Vitamin B12, Folate, Homocysteine, Inflammatory Mediators (Interleukin-6, Tumor Necrosis Factor-α and C-Reactive Protein) Levels in Adolescents with Anxiety or Depressive Symptoms

Abstract

Purpose To evaluate the prevalence of abnormal vitamin B12, folate, total homocysteine (tHcy), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) levels, to analyze the relationship between these parameters and the severity of anxiety or depressive symptoms, and to explore the possible factors associated with abnormal levels of these parameters in adolescents with anxiety or depressive symptoms. Methods Adolescent (aged 12–18 years) outpatients with anxiety or depressive symptoms were recruited. The patient health questionnaire-9 and generalized anxiety disorder scale-7 were used to measure the severity of depression and anxiety. Serum vitamin B12, folate, tHcy, IL-6, TNF-α, and CRP levels were determined. Results 128 subjects were recruited. The prevalence of vitamin B12 and folate deficiency, tHcy, TNF-α, IL-6, and CRP elevation was 8.6%, 10.2%, 25.8%, 14.8%, 21.9%, and 10.2%, respectively, in adolescents with anxiety or depressive symptoms. Lower vitamin B12 levels were correlated with a higher risk of severe anxiety and depressive symptoms. The severity of some symptoms of anxiety or depression were weakly correlated with vitamin B12, folate, tHcy, IL-6, and CRP levels. Vitamin B12, folate, and tHcy levels were not associated with inflammatory mediators. Vitamin B12 deficiency was associated with older age and higher tHcy levels. Folate deficiency was associated with elevated tHcy. Elevated tHcy was associated with lower vitamin B12 and folate levels. IL-6 elevation was associated with elevated CRP and TNF-α. CRP elevation was associated with older age, higher BMI, and current drinking. Conclusion Lower vitamin B12 levels were correlated with a higher risk of severe anxiety or depressive symptoms. Weak correlations were observed between the severity of some symptoms of anxiety or depression and vitamin B12, folate, tHcy, IL-6, and CRP levels. Vitamin B12, folate, and tHcy levels were related to each other. IL-6 elevation was associated with elevated CRP and TNF-α. CRP elevation was associated with older age, higher BMI, and current drinking.

Vitamin B12 and folate deficiencies, elevated homocysteine and their roles in the biochemical basis of neuropsychiatric diseases in children and adolescents: Case series, review and recommendations

“…In this study, the severity of depression and anxiety were correlated with vitamin B12, folate and Hcy, albeit weakly (Tan et al 2023). In addition, it was found that taking more B vitamins with diet during adolescence is associated with lower depressive symptoms (Murakami et al 2010).…”

Vitamin B12 deficiency and neuropsychiatric symptoms in Lebanon: A cross-sectional study of vegans, vegetarians, and omnivores

“…This association between vitamin B 12 deficiency and greater severity of GAD, as shown by the present study, is consistent with the findings of several studies. In fact, a recent Chinese study [22] that has been conducted using the same scale as the one used in our study (GAD-7 scale), found that lower serum levels of vitamin B 12 were associated with greater risk of severe anxiety. However, a cross-sectional study conducted in India [23] found no direct correlation between vitamin B 12 deficiency and GAD, but a considerable higher risk of developing GAD in individuals with hyperhomocysteinemia.…”

“…Although this study demonstrated that low serum levels of vitamin B 12 were associated with increased severity of insomnia, our results do not match with the findings of other studies. A study conducted in 2019 [ 22 ] found that vitamin B 12 levels did not significantly affect the severity of insomnia. Furthermore, it is of particular interest to mention than another study [ 24 ] found that vitamin B 12 levels were considerably higher in insomniac individuals, which does not correlate with our findings.…”

Frequency Of Depression In Patients With Vitamin B12 Deficiency

“…S-adenosylmethionine helps in the methylation of neurons in the brain which imparts the antidepressant effect (7) . Vitamin B12 deficiency and to a lesser extent folate deficiency were also related to depressive disorders (8) . Synthesis of monoamines (dopamine and serotonin) is dependent on both folate and vitamin B12.…”