Vitamin B12 deficiency

Ralph Green, Lindsay H. Allen, Anne Lise Bjørke-Monsen, Alex Brito, Jean Louis Guéant, Joshua W. Miller, Anne M. Molloy, Ebba Nexo, Sally Stabler, Ban Hock Toh, Per Magne Ueland, Chittaranjan Yajnik

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Vitamin B12 (B12; also known as cobalamin) is a B vitamin that has an important role in cellular metabolism, especially in DNA synthesis, methylation and mitochondrial metabolism. Clinical B12 deficiency with classic haematological and neurological manifestations is relatively uncommon. However, subclinical deficiency affects between 2.5% and 26% of the general population depending on the definition used, although the clinical relevance is unclear. B12 deficiency can affect individuals at all ages, but most particularly elderly individuals. Infants, children, adolescents and women of reproductive age are also at high risk of deficiency in populations where dietary intake of B12-containing animal-derived foods is restricted. Deficiency is caused by either inadequate intake, inadequate bioavailability or malabsorption. Disruption of B12 transport in the blood, or impaired cellular uptake or metabolism causes an intracellular deficiency. Diagnostic biomarkers for B12 status include decreased levels of circulating total B12 and transcobalamin-bound B12, and abnormally increased levels of homocysteine and methylmalonic acid. However, the exact cut-offs to classify clinical and subclinical deficiency remain debated. Management depends on B12 supplementation, either via high-dose oral routes or via parenteral administration. This Primer describes the current knowledge surrounding B12 deficiency, and highlights improvements in diagnostic methods as well as shifting concepts about the prevalence, causes and manifestations of B12 deficiency.

Original languageEnglish (US)
Article number17040
JournalNature Reviews Disease Primers
Volume3
DOIs
StatePublished - Jun 29 2017

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Vitamin B 12 Deficiency
Vitamin B 12
Methylmalonic Acid
Transcobalamins
Vitamin B Complex
Homocysteine
DNA Methylation
Neurologic Manifestations
Population
Biological Availability
Biomarkers
Food

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Green, R., Allen, L. H., Bjørke-Monsen, A. L., Brito, A., Guéant, J. L., Miller, J. W., ... Yajnik, C. (2017). Vitamin B12 deficiency. Nature Reviews Disease Primers, 3, [17040]. https://doi.org/10.1038/nrdp.2017.40

Vitamin B12 deficiency. / Green, Ralph; Allen, Lindsay H.; Bjørke-Monsen, Anne Lise; Brito, Alex; Guéant, Jean Louis; Miller, Joshua W.; Molloy, Anne M.; Nexo, Ebba; Stabler, Sally; Toh, Ban Hock; Ueland, Per Magne; Yajnik, Chittaranjan.

In: Nature Reviews Disease Primers, Vol. 3, 17040, 29.06.2017.

Research output: Contribution to journalArticle

Green, R, Allen, LH, Bjørke-Monsen, AL, Brito, A, Guéant, JL, Miller, JW, Molloy, AM, Nexo, E, Stabler, S, Toh, BH, Ueland, PM & Yajnik, C 2017, 'Vitamin B12 deficiency', Nature Reviews Disease Primers, vol. 3, 17040. https://doi.org/10.1038/nrdp.2017.40
Green R, Allen LH, Bjørke-Monsen AL, Brito A, Guéant JL, Miller JW et al. Vitamin B12 deficiency. Nature Reviews Disease Primers. 2017 Jun 29;3. 17040. https://doi.org/10.1038/nrdp.2017.40
Green, Ralph ; Allen, Lindsay H. ; Bjørke-Monsen, Anne Lise ; Brito, Alex ; Guéant, Jean Louis ; Miller, Joshua W. ; Molloy, Anne M. ; Nexo, Ebba ; Stabler, Sally ; Toh, Ban Hock ; Ueland, Per Magne ; Yajnik, Chittaranjan. / Vitamin B12 deficiency. In: Nature Reviews Disease Primers. 2017 ; Vol. 3.
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