It is responsible for one-carbon metabolism and cell division of nervous and hematopoietic cells. Vitamin B12 is metabolically related to other essential nutrients, such as choline, methionine and folic acid. Chloramphenicol (Chloromycetin®) is a bacteriostatic antibiotic. It supports the normal function of your nerve cells and is needed for red blood cell formation and DNA synthesis. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia. Homocysteine as a biomarker for cognitive dysfunction in the elderly. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. Selhub J, Jacques PF, Wilson PF, Rush D, Rosenberg IH. In the U.S., the National Institutes of Health (NIH) recommend that teens and adults over the age of 14 years should consume 2.4 micrograms (mcg) of vitamin B-12 a day. Treatment includes vitamin B-12 injections. Vitamin B12 is an essential nutrient, important in nerve and blood cell health, and most people obtain enough of it in food. Annu Rev Med 1998;49:31-62. [, Kasper H. Vitamin absorption in the elderly. 1. Gastric acidity in older adults. Low vitamin B12 status has also been positively associated with cognitive decline . These preparations are frequently marketed as having superior bioavailability, although evidence suggests no difference in efficacy between oral and sublingual forms [19,20]. It plays a vital role in brain function and the production of DNA and red blood cells. Cyanocobalamin (B12) Cyanocobalamin (or vitamin B12) helps to produce and maintain the myelin surrounding nerve cells, mental ability, red blood cell formation and the breaking down of some fatty acids and amino acids to produce energy. B12 is present in many food sources (mainly anima-based), where it is bound to the protein molecules in the food. Vitamin B-12 is involved in important processes in your body. Adults (aged 19 to 64) need about 1.5 micrograms a day of vitamin B12. It is also involved in the formation of red blood cells and helps to … Evidence from retrospective, cross-sectional, and prospective studies links elevated homocysteine levels with coronary heart disease and stroke [50,53-62]. Vitamin B-12 deficiency in the elderly is more common and usually diagnosed from low serum vitamin B-12 concentrations or, less often, fro… [, Markle HV. Supports Energy. Elevated methylmalonic acid and total homocysteine levels show high prevalence of vitamin B12 deficiency after gastric surgery. [, Carmel R. Prevalence of undiagnosed pernicious anemia in the elderly. Get the latest public health information from CDC: https://www.coronavirus.gov
Vitamin B12 is utilized in many parts of the body and metabolism. Get the latest research information from NIH: https://www.nih.gov/coronavirus, Have a question? It keeps … Special Holiday Offers! As a result, vitamin B12 deficiency is common, affecting between 1.5% and 15% of the general population [28,29]. Vitamin B12 deficiency, however, affects nearly half of all adults. A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B12 deficiency in older adults. 2006;354:1567-77. Ann Intern Med 1996;124:469-76. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. Mutat Res. Homocysteine and methylmalonic acid in diagnosis and risk assessment from infancy to adolescent. However, evidence suggests that serum vitamin B12 concentrations might not accurately reflect intracellular concentrations . Any excess or unwanted vitamin B-12 is excreted in the urine. The IOM did not establish a UL for vitamin B12 because of its low potential for toxicity. However, high doses of oral vitamin B12 may also be effective. In another study, older men and women who took a multivitamin/multimineral supplement for 8 weeks experienced a significant decrease in homocysteine levels . Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. The more protein you eat the more pyridoxine your body requires. Fenech M. Folate (vitamin B9) and vitamin B12 and their function in the maintenance of nuclear and mitochondrial genome integrity. The U.S. Department of Agriculture's (USDA's) FoodData Central Web site ) 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. The Seven Most Important Functions of Vitamin B12. Homocysteine and cardiovascular disease. [, Butler CC, Vidal-Alaball J, Cannings-John R, McCaddon A, Hood K, Papaioannou A, et al. 32. A vitamin B-12 injection must be administered to people that have problems with nutrient absorption. The antibiotic chloramphenicol, or chloromycetin, may also interfere with red blood cell production in people taking supplements. Cobalamin. Limited evidence from case reports indicates that chloramphenicol can interfere with the red blood cell response to supplemental vitamin B12 in some patients . These values, which vary by age and gender , include: Table 1 lists the current RDAs for vitamin B12 in micrograms (mcg) . [, Buvat DR. Use of metformin is a cause of vitamin B12 deficiency. J Am Geriatr Soc 1998;46:1199-206. Vitamin B-12 is crucial to the normal function of the brain and the nervous system. However, this indicator has poor specificity because it is influenced by other factors, such as low vitamin B6 or folate levels . This study found that the percentage of participants in three age groups (26–49 years, 50–64 years, and 65 years and older) with deficient blood levels of vitamin B12 was similar. [, Bønaa KH, Njølstad I, Ueland PM, Schirmer H, Tverdal A, Steigen T, et al. Surgical removal of the distal ileum also can result in the inability to absorb vitamin B12. [, Albert CM, Cook NR, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, et al. Vitamin B12 is a water-soluble nutrient in the vitamin B complex that the body needs in small amounts to function properly. Blood.2008;112:2214-21. [, McKay DL, Perrone G, Rasmussen H, Dallal G, Blumberg JB. Proc Nutr Soc 2008;67:75-81. In the Women’s Antioxidant and Folic Acid Cardiovascular Study, women at high risk of cardiovascular disease who took daily supplements containing 1 mg vitamin B12, 2.5 mg folic acid, and 50 mg vitamin B6 for 7.3 years did not have a reduced risk of major cardiovascular events, despite lowered homocysteine levels . Another study found similar results in 142 individuals at risk of dementia who received supplements of 2 mg folic acid and 1 mg vitamin B12 for 12 weeks . Here, we review Hello Fresh and…, Blue Apron are a meal kit delivery service that send out recipes and pre-measured ingredients to people who want to cook at home. Vitamin B12 is an essential nutrient, important in nerve and blood cell health, and most people obtain enough of it in food. Methodology: Sample included 1733 individuals 60 years old and older, who participated in the SABE study that was carried out in Ecuador. N Engl J Med. [, Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, et al. For a reader-friendly overview of Vitamin B12, see our consumer fact sheet on Vitamin B12. FDA required manufacturers to use these new labels starting in January 2020, but companies with annual sales of less than $10 million may continue to use the old labels that list a vitamin B12 DV of 6.0 mcg until January 2021 [16,18]. [, Schulz RJ. [, Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency. Researchers have long been interested in the potential connection between vitamin B12 deficiency and dementia [51,73]. Vitamin B-12 is the largest and most structurally complicated vitamin. [, Bronstrup A, Hages M, Prinz-Langenohl R, Pietrzik K. Effects of folic acid and combinations of folic acid and vitamin B12 on plasma homocysteine concentrations in healthy, young women. New York: Academic Press, Inc., 1992. It is responsible for one-carbon metabolism and cell division of nervous and hematopoietic cells. Intranasal treatment of vitamin B, Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Sem Hematol 1999;36:35-46. Various B-12 supplements are available to purchase in health food stores and online. It is also involved in the formation of red blood cells and helps to create and regulate DNA. Neth J Med 1994;45:34-41. What are the best meal delivery services for families? Pernicious anemia is an autoimmune condition in which destruction of gastric parietal cells leads to loss of the intrinsic factor required for the active absorption of the vitamin. Vitamin B12 has the potential to interact with certain medications. B12 deficiency: a look beyond pernicious anemia. [, Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, et al. Individuals with pernicious anemia cannot properly absorb vitamin B12 in the gastrointestinal tract [3,5,9,10]. N Engl J Med 1995;332:286-91. Effect of vitamins and aspirin on markers of platelet activation, oxidative stress and homocysteine in people at high risk of dementia. Use of metformin is a cause of vitamin B12 deficiency. Homocysteine lowering and cardiovascular events after acute myocardial infarction. [, Refsum H, Nurk E, Smith AD, Ueland PM, Gjesdal CG, Bjelland I, et al. Vitamin B12, like the other B vitamins, is important for protein metabolism. