Vitamin B
            <sub>12</sub>

Wolffenbuttel, Bruce HR; Owen, P Julian; Ward, Mary; Green, Ralph

doi:10.1136/bmj-2022-071725

Cited by 14 publications

(14 citation statements)

References 71 publications

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“…It should be noted that AIG is much more commonly found in idiopathic iron deficiency than celiac disease [8]. B12 deficiency itself is challenging to detect, as it lacks a gold standard for diagnosis, with laboratory measures of B12 status being less reliable than the overall clinical picture [9]. Complicating matters further, the microcytosis of iron deficiency and the macrocytosis of B12 deficiency combined can produce a normocytic mean corpuscular volume in AIG [4].…”

Section: Presentation and Diagnosis Of Aigmentioning

confidence: 99%

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Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Taylor,

McCaddon,

Wolffenbuttel

2024

Nutrients

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Autoimmune gastritis (AIG) is characterized by the destruction of gastric parietal cells, resulting in hypochlorhydria and eventual achlorhydria, as oxyntic glands in the corpus are destroyed and become atrophic. The permanent loss of gastric acid has many impacts—both theoretical and documented. The most concerning of these are hypergastrinemia and increased N-nitroso compounds, both of which increase the risk of gastric cancers. While known deficiencies of B12 and iron are often replaced in AIG, acid is not. Moreover, patients with AIG are often prescribed acid suppression for a stomach that is decidedly no longer acidic, worsening the sequelae of gastric atrophy. Betaine hydrochloride (BHCL) is a short-acting acidifying agent, available over the counter in capsule form. Mealtime acid supplementation has an historic basis and could ameliorate many AIG-related gastrointestinal symptoms. Theoretically, acidification could also reduce the potential for hypergastrinemia and the production of N-nitroso compounds, consequently reducing the risk of gastric cancers. Supplemental vitamin C may also help in preventing gastric N-nitroso formation, regardless of the gastric pH. This narrative review describes the functions of gastric acid in gastrointestinal and immune health, documents the effects of hypochlorhydria in AIG, and proposes potential options for safely re-establishing the acid milieu of the stomach for patients with AIG.

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Section: Presentation and Diagnosis Of Aigmentioning

confidence: 99%

“…These symptoms can be best alleviated with parenteral B12 treatment but can take months or years to completely resolve. If B12 deficiency is severe or longstanding, some neurological damage may be permanent [9].…”

Section: Presentation and Diagnosis Of Aigmentioning

confidence: 99%

Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Taylor,

McCaddon,

Wolffenbuttel

2024

Nutrients

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“…To produce healthy red blood cells, white blood cells, and platelets, your body needs vitamin B12 (Zhang et al, 2016). An article about therapeutics for common serious condition (Wolffenbuttel et al, 2023), explained that B12 increases the risk of adverse pregnancy outcomes, including early pregnancy loss, neural tube defects, preterm birth, and low birth weight, including insulin resistance and adiposity. Further, it also may lead to neurological complications in newborns, such as hypotonia, failure to thrive, central apneas, and seizures (Gottwald-Hostalek & Kahaly, 2023).…”

Section: Vitamin B12 Deficiency Anemiamentioning

confidence: 99%

Understanding Anemia among Women of Reproductive Age and Children in Namibia: A Comprehensive Review

Nangwasha

2024

J. Innov. Res.

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Anemia is one of the leading causes of death globally, not only among children and women; however, there have been records of deaths among men too. Anemia disproportionately affects young children and expecting mothers with increased morbidity and mortality. Who estimates that anemia affects 30% of women aged 15 to 49, 37% of pregnant women, and 40% of children aged 6 to 59 months globally. The goal of lowering anemia among women of reproductive age has not been met, and 25.2% of women between the ages of 15 and 49 are now affected in Namibia. Namibia with a current prevalence rate of 46.1% of children under 5 years, is a severe global public health issue. According to the morphological classification of anemia, normocytic normochromic anemia (86.3%) was the most common kind in Namibia, with a moderate frequency of iron deficiency anemia whereas the highest prevalence of vitamin b12 deficient anemia was found in some regions. Anemia indicates both poor nutrition and poor health and is often categorized based on its cause. Iron deficiency, pregnancy, antiretroviral therapy side effects, and hereditary blood abnormalities increase the risk of anemia. Depending on the hemoglobin levels in the blood, anemia can be either short-term or long-term. For pregnant women and children under the age of 5, mild anemia is defined as a level of hemoglobin concentration between 10.0 and 10.9g/dl, moderate anemia is defined as a level between 7.0 and 9.9g/dl, and severe anemia is defined as a level below 7.0g/dl. Medical professionals follow different standards such as typical treatment recommendations, World Health Organization recommendations, and reference materials while dealing with individuals who have suspected anemia.

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“…Vitamin B12 (cobalamin, B12) deficiency may result in irreversible neurological damage. Therefore, an early diagnosis is mandatory, most often guided by the measurement of total B12 in a blood sample [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Measurements of other biomarkers, such as the "active" part of B12 (holoTC or "active B12"), or the metabolic marker methylmalonic acid (MMA) and, to some extent, homocysteine (Hcy), are considered superior to total B12 in their diagnostic utility [2][3][4]. Yet, the measurement of total plasma B12 remains the first-line analysis when suspecting B12 deficiency.…”

Section: Introductionmentioning

confidence: 99%

Macro-B12 and Unexpectedly High Levels of Plasma B12: A Critical Review

Fedosov,

Nexo

2024

Nutrients

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A low total plasma vitamin B12 supports a clinical suspicion of B12 deficiency, while the interpretation of an unexpectedly normal/high level is marred by controversies. Here, we critically review current knowledge on B12 in blood plasma, including the presence of the so-called “macro-B12”. The latter form is most often defined as the fraction of B12 that can be removed by precipitation with polyethylene glycol (PEG), a nonspecific procedure that also removes protein polymers and antibody-bound analytes. Plasma B12 includes B12 attached to transcobalamin and haptocorrin, and an increased concentration of one or both proteins almost always causes an elevation of B12. The total plasma B12 is measured by automated competitive binding assays, often incorrectly referred to as immunoassays, since the binding protein is intrinsic factor and not an antibody. An unexpectedly high level of B12 may be further explored using immunological measurements of haptocorrin and transcobalamin (optionally combined with e.g., size-exclusion chromatography). Nonspecific methods, such as PEG precipitation, are likely to give misleading results and cannot be recommended. Currently, the need for evaluation of a high B12 of unknown etiology is limited since other tests (such as measurements of methylmalonic acid) may better guide the diagnosis of B12 deficiency.

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Vitamin B ₁₂

Cited by 14 publications

References 71 publications

Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Understanding Anemia among Women of Reproductive Age and Children in Namibia: A Comprehensive Review

Macro-B12 and Unexpectedly High Levels of Plasma B12: A Critical Review

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Vitamin B 12

Cited by 14 publications

References 71 publications

Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Creating a Framework for Treating Autoimmune Gastritis—The Case for Replacing Lost Acid

Understanding Anemia among Women of Reproductive Age and Children in Namibia: A Comprehensive Review

Macro-B12 and Unexpectedly High Levels of Plasma B12: A Critical Review

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Product

Resources

About

Vitamin B ₁₂