates the limited evidence available on the management of severe vitamin B12 deficiency in pregnancy Attachments · Word · 52 KB Regional Medicines Information Manager, London

2017 Specialist Pharmacy Services

6. Effect of 8-week oral supplementation with 3-µg cyano-B12 or hydroxo-B12 in a vitamin B12-deficient population. (PubMed)

Effect of 8-week oral supplementation with 3-µg cyano-B12 or hydroxo-B12 in a vitamin B12-deficient population. We compare the effect of 8-week oral supplementation with cyano-B12 (currently used in vitamin pills) and hydroxo-B12 (predominant form in the diet) in a population with nutritional vitamin B12 deficiency.Fifty-one healthy Indian adults with baseline serum cobalamin < 200 pmol/L were supplied for 8 weeks with daily oral supplements of 3-µg cyano-B12 (n = 15), 3-µg hydroxo-B12 (n = 16 (...) with cyano-B12 showed a higher increase in total serum cobalamin than the group treated with hydroxo-B12, while other biomarkers changed comparably in the two groups. After 8 weeks of treatment, the biomarker values of the supplemented groups (pooled) differed significantly from the placebo group. Yet, the vitamin B12 status was still poor [cobalamin: 168 (87-302) pmol/L; holotranscobalamin: 19 (8-45) pmol/L; methylmalonic acid: 0.7 (0.2-1.7) µmol/L; homocysteine: 17.2 (2.6-96.8) µmol/L; 4cB12 = - 1.34

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2017 European journal of nutrition

7. Oral vitamin B<sub>12</sub> versus intramuscular vitamin B<sub>12</sub> for vitamin B<sub>12</sub> deficiency. (PubMed)

Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Vitamin B12 deficiency is common, and the incidence increases with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular (IM) vitamin B12. Doctors may not be prescribing oral vitamin B12 formulations because they may be unaware of this option or have concerns regarding its effectiveness.To assess the effects of oral vitamin B12 versus intramuscular (...) by Cochrane. Our primary outcomes were serum vitamin B12 levels, clinical signs and symptoms of vitamin B12 deficiency, and adverse events. Secondary outcomes were health-related quality of life, acceptability to patients, haemoglobin and mean corpuscular volume, total homocysteine and serum methylmalonic acid levels, and socioeconomic effects. We used GRADE to assess the quality of the evidence for important outcomes. We did not perform meta-analyses due to the small number of included trials

2018 Cochrane

8. Fortification of staple foods with vitamin A for vitamin A deficiency. (PubMed)

Fortification of staple foods with vitamin A for vitamin A deficiency. Vitamin A deficiency is a significant public health problem in many low- and middle-income countries, especially affecting young children, women of reproductive age, and pregnant women. Fortification of staple foods with vitamin A has been used to increase vitamin A consumption among these groups.To assess the effects of fortifying staple foods with vitamin A for reducing vitamin A deficiency and improving health-related (...) the studies were conducted in low- and upper-middle income countries where vitamin A deficiency was a public health issue. One of the included trials did not contribute data to the outcomes of interest.Three trials compared provision of staple foods fortified with vitamin A versus unfortified staple food, five trials compared provision of staple foods fortified with vitamin A plus other micronutrients versus unfortified staple foods, and two trials compared provision of staple foods fortified with vitamin

2019 Cochrane

9. The association of metformin use with vitamin B12 deficiency and peripheral neuropathy in Saudi individuals with type 2 diabetes mellitus. (PubMed)

The association of metformin use with vitamin B12 deficiency and peripheral neuropathy in Saudi individuals with type 2 diabetes mellitus. To compare the prevalence of vitamin B12 deficiency and peripheral neuropathy between two groups of type 2 diabetes mellitus (T2DM) patients treated with or without metformin, and to determine factors associated with vitamin B12 deficiency therapy and dietary intake of vitamin B12.In this retrospective study, we recruited 412 individuals with T2DM: 319 (...) taking metformin, and 93 non-metformin users. Demographics, dietary assessment for vitamin B12 intakes, and medical history were collected. Participants were assessed for peripheral neuropathy. Blood specimens were collected and checked for serum vitamin B12 levels. The differences between the two groups were analyzed using an independent t-test for continuous data, and the Chi-squared or Fisher's exact test was used for categorical data. The relationship of vitamin B12 deficiency with demographics

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2018 PLoS ONE

10. Lack of historical evidence to support folic acid exacerbation of the neuropathy caused by vitamin B12 deficiency. (PubMed)

