Iron deficiency and vitamin b12
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Iron Deficiency and Vitamin B12: A Comprehensive Overview
Prevalence of Iron and Vitamin B12 Deficiencies
Iron and vitamin B12 deficiencies are prevalent nutritional issues affecting various populations globally. In children under five in Mexico, 22.9% were found to be anemic, with 10% iron deficient and 5.4% vitamin B12 deficient 2. Similarly, in Ecuador, 11.3% of non-pregnant women of reproductive age were anemic, with 14.4% iron deficient and 4.3% vitamin B12 deficient 3. These deficiencies are also significant in patients with inflammatory bowel disease (IBD), where 19.6% of Crohn's disease (CD) patients and 21.6% of ulcerative colitis (UC) patients were found to have iron deficiency anemia 5.
Impact on Health and Development
Iron and vitamin B12 deficiencies can have severe health implications. In children, these deficiencies are associated with increased oxidative stress, as indicated by higher TBARS and nesfatin-I levels, and lower total antioxidant levels 1. In an 18-year-old patient, combined deficiencies led to severe anemia, short stature, and delayed puberty, highlighting the critical role of these nutrients in growth and development 4.
Diagnostic Markers and Differential Diagnosis
The diagnosis of iron and vitamin B12 deficiencies involves various biomarkers. Plasma hepcidin levels are significantly lower in iron deficiency anemia, while plasma homocysteine levels are higher in vitamin B12 deficiency 1. These markers, along with nesfatin-1 hormone levels, can aid in the differential diagnosis of nutritional deficiency anemias in children 1.
Nutritional Interventions and Supplementation
Supplementation strategies are crucial in managing these deficiencies. In pregnant women, adding vitamin B12 to standard iron and folic acid supplements significantly improved hematological and biochemical markers, reducing the risk of anemia 10. Similarly, vitamin A, folate, and riboflavin have been shown to enhance the efficacy of iron supplementation and improve hematological indicators 9.
Special Populations and Risk Factors
Certain populations are at higher risk for these deficiencies. In patients with IBD, chronic intestinal inflammation and malabsorption significantly contribute to iron and vitamin B12 deficiencies 5. Additionally, non-pregnant women of reproductive age in Mexico showed a high prevalence of iron deficiency (29.4%) and vitamin B12 deficiency (8.5%) 6.
Conclusion
Iron and vitamin B12 deficiencies are widespread and have significant health impacts, particularly in children, women of reproductive age, and patients with chronic conditions like IBD. Effective diagnosis using specific biomarkers and targeted supplementation strategies are essential in managing these deficiencies and mitigating their adverse effects on health and development. Regular monitoring and appropriate nutritional interventions can help prevent long-term complications associated with these deficiencies.
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Most relevant research papers on this topic
Oxidative stress, hepcidin and nesfatin-I status in childhood iron and vitamin B12 deficiency anemias.
High levels of oxidative stress are present in childhood iron and vitamin B12 deficiency anemias, and plasma hepcidin and homocycteine levels may aid in differential diagnosis.
RCTAnemia and Iron and Vitamin B12 Deficiencies in Children Under 5 in Mexico: Results from the National Health and Nutrition Survey (ENSANUT)
Anemia and iron and vitamin B12 insufficiency are high in children under 5 in Mexico.
Observational Study
Very Rigorous JournalAnemia and Iron, Vitamin B12, and Folate Deficiencies in Women of Reproductive Age in Ecuador: Results from the Ecuadorian National Health and Nutrition Survey (P10-027-19).
Higher iron, vitamin B12, and folate levels are associated with lower anemia risk in women of reproductive age in Ecuador.
Observational StudyVery Rigorous JournalA case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty
Vitamin B12 and iron deficiency can cause short stature and delayed puberty in children, but treatment with parenteral vitamin B12 and iron can improve both anemia and growth.
Case ReportThe Relevance of Vitamin and Iron Deficiency in Patients with Inflammatory Bowel Diseases in Patients of the Swiss IBD Cohort.
Regular monitoring and substitution of vitamins and iron are crucial to prevent long-term intestinal and extraintestinal complications in inflammatory bowel disease patients.
Observational Study
Rigorous JournalPrevalence of iron, folate, and vitamin B12 deficiencies in 20 to 49 years old women: Ensanut 2012.
Vitamin B12 deficiency remains a problem for Mexican women of reproductive age, while folate deficiency has disappeared, and iron deficiency needs prevention and fortification strategies.
Observational StudyIron, vitamin B12 and folate
Iron, vitamin B12, and folate deficiency can cause disordered haematopoiesis and widespread effects in other organs, and can be effectively treated with supplements and avoidance of blood transfusions.
Very Rigorous Journal
Highly CitedDo all the patients with vitamin B12 deficiency have pernicious anemia?
Only 18.9% of patients with vitamin B12 deficiency are diagnosed with pernicious anemia by the WHO definition.
Observational StudyThe role of vitamins in the prevention and control of anaemia
Vitamin A, B12, riboflavin, and vitamin C may help control anaemia, but the public health impact of vitamin supplementation on anaemia remains unclear.
Systematic ReviewHighly CitedVitamin B12 Supplementation in Addition to Folic Acid and Iron Improves Hematological and Biochemical Markers in Pregnancy: A Randomized Controlled Trial.
Vitamin B12 supplementation in addition to folic acid and iron improves hematological and biochemical markers in pregnancy, reducing the risk of anemia within the reference range.
RCT