eCollection 2020. *DV = Daily Value. Vital Heath Stat 11 2002;(245):1-158. However, the evidence is conflicting on whether proton pump inhibitor use affects vitamin B12 status [90-93]. Vitamin B 12 (B12; also known as cobalamin) is a B vitamin that has an important role in cellular metabolism, especially in DNA synthesis, methylation and mitochondrial metabolism. [, Huritz A, Brady DA, Schaal SE, Samloff IM, Dedon J, Ruhl CE. Some nutritional yeast products also contain vitamin B12. Generally 1 to 2 mg daily is required as a large dose. Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Proposed Extension of Compliance Dates. In the Western Norway B Vitamin Intervention Trial, which included 3,096 patients undergoing coronary angiography, daily supplements of 0.4 mg vitamin B12 and 0.8 mg folic acid with or without 40 mg vitamin B6 for 1 year reduced homocysteine levels by 30% but did not affect total mortality or the risk of major cardiovascular events during 38 months of follow-up [70]. Hong Kong Med J. Elevated homocysteine levels have also been identified as an independent risk factor for cardiovascular disease [50-52]. Vitamin B12 exists in several forms and contains the mineral cobalt [1-4], so compounds with vitamin B12 activity are collectively called "cobalamins". Nutr Rev 1996;54:382-90. Expert Panel on Weight Loss Surgery, Executive Report, 2007. von Schenck U, Bender-Gotze C, Koletzko B. Persistence of neurological damage induced by dietary vitamin B12 deficiency in infancy. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Additional large clinical trials of vitamin B12 supplementation are needed to assess whether vitamin B12 has a direct effect on cognitive function and dementia [6]. Vitamin B12 deficiency should be treated as early as possible. Evidence supports a role for folic acid and vitamin B12 supplements in lowering homocysteine levels, but results from several large prospective studies have not shown that these supplements decrease the risk of cardiovascular disease [52,66-71]. Online ahead of print. Pregnant and lactating women who follow strict vegetarian or vegan diets should consult with a pediatrician regarding vitamin B12 supplements for their infants and children [5]. Some studies suggest that supplemental calcium might help improve the vitamin B12 malabsorption caused by metformin [96,97], but not all researchers agree [99]. Get the latest research information from NIH: https://www.nih.gov/coronavirus, Have a question? New York: Academic Press, Inc., 1992. Wang S, Liu Y, Liu J, Tian W, Zhang X, Cai H, Fang S, Yu B. Redox Biol. What Are the Signs of Vitamin B12 Deficiency? Values below approximately 170–250 pg/mL (120–180 picomol/L) for adults [5] indicate a vitamin B12 deficiency. The U.S. Department of Agriculture's (USDA's) FoodData Central Web site [13]) lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin B12 arranged by nutrient content and by food name. As a result, the IOM recommends that adults older than 50 years obtain most of their vitamin B12 from vitamin supplements or fortified foods [5]. Long-term use of proton pump inhibitors (PPIs) and vitamin B12 status in elderly individuals. A response usually is seen within 48 to 72 hours, with brisk production of new red blood cells. In another study, older men and women who took a multivitamin/multimineral supplement for 8 weeks experienced a significant decrease in homocysteine levels [72]. N Engl J Med. Fortified breakfast cereals and fortified nutritional yeasts are some of the only sources of vitamin B12 from plants and can be used as dietary sources of vitamin B12 for strict vegetarians and vegans. In addition to oral dietary supplements, vitamin B12 is available in sublingual preparations as tablets or lozenges. 2006;354:1567-77. Autoantibodies in pernicious anemia type I patients recognize sequence 251-256 in human intrinsic factor. 2015 Apr;21(2):155-64. doi: 10.12809/hkmj144383. By clicking Subscribe, I agree to the WebMD, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. Exclusively breastfed infants of women who consume no animal products may have very limited reserves of vitamin B12 and can develop vitamin B12 deficiency within months of birth [5,47]. With age, it can become harder to absorb this vitamin. People who cannot absorb vitamin B12 should continue to eat a well-balanced diet that provides other nutrients (folic acid, iron and vitamin C) necessary to produce healthy blood cells. [, Gueant JL, Safi A, Aimone-Gastin I, Rabesona H, Bronowicki J P, Plenat F, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. Laboratory tests will include: With proper treatment, symptoms of vitamin B12 deficiency begin to improve within a few days. The main type of vitamin B 12 deficiency anemia is pernicious anemia. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. Overall, an individual patient’s ability to absorb vitamin B12 is the most important factor in determining whether vitamin B12 should be administered orally or via injection [8]. Gastroenterology 1973;64:913-9. Vitamin B12 is available only in animal foods (meat and dairy products) or yeast extracts (such as brewer's yeast).

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