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Special Holiday Offers for Online Subscriptions! They may not be able to absorb cobalamin properly. Vitamin B12 does a lot of things for your body. Zittoun J, Zittoun R. Modern clinical testing strategies in cobalamin and folate deficiency. Reversal of protein-bound vitamin B12 malabsorption with antibiotics in atrophic gastritis. [, Chanarin I. Am J Clin Nutr 2006;84:361-70. [, Tucker KL, Rich S, Rosenberg I, Jacques P, Dallal G, Wilson WF, et al. Learn more…. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The company say that they use fresh vegetables and sustainable seafood. Because these chemical compounds have a similar molecular structure, each of which shows vitamin activity in a vitamin-deficient biological syste… When synthetic vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and, thus, does not require this separation step. During infancy, signs of a vitamin B12 deficiency include failure to thrive, movement disorders, developmental delays, and megaloblastic anemia . This can lead to irreversible neurological symptoms. Vitamin B12 and folate deficiencies in fetal and early life cause poor brain development and cognitive functions. J Am Coll Nutr 1998;17:435-41. Observational studies show positive associations between elevated homocysteine levels and the incidence of both Alzheimer's disease and dementia [6,51,75]. Vitamin B12 also plays a role in the normal function of the immune and nervous systems, normal psychological function and the process of cell division. Two steps are required for the body to absorb vitamin B12 from food. Metformin, a hypoglycemic agent used to treat diabetes, might reduce the absorption of vitamin B12 [95-97], possibly through alterations in intestinal mobility, increased bacterial overgrowth, or alterations in the calcium-dependent uptake by ileal cells of the vitamin B12-intrinsic factor complex [96,97]. “B12 is found mostly in … Here I’m going to explain the benefits of vitamin B12 for hepatitis C. Vitamin B12 and liver health. For example, the bone marrow, a sponge-like tissue inside bones, needs B12 to produce healthy red blood cells. How does fake news of 5G and COVID-19 spread worldwide? [, Carmel R. How I treat cobalamin (vitamin B12) deficiency. [. Vitamin B12 benefits your energy levels, mood, memory, heart, hair, skin and digestion. Methionine is required for the formation of S-adenosylmethionine, a universal methyl donor for almost 100 different substrates, including DNA, RNA, hormones, proteins, and lipids. J Fam Pract 2007;56:537-42. Vitamin B-12 deficiency occurs when the body does not receive enough vitamin B-12. Cases of B-12-triggered acne have also been reported. [, de Jager J, Kooy A, Lehert P, Wulffelé MG, van der Kolk J, Bets D, Verburg J, Donker AJ, Stehouwer CD. People over the age of 14 should consume more than 2.4 micrograms (mcg) of vitamin B-12 daily. A deficiency in vitamin B12 causes an accumulation of homocysteine in the blood  and might decrease levels of substances needed to metabolize neurotransmitters . [, Force RW, Nahata MC. The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. Pernicious anemia is an autoimmune disease that affects the gastric mucosa and results in gastric atrophy. [, Ruscin JM, Page RL 2nd, Valuck RJ. These include metformin, proton pump inhibitors, and h2 receptor agonists, often used for peptic ulcer disease. Am J Clin Nutr 1997;66:750-9. HoloTC is a minor fraction of the total Vitamin B12 in the blood and it varies between 10% and 30 % of total Vitamin B12. Nutr Rev 1996;54:382-90. Methionine is required for the formation of S-adenosylmethionine, a universal methyl donor for almost 100 … 8th ed. Australas Ann Med 1967;16:230-5. Includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. These cells cannot multiply properly without vitamin B-12. In the presence of insufficient vitamin B12, homocysteine levels can rise due to inadequate function of methionine synthase . Cardiovascular disease. Results from several randomized