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Nutrients Sep 2020Vitamins B9 (folate) and B12 are essential water-soluble vitamins that play a crucial role in the maintenance of one-carbon metabolism: a set of interconnected... (Review)
Review
Vitamins B9 (folate) and B12 are essential water-soluble vitamins that play a crucial role in the maintenance of one-carbon metabolism: a set of interconnected biochemical pathways driven by folate and methionine to generate methyl groups for use in DNA synthesis, amino acid homeostasis, antioxidant generation, and epigenetic regulation. Dietary deficiencies in B9 and B12, or genetic polymorphisms that influence the activity of enzymes involved in the folate or methionine cycles, are known to cause developmental defects, impair cognitive function, or block normal blood production. Nutritional deficiencies have historically been treated with dietary supplementation or high-dose parenteral administration that can reverse symptoms in the majority of cases. Elevated levels of these vitamins have more recently been shown to correlate with immune dysfunction, cancer, and increased mortality. Therapies that specifically target one-carbon metabolism are therefore currently being explored for the treatment of immune disorders and cancer. In this review, we will highlight recent studies aimed at elucidating the role of folate, B12, and methionine in one-carbon metabolism during normal cellular processes and in the context of disease progression.
Topics: Folic Acid; Folic Acid Deficiency; Humans; One-Carbon Group Transferases; Polymorphism, Genetic; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 32961717
DOI: 10.3390/nu12092867 -
Tidsskrift For Den Norske Laegeforening... Sep 2022Severe vitamin B12 (cobalamin) deficiency is rare, but international reports show that up to 26 % of the general population may have subclinical vitamin B12 deficiency....
BACKGROUND
Severe vitamin B12 (cobalamin) deficiency is rare, but international reports show that up to 26 % of the general population may have subclinical vitamin B12 deficiency. The prevalence of vitamin B12 deficiency has not been investigated in Norway. Since 2017, treatment with vitamin B12 tablets has represented an alternative to traditional treatment with intramuscular injections in Norway. When we studied the transition from injection to tablet treatment, we discovered an unexpected difference in the counties' use of vitamin B12 supplements, which we wished to investigate in more detail.
MATERIAL AND METHOD
Data on the dispensing of vitamin B12 supplements from pharmacies in 2020, broken down by the patients' county of residence, were retrieved from the Norwegian Prescription Database. The Norwegian Health Economics Administration (Helfo) provided figures on the number of reimbursed vitamin B12-related laboratory tests in 2020, classified by patients' municipality of residence.
RESULTS
In 2020, the sale of vitamin B12 supplements on prescription in Norway amounted to 12 defined daily doses (DDD) per inhabitant and varied from 7 to 15 between the counties. The number of laboratory analyses that were performed varied by county from 26 to 46 per 100 inhabitants for total vitamin B12, and from 21 to 37 for folate. The number of analyses varied correspondingly from 1 to 12 per 100 inhabitants for homocysteine, from 1 to 13 for methylmalonic acid and from 0.01 to 8.13 for active vitamin B12.
INTERPRETATION
Our study showed large intercounty differences in the consumption of vitamin B12 supplements. These differences may have a number of explanations. Variations in the number of vitamin B12-related laboratory analyses requisitioned may indicate that doctors' assessment and diagnosis of vitamin B12 deficiency could be a contributory factor.
Topics: Dietary Supplements; Folic Acid; Humans; Methylmalonic Acid; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 36066225
DOI: 10.4045/tidsskr.21.0749 -
Journal of Pharmacy & Pharmaceutical... 2016The association between metformin use and low vitamin B12 levels in type 2 diabetes mellitus patients is well-established. However, many aspects of the topic remain to... (Review)
Review
The association between metformin use and low vitamin B12 levels in type 2 diabetes mellitus patients is well-established. However, many aspects of the topic remain to be elucidated. There is still controversy on the current diagnostic approaches to vitamin B12 deficiency. It is now believed that measuring the serum levels of the vitamin may not reflect its metabolic status. Moreover, there were conflicting results from studies attempting to quantify and explore metformin-associated vitamin B12 deficiency and its clinical impacts. This article reviews the cellular functions of vitamin B12, the biomarkers utilized to define the vitamin deficiency and metformin-induced vitamin B12 deficiency with an emphasis on its prevalence and clinical impacts. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
Topics: Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Metformin; Vitamin B 12 Deficiency
PubMed: 27806244
DOI: 10.18433/J3PK7P -
Nutrients Jun 2023Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can... (Review)
Review
Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can result in rickets in children and osteomalacia in children and adults. