Vitamin B12, Folic Acid, and Bone

Abstract

Vitamin B12 and folic acid deficiency are associated with a higher serum concentration of homocysteine. A high serum homocysteine is a risk factor for fractures. Both vitamins play a role in the remethylation of homocysteine to methionine. The pathophysiology from a high serum homocysteine to fractures is not completely clear, but might involve bone mineral density, bone turnover, bone blood flow, DNA methylation, and/or physical function and fall risk. Genetic variation, especially polymorphisms of the gene encoding for methylenetetrahydrofolate reductase may play a role in homocysteine metabolism and fracture risk. It is uncertain whether supplementation with vitamin B12 and folate can decrease fracture incidence. One double blind clinical trial in post-stroke patients showed that these B vitamins could decrease hip fracture incidence, but the results of further clinical trials should be awaited before a definite conclusion can be drawn.

The Impact of Disease and Drugs on Hip Fracture Risk

“…A slightly lower risk estimate for the effect of pernicious anemia (vitamin B12 deficiency) on hip fracture has been reported previously [36, 37]. Although vitamin B12 deficiency might negatively influence bone strength [38], it may not be the sole mechanism.…”

Homocystein: A new biochemical marker in livestock sector

“…On the alternative, with the assist of vitamin B12 Hcy can be changed to methionine (Swart et al, 2013). In a case of increase methylmalonic acid and Hcy levels, it means that only with Hcy (sans methylmalonic acid) deficiency of vitamin B12 can be determined and its answer to therapy.…”

“…Folic acid, vitamins B6 and B12, has been demonstrated in several surveys to help decrease Hcy amounts. L-methylfolate (active form of folic acid), can increase plasma folic acid levels up to 700% much more than synthetic folate, so this may be more useful decreasing Hcy amounts (Refsum et al, 2004;Swart et al, 2013). …”

Nanostructured hybrids for the improvement of folic acid biopharmaceutical properties

“…The importance of folates in health field comes from their ability to prevent some diseases as demonstrated by many studies . Folates are able to bind enzymes (folate‐dependent enzymes) involved in many types of cancer, vascular disease, birth defects, complications of pregnancy, health disorders as Alzheimer's, poor cognitive performance and hearing loss …”