controlled trials indicate that combinations of vitamin B12 and folic acid supplements with or without vitamin B6 decrease homocysteine levels in people with vascular disease or diabetes and in young adult women [63-71]. Vitamin B12 is a powerful neural compound that is extremely essential for the synthesis of neurotransmitters. It also prevents brain atrophy which is loss of brain neurons and it can cause dementia or memory loss. [, Gueant JL, Safi A, Aimone-Gastin I, Rabesona H, Bronowicki J P, Plenat F, et al. Cochrane Database Syst Rev 2005;(3):CD004655. J Clin Epidemiol 2004;57:422-8. [, Kapadia CR. If high folic acid aggravates vitamin B12 deficiency what should be done about it? This review found very low quality evidence that suggests a connection between high plasma homocysteine levels (a by-product of B vitamin … It is always better to maintain a balanced diet and receive healthful amounts of nutrients before active treatment is required. Vitamin B12 in health and disease: part I—inherited disorders of function, absorption, and transport. These claims are based on the fact that correcting the megaloblastic anemia caused by vitamin B12 deficiency should improve the associated symptoms of fatigue and weakness. Am J Clin Nutr 1998;68:1104-10. Individuals who have trouble absorbing vitamin B12 from foods, as well as vegetarians who consume no animal foods, might benefit from vitamin B12-fortified foods, oral vitamin B12 supplements, or vitamin B12 injections . Ervin RB, Wright JD, Wang CY, Kennedy-Stephenson J. Carmel R. Cobalamin, the stomach, and aging. Women at high risk of cardiovascular disease who participated in the Women’s Antioxidant and Folic Acid Cardiovascular Study were randomly assigned to receive daily supplements containing 1 mg vitamin B12, 2.5 mg folic acid and 50 mg vitamin B6, or placebo . Benefits of Vitamin B12. Parenteral administration is typically used to treat vitamin B12 deficiency caused by pernicious anemia and other conditions that result in vitamin B12 malabsorption and severe vitamin B12 deficiency . As part of the B-vitamin family, B12 helps release energy from the food we eat. This article will explore the functions of vitamin B-12, how a person would know they are not consuming enough vitamin B-12, and where to source more. There have been no reports of an adverse reaction to B-12 since 2001 when a person in Germany reported rosacea as a result of a B-12 supplement. If pernicious anemia is left untreated, it causes vitamin B12 deficiency, leading to megaloblastic anemia and neurological disorders, even in the presence of adequate dietary intake of vitamin B12. Vitamin B12 deficiency, however, affects nearly half of all adults. [, American Heart Association Nutrition Committee, Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Vitamin B12 aids in the development of red blood cells in higher animals. Introduction: Current evidence still does not support the role of vitamin B12 or vitamin D in age-associated cognitive impairment. The human body produces millions of red blood cells every minute. It can result in irreversible and potentially severe damage, especially to the nervous system and brain. [, Malouf R, Grimley Evans J. Folic acid with or without vitamin B12 for the prevention and treatment of health elderly and demented people. Vitamins B1, pantothenic acid, biotin and B12 are important for energy metabolism, while B2 and B6 aid in red blood cell production. Institute of Medicine. It is needed for nerve tissue health, brain function, and the production of red blood cells. Vitamin C promotes healthy teeth and gums and helps the body absorb iron. This includes older adults, patients with pernicious anemia, and those with achlorhydria or intestinal disorders may have problems absorbing vitamin B-12 from food. Vitamin B12, also known as cobalamin, is a water-soluble vitamin essential to the function of all cells. Aliment Pharmacol Ther 2008;27:491-7. Vitamin B12 levels during prolonged treatment with proton pump inhibitors. Cardiovascular disease is the most common cause of death in industrialized countries, such as the United States, and is on the rise in developing countries. Subscribe Now> JAMA 2008 ;300:1774-83. Undetected and untreated vitamin B12 deficiency in infants can result in severe and permanent neurological damage. These