Late Life Vitamin B12 Deficiency

Zik, Chad

doi:10.1016/j.cger.2019.03.004

Cited by 13 publications

(19 citation statements)

References 25 publications

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“…The reduction of the level of VitB12 may also be due to a dietary deficiency such as in strict vegetarian and vegan diets [6]. Furthermore, aging leads to metabolic and nutritional changes determining an increased vulnerability of vitamin deficiency, and, especially in geriatric patients, these changes can have effects on the nervous system [12]. Frequently, the B-vitamin deficiencies are also caused by a decreased availability associated with an unbalanced diet that can occur in certain subjects (i.e., diabetics, alcoholics, dialysis patients, and patients with gastrointestinal diseases) but may also be caused by the impaired absorption, accelerated usage, and increased hydrolysis, in particular during inflammatory diseases.…”

Section: Introductionmentioning

confidence: 99%

Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

et al. 2021

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Vitamin B12 (VitB12) is a naturally occurring compound produced by microorganisms and an essential nutrient for humans. Several papers highlight the role of VitB12 deficiency in bone and heart health, depression, memory performance, fertility, embryo development, and cancer, while VitB12 treatment is crucial for survival in inborn errors of VitB12 metabolism. VitB12 is administrated through intramuscular injection, thus impacting the patients’ lifestyle, although it is known that oral administration may meet the specific requirement even in the case of malabsorption. Furthermore, the high-dose injection of VitB12 does not ensure a constant dosage, while the oral route allows only 1.2% of the vitamin to be absorbed in human beings. Nanocarriers are promising nanotechnology that can enable therapies to be improved, reducing side effects. Today, nanocarrier strategies applied at VitB12 delivery are at the initial phase and aim to simplify administration, reduce costs, improve pharmacokinetics, and ameliorate the quality of patients’ lives. The safety of nanotechnologies is still under investigation and few treatments involving nanocarriers have been approved, so far. Here, we highlight the role of VitB12 in human metabolism and diseases, and the issues linked to its molecule properties, and discuss how nanocarriers can improve the therapy and supplementation of the vitamin and reduce possible side effects and limits.

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Section: Introductionmentioning

confidence: 99%

Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

et al. 2021

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“…Megaloblastic anemia is the classic hematological manifestation of vitamin B12 deficiency, affecting both the synthesis and shape of red and white blood cells 21 , however, neither anemia nor macrocytosis is very sensitive for the diagnosis of vitamin B12 deficiency 11 . There were no significant hematological differences between the groups related to the concentration of vitamin B12, even considering the frequency of anemia in the sample (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, metformin may interfere with the mechanism of action of the calcium-dependent membrane in the terminal ileum, responsible for the absorption of the intrinsic factor-vitamin B12 complex 10 . In this sense, old people residing in Long-Term Geriatric Institutions (LTIEs) often have several chronic diseases and noncommunicable diseases, concomitant use of various drugs and fragility that associate them with an increased risk of developing B12 hypovitaminosis 11 .…”

Section: Introductionmentioning

confidence: 99%

“…The clinical manifestations of vitamin B12 deficiency in old people are nonspecific and variable, generally absent and difficult to identify, frequent in common chronic diseases with aging, especially in people with dementia 11 . On the other hand, it presents low sensitivity of the biomarkers methylmalonic acid and plasma homocysteine due to the decrease in glomerular filtration 12 , however, if left untreated, it can cause anemia and neurological changes, which are progressive and potentially fatal 13 .…”

Section: Introductionmentioning

confidence: 99%

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Deficiência de vitamina B12 e fatores associados em idosos institucionalizados

Menegardo

Friggi

Santos

et al. 2020

Rev. bras. geriatr. gerontol.

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Resumo Objetivo Avaliar a frequência de deficiência de vitamina B12 e fatores associados em idosos institucionalizados. Método Analisamos 65 idosos, com idade média de 80±9 anos (61-113), de uma instituição geriátrica filantrópica de longa permanência. A dosagem sérica de vitamina B12 foi analisada e classificada em: normal (≥299 pg/mL), limítrofe (200-298 pg/mL) e deficiência (<200 pg/mL). Foi analisada a associação com tempo de permanência na instituição, declínio cognitivo e funcional, uso regular de biguanidas e inibidores de bomba de prótons, considerados fatores de risco para hipovitaminose B12, utilizando os testes de análise bivariada (paramétrica e não paramétrica) e regressão de Poisson. Resultados A deficiência de vitamina B12 estava presente em 21,5% e valores limítrofes em 32,3% da amostra. Dentre os idosos, 52,9% apresentavam demência de causas diversas, 49,2% hipertensão arterial, 29,2% com anemia (21,5% normocítica, 4,6% microcítica e 3,1% macrocítica), 18,5% diabéticos; 27,7% faziam uso de polifarmácia, com 12,3% em uso de metformina e 16,9% com inibidores de bomba de prótons. No modelo multivariado não houve associação entre a deficiência de vitamina B12 com as variáveis estudadas. Conclusão Observamos uma frequência importante de valores limítrofes e baixos de vitamina B12 nos pacientes dessa instuição geriátrica de cuidados permanentes, porém sem associação com os fatores de risco para sua deficiência estudado, o que torna importante a inclusão da dosagem sérica dessa vitamina na rotina de exames laboratoriais desse grupo.

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“…23 The risk of both pernicious anemia and neuropsychiatric disorders is significantly higher in the elderly than that in younger people. 9,24 Many elderly patients, especially those with comorbidity, such as renal insufficiency and/or diabetes mellitus, even with normal serum levels of cobalamin and HoloTC, may have elevated MMA levels, which led to the hypothesis that they are resistant to cobalamin and, consequently, should be prescribed higher doses of vitamin B12. 25 Other vulnerable population categories for vitamin B12 deficiency include vegans and strict vegetarians, pregnant and breastfeeding women, infants of the first 2 years of life, particularly those who were exclusively breastfed, those with pernicious anemia, celiac disease, and Crohn's disease, those who underwent GI surgery resulting in the impaired production of the Castle's intrinsic factor and hydrochloric acid secretion.…”

Section: Introductionmentioning

confidence: 99%

The Screening and Treatment of Vitamin B12 Deficiency

Sahni¹

2021

IHRJ

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Vitamin B12 deficiency is now more prevalent than ever. It is a common cause of megaloblastic anemia, neuropsychiatric disorders, and other clinical manifestations. Screening is required in patients with single or multiple risk factors. Measurement of serum methylmalonic acid can be used to confirm deficiency in asymptomatic high-risk patients with low-normal levels of vitamin B12. Oral administration of high-dose vitamin B12 as well as intramuscular administration are effective as corrective therapy. This review briefs about the pharmacokinetics and pharmacodynamics of Vitamin B12, risk factors associated with its deficiency, screening methods and treatment options.

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Late Life Vitamin B12 Deficiency

Cited by 13 publications

References 25 publications

Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

Deficiência de vitamina B12 e fatores associados em idosos institucionalizados

The Screening and Treatment of Vitamin B12 Deficiency

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