Vitamin d and b12 low
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Understanding the Impact of Low Vitamin D and B12 Levels
Prevalence of Vitamin D and B12 Deficiencies
High Prevalence in Aging Populations
Research indicates a significant prevalence of vitamin D and B12 deficiencies among older adults, particularly in rural communities. A study conducted in rural India found that 75.7% of the elderly population had low vitamin D levels, and 42.3% had vitamin B12 deficiency. Women, especially those aged 75 and above, were more affected by these deficiencies1. This high prevalence is concerning due to the potential negative impacts on cognition, immunity, and frailty in aging populations.
Deficiencies in Pregnant Women
Vitamin D and B12 deficiencies are also common in pregnant women. A study assessing the efficacy of supplementation during pregnancy found that despite high-dose vitamin D and low-dose B12 supplementation, there was no significant improvement in vitamin levels at term compared to the control group. This suggests that dietary supplementation alone may not be sufficient to correct these deficiencies during pregnancy2.
Children and Adolescents
In children, particularly those over 12 years old, vitamin B12 deficiency is prevalent, with 23.2% of cases showing low levels. Vitamin D deficiency was found in 49.3% of the children studied, with a significant correlation between the deficiencies of both vitamins3. This highlights the need for monitoring and addressing these deficiencies early in life to prevent long-term health issues.
Health Implications of Low Vitamin D and B12 Levels
Cognitive Impairment and Neurodegenerative Diseases
Low levels of vitamin B12 are associated with cognitive impairment and neurodegenerative diseases such as Alzheimer's and Parkinson's. Studies have shown that vitamin B12 deficiency can lead to cognitive decline, and supplementation may only improve cognition in patients with pre-existing deficiencies7 10. This underscores the importance of maintaining adequate vitamin B12 levels to support cognitive health.
Bone Health
Vitamin B12 and D deficiencies can adversely affect bone health. A randomized controlled trial found that low-dose B-vitamin supplementation, including B12, improved bone mineral density in adults with lower baseline B12 status. However, there was no overall effect on bone mineral density in the general population4. Additionally, patients with small intestinal neuroendocrine tumors (SI-NET) often experience low bone density due to malabsorption issues, which can be mitigated with vitamin D and B12 supplementation5.
Cochlear Health
Low levels of vitamin B12 and D have been linked to poor cochlear health in women. A study found that women with deficiencies in these vitamins had significantly lower otoacoustic emission results, indicating compromised cochlear function6. This suggests that maintaining adequate levels of these vitamins is crucial for auditory health.
Risk Factors and Recommendations
Long-term Metformin Use
Long-term use of metformin, a common diabetes medication, has been associated with an increased risk of vitamin B12 deficiency. A study from the Diabetes Prevention Program Outcomes Study found that metformin use over several years significantly increased the risk of B12 deficiency, anemia, and peripheral neuropathy8. Routine testing for vitamin B12 levels in metformin-treated patients is recommended to prevent these adverse effects.
Sickle Cell Disease
Patients with sickle cell disease (SCD) are also at risk for vitamin B12 deficiency. A study in Tanzania found consistently low levels of vitamin B12 across all age groups in SCD patients, despite normal homocysteine levels. This indicates a need for better detection and supplementation strategies for vitamin B12 in this population9.
Conclusion
Vitamin D and B12 deficiencies are prevalent across various populations, including the elderly, pregnant women, children, and individuals with chronic conditions like diabetes and SCD. These deficiencies can lead to significant health issues, including cognitive impairment, poor bone health, and compromised cochlear function. Addressing these deficiencies through routine monitoring, dietary adjustments, and appropriate supplementation is crucial for maintaining overall health and preventing long-term adverse outcomes.
Sources and full results
Most relevant research papers on this topic
Burden of Vitamin D, Vitamin B12 and Folic Acid Deficiencies in an Aging, Rural Indian Community
Older, rural-dwelling Indians have a high burden of vitamin D and B12 deficiencies, potentially impacting cognition, immunity, and frailty.
Observational StudyVitamin D3 and B12 Supplementation in Pregnancy.
Oral vitamin D3 and B12 supplementation during pregnancy failed to correct nutritional deficiencies in Bangladeshi pregnant women, while dietary supplementation and high dose vitamin D effectively corrected severe deficiency.
RCTIs There An Association Between Vitamin B12 Level and Vitamin D Status in Children?
Vitamin B12 deficiency is common in school-age children, especially in the adolescent age group, and vitamin D deficiency may also be present in these cases.
Observational StudyA 2‐Year Randomized Controlled Trial With Low‐Dose B‐Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status
Low-dose B-vitamin supplementation for 2 years had no overall effect on bone mineral density, but improved B-vitamin status may have specific benefits for bone health in adults with lower B12 status.
RCT
Very Rigorous JournalVitamin D and vitamin B12 deficiencies are common in patients with midgut carcinoid (SI-NET)
Supplementation with vitamin D, B12, and calcium can improve vitamin D levels, lower parathyroid hormone levels, and diminish severe vitamin D deficiency in patients with disseminated SI-NET.
Observational StudyLow Vitamin B12 level and Vitamin D level Adversely Affect on Cochlear Health in Women.
Low vitamin B12 and vitamin D levels are significantly associated with poor cochlear health in women.
Observational StudyCognitive impairment and vitamin B12: a review
Low vitamin B12 levels are associated with neurodegenerative diseases and cognitive impairment, and vitamin B12 therapy can improve cognition in patients with pre-existing deficiency.
Systematic Review
Highly CitedLong-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study.
Long-term metformin use in the Diabetes Prevention Program Outcomes Study was associated with increased risk of B12 deficiency and anemia.
RCT
Large Human Trial
Rigorous JournalHighly CitedLow vitamin B12 blood levels in sickle cell disease: Data from a large cohort study in Tanzania
Low vitamin B12 levels are consistently found in sickle cell disease patients across all age groups, highlighting the need for supplementation.
Observational StudyVitamin B12 for cognition.
Vitamin B12 supplementation shows insufficient evidence to improve cognitive function in people with dementia and low serum B12 levels.
Systematic ReviewHighly Cited