medications can interfere with the absorption of vitamin B12 from food by slowing the release of hydrochloric acid into the stomach. [, Clarke R, Birks J, Nexo E, Ueland PM, Schneede J, Scott J, et al. Vitamin B12, a complex water-soluble organic compound that is essential to a number of microorganisms and animals, including humans. Plasma homocyst(e)ine and arterial occlusive diseases: a mini-review. People with pernicious anemia may lack vitamin B-12. However, many fruits and vegetables contain these traces, and it is not considered a significant health risk. Atrophic gastritis, a condition affecting 10%–30% of older adults, decreases secretion of hydrochloric acid in the stomach, resulting in decreased absorption of vitamin B12 [5,11,36-40]. Meal kits are also a good way to get children…, MealPro are a company who deliver premade meals to a person's door. Patients with this disorder do not have enough intrinsic factor (IF), a protein in the stomach that allows the body to absorb vitamin B-12. In many of these cases, the cause of the vitamin B12 deficiency is unknown . Find out what you need to do to overcome this problem and improve your cognitive and mental function. [, Kang JH, Cook N, Manson J, Buring JE, Albert CM, Grodstein F. A trial of B vitamins and cognitive function among women at high risk of cardiovascular disease. Low levels of vitamin B12 have been associated with neurocognitive disorders. Compr Psychiatry 1997;38:305-14. 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 . Canned tuna has a good amount of B12 but it is better to consume it in cooked form. In most countries, the practice of using intramuscular vitamin B12 to treat vitamin B12 deficiency has remained unchanged . Although H2 receptor antagonists have the potential to cause vitamin B12 deficiency , no evidence indicates that they promote vitamin B12 deficiency, even after long-term use . Vegans can take supplements to avoid deficiency, as the vegan diet remove the meat products that provide B-12 naturally. Working together with vitamin B9 (folate), it helps iron function better and helps the body to make healthy red blood cells. Most, however, can absorb the synthetic vitamin B12 added to fortified foods and dietary supplements. Some studies suggest that supplemental calcium might help improve the vitamin B12 malabsorption caused by metformin [96,97], but not all researchers agree . What can science tell us about mediums who hear voices? Only HoloTC is considered to be bioavailable because it can be taken up by the cells via a specific receptor, the TC receptor. [, Brolin RE, Gorman JH, Gorman RC, Petschenik A J, Bradley L J, Kenler H A, et al. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. [, Malouf R, Areosa Sastre A. Vitamin B12 for cognition. Vitamin B6 helps form red blood cells and maintain brain function. 17th ed. Most of the Vitamin B12 in blood (70 – 90 %) is bound to HC. "Cobalamin" actually refers to a group of compounds (corrinoids) with near-identical structure. Due to its role in energy metabolism, vitamin B12 is frequently promoted as an energy enhancer and an athletic performance and endurance booster. Vitamin B12 crosses the placenta during pregnancy and is present in breast milk. [, Klee GG. Vitamin B12 functions as a cofactor for methionine synthase and L-methylmalonyl-CoA mutase. B12 is also required to maintain the rapidly dividing cells lining the gastrointestinal tract. Includes a variety of vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, and oils. Functions of vitamin B12. Some people—particularly older adults, those with pernicious anemia, and those with reduced levels of stomach acidity (hypochlorhydria or achlorhydria) or intestinal disorders—have difficulty absorbing vitamin B12 from food and, in some cases, oral supplements [26,27]. Br Med J 1998:316:894-8. Circulation 2006;114:82-96. Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis . Vitamin B12 is a water-soluble vitamin, also known as cobalamin. Objective: Evaluate the association between vitamin B12 and D and cognitive function in elders. [, Howden CW. Vitamin B-12 enables the release of energy by helping the human body absorb folic acid. Vitamin B12, also known as cobalamin, works with many other B vitamins to carry out key roles in functions of the human body. Vital Heath Stat 11 2002;(245):1-158. Folic acid and vitamin B12 are more effective than vitamin B6 in lowering fasting plasma homocysteine concentration in patients with coronary artery disease. Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials. Join the ODS Email List. The two trials of acceptable methodology (Fourniere 1997; Seal 2002) were restricted to a small number of patients with Alzheimer's disease and other types of … In the NORVIT and HOPE 2 trials, vitamin B12 supplementation (in combination with folic acid and vitamin B6) did not cause any serious adverse events when administered at doses of 0.4 mg for 40 months (NORVIT trial) and 1.0 mg for 5 years (HOPE 2 trial) [66,67]. Vitamin B12 functions as a cofactor for methionine synthase and L-methylmalonyl-CoA mutase. However, people are always advised to speak with their physician before starting to take supplements. Proc Assoc Am Physicians 1997;109:462-9. The best defense is always a good offense. Dietary supplements can also contain methylcobalamin and other forms of vitamin B12. 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 . Most reactions involve transfer or synthesis of one-carbon units, such as methyl groups. Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Here I’m going to explain the benefits of vitamin B12 for hepatitis C. Vitamin B12 and liver health. Fortified foods vary in formulation, so it is important to read the Nutrition Facts labels on food products to determine the types and amounts of added nutrients they contain. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. In one randomized, double-blind, placebo-controlled trial, 195 subjects aged 70 years or older with no or moderate cognitive impairment received 1,000 mcg vitamin B12, 1,000 mcg vitamin B12 plus 400 mcg folic acid, or placebo for 24 weeks . The authors of two Cochrane reviews and a systematic review of randomized trials of the effects of B vitamins on cognitive function concluded that insufficient evidence is available to show whether vitamin B12 alone or in combination with vitamin B6 or folic acid has an effect on cognitive function or dementia [82-84]. This systematic review evaluates whether the relation between vitamin B12 … Int J Vitam Nutr Res 1999;69:169-72. [, Lee BJ, Huang MC, Chung LJ, Cheng CH, Lin KL, Su KH, et al. For example, only about 10 mcg of a 500 mcg oral supplement is actually absorbed in healthy people . [, Hvas AM, Juul S, Lauritzen L, Nexø E, Ellegaard J. Age Ageing 2006;35:200-1. Proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), are used to treat gastroesophageal reflux disease and peptic ulcer disease. [, Suzuki DM, Alagiakrishnan K, Masaki KH, Okada A, Carethers M. Patient acceptance of intranasal cobalamin gel for vitamin B12 replacement therapy. Functions. You do too. However, … about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Am J Med 1998;104:422-30. [, Johnson MA. A study was conducted on people who had early stage dementia. Among its various functions, the role as immunomodulator in cellular immunity, especially in elevating the number of CD8+ cells and NK cells, attracts scientific interest. The effect of a subnormal vitamin B6 status on homocysteine metabolism. L-methylmalonyl-CoA mutase converts L-methylmalonyl-CoA to succinyl-CoA in the degradation of propionate [3,5,6], an essential biochemical reaction in fat and protein metabolism. Folate and cobalamin in psychiatric illness. N Engl J Med 2002;346:476-83. Liver disease can cause B vitamin deficiencies, mostly due to poor diet. Pregnancy and lactation can worsen deficiency in vegans. Curr Opin Hematol 1994;1:107-12. [, Flynn MA, Herbert V, Nolph GB, Krause G. Atherogenesis and the homocysteine-folate-cobalamin triad: do we need standardized analyses? Aids in the elderly crucial nutrient atrophic gastritis are unable to absorb the vitamin..., Garrett TF, Lindenbaum J tired and weak carry out a number of basic metabolic functions function... Andrès E, Ueland PM, Nordrehaug JE, Nilsen DW, Vollset SE is extremely essential for the Department! Lowering blood homocysteine with folic acid and homocysteine in people taking supplements energy levels difficulties and Meij,! Typically assessed via serum or plasma vitamin B12 is an injectable form of the population are currently diagnosed vitamin! 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