Lack of historical evidence to support folic acid exacerbation of the neuropathy caused by vitamin B12 deficiency. In 1998 a Tolerable Upper Intake Level (UL) for folic acid was established based on case reports from the 1940s suggesting that high-dosage folic acid intake, used to treat patients with pernicious anemia, had the potential to precipitate or speed-up the development of neurological problems. This UL has been employed in the decision-making process used by more than 80 countries (...) medical practice for the treatment of pernicious anemia and with the changes in usage of folic acid preparations, including recommended therapeutic dosage and precautions for its usage surrounding the synthesis of folic acid in 1945 and vitamin B12 in 1948. Folic acid package inserts, early editions of hematology textbooks, and international expert reports provide valuable historical information. The recommended therapeutic daily dosage for folic acid of 5-20 mg was unchanged from 1946 through to 1971

2019 American Journal of Clinical Nutrition

11. Prophylactic vitamin K for the prevention of vitamin K deficiency bleeding in preterm neonates. (PubMed)

Prophylactic vitamin K for the prevention of vitamin K deficiency bleeding in preterm neonates. Vitamin K is necessary for the synthesis of coagulation factors. Term infants, especially those who are exclusively breast fed, are deficient in vitamin K and consequently may have vitamin K deficiency bleeding (VKDB). Preterm infants are potentially at greater risk for VKDB because of delayed feeding and subsequent delay in the colonization of their gastrointestinal system with vitamin K producing (...) microflora, as well as immature hepatic and hemostatic function.  OBJECTIVES: To determine the effect of vitamin K prophylaxis in the prevention of vitamin K deficiency bleeding (VKDB) in preterm infants.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 11), MEDLINE via PubMed (1966 to 5 December 2016), Embase (1980 to 5 December 2016), and CINAHL (1982 to 5 December 2016). We also searched clinical trials databases

2018 Cochrane

12. Can vitamin B12 deficiency manifest with acute posterolateral or posterior cord syndrome? (PubMed)

Can vitamin B12 deficiency manifest with acute posterolateral or posterior cord syndrome? Vitamin B12 deficiency can cause varied neurological manifestations which are subacute to chronic in onset. Subacute combined degeneration of spinal cord is one such characteristic neurological manifestation of vitamin B12 deficiency. We report a case series of five patients who presented with acute onset (<15 days) neurological manifestations due to vitamin B12 deficiency. Detailed history and clinical (...) parenteral vitamin B12 supplementation. Vitamin B12 deficiency can present with acute neurological manifestations.

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2016 Spinal cord series and cases

13. High Prevalence of Vitamin B12 Deficiency and No Folate Deficiency in Young Children in Nepal (PubMed)

High Prevalence of Vitamin B12 Deficiency and No Folate Deficiency in Young Children in Nepal Many children in low- and middle-income countries may have inadequate intake of vitamin B12 and folate; data confirming these inadequacies are limited. We used biochemical, demographic, behavioral and anthropometric data to describe the folate and vitamin B12 concentrations among six- to 23-month-old Nepalese children. Vitamin B12 (serum B12 < 150 pmol/L) and folate deficiencies (red blood cell (RBC (...) ) folate < 226.5 nmol/L) were assessed. We used logistic regression to identify predictors of vitamin B12 deficiency. The vitamin B12 geometric mean was 186 pmol/L; 30.2% of children were deficient. The mean RBC folate concentration was 13,612 nmol/L; there was no deficiency. Factors associated with vitamin B12 deficiency included: (a) age six to 11 months (adjusted odds ratio (aOR) 1.51; 95% confidence interval (CI): 1.18, 1.92) or 12-17 months (aOR 1.38; 95% CI: 1.10, 1.72) compared to 18-23 months

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2017 Nutrients

14. Active B12 assay for diagnosing vitamin B12 deficiency

Active B12 assay for diagnosing vitamin B12 deficiency Activ Active B12 assa e B12 assay for diagnosing vitamin B12 y for diagnosing vitamin B12 deficiency deficiency Medtech innovation briefing Published: 30 September 2015 nice.org.uk/guidance/mib40 pathways Summary Summary The Abbott ARCHITECT Active-B12 assay is a test for detecting levels of serum holotranscobalamin, which is the metabolically available component of vitamin B12, and can be used as a marker of vitamin B12 deficiency. Four (...) diagnostic test accuracy studies, using different reference standards, reported greater diagnostic accuracy for the Active-B12 assay compared with assays measuring other markers of vitamin B12 deficiency. The assay needs less sample preparation than a total vitamin B12 test and the expected cost is about £3.50 per test including VAT, depending on sample throughput. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1

2015 National Institute for Health and Clinical Excellence - Advice

15. Spontaneous Left Anterior Descending Artery Dissection in a Middle-Aged Woman with Vitamin B12 Deficiency Treated with Coronary Artery Bypass Grafting (PubMed)

Spontaneous Left Anterior Descending Artery Dissection in a Middle-Aged Woman with Vitamin B12 Deficiency Treated with Coronary Artery Bypass Grafting Spontaneous coronary artery dissection (SCAD) is one of the rarest causes of acute coronary syndromes, which include myocardial infarction (MI), stable and unstable angina, cardiogenic shock, and sudden death. The course of the disease, its etiology, prevalence, prognosis, and treatment remain ill-defined. Adding to the complexity is the fact (...) that patients may lack typical risk factors for coronary heart disease. Herein, we report a case of a 42-year-old woman with vitamin B12 deficiency, who presented with chest pain; electrocardiography (ECG) findings were consistent with the acute anterior wall MI. Cardiac catheterization was done, which showed a very large left anterior descending (LAD) artery dissection.

