Special Precautions/Comments:

Additional Information:

Vitamin B12 deficiencies are common in wealthier countries principally among the elderly, yet are most prevalent in economically disadvantaged populations. In general the prevalence increases with age. The most frequent cause of severe vitamin B12 deficiency is a lack of intrinsic factor due to autoimmune atrophic gastritis. The disease is historically called “pernicious anaemia”, even though many patients present with mainly neurologic manifestations.

Examples of other causes for vitamin B12 deficiency are malabsorption due to gastrectomy, inflammatory bowel disease or dietary deficiency, e.g. in strict vegetarians or vegans. Vitamin B12 deficiency impacts red blood cell synthesis, resulting in megaloblastic anaemia due to abnormal DNA synthesis.

In addition, severe vitamin B12 deficiency can result in demyelination of nerves, which may lead to peripheral neuropathy, dementia, poor cognitive performance, and depression.3 Other effects of vitamin B12 deficiency or depletion are increased risk of neural tube defects, osteoporosis, cerebrovascular and cardiovascular diseases.

Early diagnosis is essential, because of the latent nature of this disorder and the risk of permanent neurological damage.