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Latest & greatest articles for Vitamin B12 Deficiency
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How does vitamin C deficiency result in bleeding? Chiefs’ Inquiry Corner – 2/10/20 – Clinical Correlations Search Chiefs’ Inquiry Corner – 2/10/20 February 10, 2020 2 min read One of the many manifestations of severe vitamin C deficiency, also known as scurvy, is easy bleeding and bruising. Vitamin C, or ascorbic acid, serves as a cofactor in collagen synthesis. Deficiency leads to impaired collagen formation, which results in vascular fragility. When considering the differential diagnosis
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D-Deficient Patients. Vitamin D deficiency is a common, potentially reversible contributor to morbidity and mortality among critically ill patients. The potential benefits of vitamin D supplementation in acute critical illness require further study.We conducted a randomized, double-blind, placebo-controlled, phase 3 trial of early vitamin D3 supplementation in critically ill, vitamin D-deficient patients who were at high risk (...) for death. Randomization occurred within 12 hours after the decision to admit the patient to an intensive care unit. Eligible patients received a single enteral dose of 540,000 IU of vitamin D3 or matched placebo. The primary end point was 90-day all-cause, all-location mortality.A total of 1360 patients were found to be vitamin D-deficient during point-of-care screening and underwent randomization. Of these patients, 1078 had baseline vitamin D deficiency (25-hydroxyvitamin D level, <20 ng per
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
Anaemia - B12 and folate deficiency Anaemia - B12 and folate deficiency - NICE CKS Share Anaemia - B12 and folate deficiency: Summary Deficiency of vitaminB12 or folate are the most common causes of megaloblastic anaemia. Megaloblastic anaemia is characterized by the development of larger than normal red blood cells (macrocytosis), with immature nuclei due to defective DNA synthesis. This results in red cells with a mean cell volume (MCV) above the normal range (greater than 100 femtolitres (...) ). Pernicious anaemia (an autoimmune disorder which results in reduced production of intrinsic factor) is the most common cause of severe vitaminB12deficiency in the UK. Other causes of vitaminB12deficiency are rare, but include: Drugs — colchicine, metformin, nitrous oxide, protein pump inhibitors, H2-receptor antagonists. Gastric causes — total or partial gastrectomy, congenital intrinsic factor deficiency or abnormality, Zollinger-Ellison syndrome. Inherited — intrinsic factor receptor deficiency
Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12deficiency. VitaminB12deficiency is common, and the incidence increases with age. Most people with vitaminB12deficiency are treated in primary care with intramuscular (IM) vitaminB12. Doctors may not be prescribing oral vitaminB12 formulations because they may be unaware of this option or have concerns regarding its effectiveness.To assess the effects of oral vitaminB12 versus intramuscular (...) by Cochrane. Our primary outcomes were serum vitaminB12 levels, clinical signs and symptoms of vitaminB12deficiency, 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
Risk factors for vitamin A and vitamin D deficiencies in children younger than 5 years in the occupied Palestinian territory: a cross-sectional study. Vitamin A and vitamin D are essential for a child's growth and development. However, research on micronutrients in the occupied Palestinian territory is scarce. The aim of this study was to ascertain the prevalence and risk factors of vitamin A and vitamin D deficiencies in children living in the occupied Palestinian territory.The Palestinian (...) Micronutrient Survey in 2013 measured concentrations of vitamin A in 1054 children (569 children in the West Bank and 485 children in the Gaza Strip) and vitamin D in 150 children (75 children in the West Bank and 75 children in the Gaza Strip). Risk factors for deficiency were assessed in children aged 6-59 months using χ2 tests and logistic regression with each of the outcome variables of vitamin A and vitamin D deficiencies. A child was considered deficient if serum concentrations were less than 1·05
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
Vitamin D Deficiency and Its Relationship with Child-Pugh Class in Patients with Chronic Liver Disease Background and Aims: Skeletal manifestation in liver diseases represents the minimally scrutinized part of the disease spectrum. Vitamin D deficiency has a central role in developing hepatic osteodystrophy in patients with chronic liver disease. This study aimed to investigate vitamin D levels and their relationship with disease advancement in these patients. Methods: Vitamin D levels were (...) checked in 125 chronic liver disease patients. The patients were classified in three stages according to Child-Pugh score: A, B and C. The relationship of vitamin D levels with Child-Pugh score and other variables in the study was assessed by the contingency coefficient. Correlation and logistic regression analyses were also carried out to find additional predictors of low vitamin D levels. Results: Among the patients, 88% had either insufficient or deficient stores of vitamin D, while only 12% had
VitaminB12deficiencyVitaminB12deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search VitaminB12deficiency 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 vitaminB12deficiency at an early, asymptomatic state. Cause of vitaminB12deficiency should be searched for once a diagnosis is confirmed. Treatment with high-dose oral vitaminB12 therapy may be as effective
Vitamin B3 deficiencyVitamin B3 deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Vitamin B3 deficiency Last reviewed: February 2019 Last updated: January 2018 Summary Traditionally caused by consuming a diet mainly composed of corn and maize. Severe deficiency leads to pellagra, which is characterised by dermatitis, dementia, diarrhoea, and eventually death. Lean meat, poultry, fish, and peanuts are rich (...) in vitamin B3 (niacin); milk and eggs are rich sources of tryptophan, the precursor of niacin. Deficiency of vitamins B2 (riboflavin) and/or B6 (pyridoxine) reduces the synthesis of niacin from tryptophan and may lead to secondary vitamin B3 deficiency. Rare in developed countries, although there are still outbreaks in Africa, India, and China, particularly in refugees and displaced people. In developed countries, deficiency is most commonly associated with chronic alcohol abuse, GI malabsorption