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2018 Cureus

16. The influence of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency and other comorbid autoimmune diseases on treatment outcome in patients with rheumatoid arthritis: An exploratory cohort study. (PubMed)

The influence of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency and other comorbid autoimmune diseases on treatment outcome in patients with rheumatoid arthritis: An exploratory cohort study. To investigate the impact of comorbid diseases on rheumatoid arthritis (RA) outcome.All patients diagnosed with RA since 2006, who were registered in our local Danbio registry, were included in this cohort study. Patients' demographics, serology results (...) , and Disease Activity Score in 28 joints-C-reactive protein (DAS28-CRP) at the time of diagnosis and after 4 months of treatment initiation were collected. Patients' electronic hospital records were evaluated for a positive history of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency, and the presence of other diagnosed autoimmune diseases.1035 RA patients were included. The observed prevalence of thyroid diseases was 11.8%, DM 10.4%, primary hyperparathyroidism 2.8

2018 Medicine

17. Psychomotor regression due to vitamin B12 deficiency (PubMed)

Psychomotor regression due to vitamin B12 deficiency A vitamin B12 deficiency in infants is rare, but may sometimes be seen in breastfed babies of strict vegetarian mothers. Vitamin B12, also known as cobalamin, is only found in meat and other animal products. Most babies have a sufficient supply as long as the mother was not deficient herself. Symptoms and signs of vitamin B12 deficiency appear between the ages of 2 to 12 months and include vomiting, lethargy, failure to thrive, hypotonia (...) , and arrest or regression of developmental skills. Urinary concentrations of methylmalonic acid and homocystine are characteristically elevated in vitamin B12 deficiency. Early treatment for a vitamin B12 deficiency in an infant involves immediate administration of vitamin B12 to the baby and the breastfeeding mother. The infant and mother will each receive an injection of vitamin B12 containing 1,000 mcg or more of the vitamin, and the mother will continue to receive injections every month to raise her

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2018 The Pan African medical journal

18. The Evaluation of Ophthalmic Findings in Women Patients With Iron and Vitamin B12 Deficiency Anemia (PubMed)

The Evaluation of Ophthalmic Findings in Women Patients With Iron and Vitamin B12 Deficiency Anemia To determine whether there are differences in the central corneal thickness (CCT), retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) in women with iron deficiency anemia (IDA) and vitamin B12 deficiency anemia (B12DA).The patients were divided and evaluated in three groups as IDA (group 1), combined IDA-B12DA (group 2), and healthy females (group 3). Each group

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2018 Translational vision science & technology

19. Diagnostic value of oral “beefy red” patch in vitamin B12 deficiency (PubMed)

Diagnostic value of oral “beefy red” patch in vitamin B12 deficiency Vitamin B12 deficiency, which may cause serious neuropsychiatric damage, is common in the elderly. The non-specific clinical features of B12 deficiency and unreliable serum parameters make diagnosis difficult. We aimed to evaluate the value of oral "beefy red" patches as a clinical marker of B12 deficiency.A diagnostic study was conducted in patients complaining of oral soreness, burning sensation, or severe recurrent oral (...) ulcers. Patients underwent clinical examination and laboratory investigations, including complete blood count and estimation of serum B12, folate, iron, and ferritin levels. Resolution of clinical signs and symptoms after 1 month of B12 supplement was regarded as the diagnostic gold standard.Of 136 patients, 70 had B12 deficiency. Among these patients, the oral "beefy red" patch was observed in 61, abnormal mean corpuscular volume (MCV) was noted in 30, and serum cobalamin levels <200 and <350 pg/mL

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2018 Therapeutics and clinical risk management

20. Thalassemia minor presenting with vitamin B12 deficiency, paraparesis, and microcytosis (PubMed)

Thalassemia minor presenting with vitamin B12 deficiency, paraparesis, and microcytosis Vitamin B12 is essential for proper neurological functioning, and its deficiency may cause a wide range of neuropsychiatric and hematological manifestations. We report a case of a previously healthy 32-year-old female who was admitted to our hospital with sudden onset of bilateral lower limb paraparesis and loss of sensation. The serum level of vitamin B12 was mildly decreased with high methylmalonic acid (...) and homocysteine levels. However, her complete blood count showed no evidence of anemia or macrocytosis; instead, her mean corpuscular volume was low. Hemoglobin electrophoresis showed thalassemia trait, and that probably masked the megaloblastic features of vitamin B12 deficiency. She responded fully to vitamin B12 replacement therapy.

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2018 Journal of blood medicine

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