Vitamin B1 deficiencyVitamin B1 deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Vitamin B1 deficiency Last reviewed: February 2019 Last updated: May 2018 Summary The underlying cause of several clinical syndromes, including Wernicke's encephalopathy, wet beriberi, and dry beriberi, rather than a single clinical condition or diagnosis. Clinical presentation depends on the chronicity of the vitamin B1 (...) (thiamine) deficiency. As signs and symptoms are non-specific, the presence of risk factors raises suspicion of the diagnosis. Risk factors include alcohol dependence, malabsorption, and a diet low in thiamine (e.g., based on polished rice). As there is no rapid diagnostic test for the condition, presumptive treatment should be commenced immediately if vitamin B1 deficiency is suspected. Untreated vitamin B1 deficiency in the form of Wernicke's encephalopathy can result in the need for institutional
Vitamin D deficiencyVitamin D deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Vitamin D deficiency Last reviewed: February 2019 Last updated: July 2018 Summary The most common nutritional deficiency worldwide, characterised by serum 25-hydroxyvitamin D <50 nanomol/L (<20 nanograms/mL). Vitamin D insufficiency is regarded as a serum 25-hydroxyvitamin D level between 52 and 72 nanomol/L (21 and 29 nanograms (...) /mL). Main causes include sun avoidance, using sun protection, increased skin pigmentation, inadequate dietary and supplemental vitamin D intake, malabsorption syndromes, obesity, and medication use. Acquired and inherited disorders that either reduce or prevent the metabolism of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D also present with biochemical and skeletal abnormalities seen with vitamin D deficiency, but in a more severe form. Most patients are asymptomatic. Severe, prolonged vitamin
Vitamin D deficiency in adults - treatment and prevention Vitamin D deficiency in adults - treatment and prevention - NICE CKS Share Vitamin D deficiency in adults - treatment and prevention: Summary Vitamin D is a fat soluble vitamin that regulates calcium and phosphate homeostasis and is therefore vital for musculoskeletal health. There are two main forms: vitamin D 3 (cholecalciferol) and D 2 (ergocalciferol). Vitamin D 3 is synthesized in the skin by the action of sunlight. Both vitamin D 3 (...) D status. However, there is no clear consensus on the threshold concentration used to define vitamin D deficiency in adults. Evidence identified by the Scientific Advisory Committee on Nutrition (SACN) suggests that the risk of poor musculoskeletal health is increased at serum 25(OH)D concentration below 25 nmol/L. People with insufficient exposure to sunlight and those with darker skin are at higher risk of vitamin D deficiency. Other risk factors include nutritional deficiency, certain
Rapid vs Maintenance Vitamin D Supplementation in Deficient Children With Asthma to Prevent Exacerbations Whether vitamin D reduces clinically important exacerbations of childhood asthma remains uncertain. We compared rapid to maintenance vitamin D repletion analyzed by baseline vitamin D level.Children presenting to the ED with moderate-to-severe asthma exacerbations and vitamin D levels ≤ 25 ng/mL underwent masked randomization, and then open dosing to either IM+oral (the latter daily (...) ) therapy or daily oral-only therapy, and were followed for 12 months. The primary outcome was patient-initiated unplanned visits for asthma exacerbations, examined two ways: cumulative proportions with an exacerbation, and average exacerbation frequency. As this was a nutrient study, we analyzed treatment groups by quartile of baseline vitamin D level, collecting repeat levels and clinical observations at 3, 6, 9, and 12 months after enrollment.One hundred and sixteen patients in the IM+oral cohort vs
Association between vitamin D deficiency and heart failure risk in the elderly The aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics.A cross-sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency (...) ; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia. To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model. Of the 137 elderly, the study found the following: women (75.9%); overweight
Gestational vitamin D deficiency and autism spectrum disorder There is growing interest in linking vitamin D deficiency with autism spectrum disorders (ASDs). The association between vitamin D deficiency during gestation, a critical period in neurodevelopment, and ASD is not well understood.To determine the association between gestational vitamin D status and ASD.Based on a birth cohort (n=4334), we examined the association between 25-hydroxyvitamin D (25OHD), assessed from both maternal mid (...) -gestation sera and neonatal sera, and ASD (defined by clinical records; n=68 cases).Individuals in the 25OHD-deficient group at mid-gestation had more than twofold increased risk of ASD (odds ratio (OR)=2.42, 95% confidence interval (CI) 1.09 to 5.07, P=0.03) compared with the sufficient group. The findings persisted in analyses including children of European ethnicity only.Mid-gestational vitamin D deficiency was associated with an increased risk of ASD. Because gestational vitamin D deficiency
Vitamin C deficiencyVitamin C deficiency - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Vitamin C deficiency Last reviewed: February 2019 Last updated: December 2017 Summary Scurvy is a rare disorder, with epidemics typically affecting populations subject to famine or displacement during wartime. Most key clinical manifestations are related to impaired collagen synthesis. These include bleeding complications (...) (spontaneous petechiae and ecchymoses), friable gingiva and loose teeth, bone pain, and joint effusions. Other complications include heart failure, encephalopathy, and entrapment neuropathies. If not treated promptly, scurvy can be fatal. Complete recovery is anticipated in most patients. Definition Scurvy is a life-threatening condition due to dietary vitamin C deficiency. Those affected are mostly refugees or victims of famine, alcoholics, older people, fad dieters, or children with autism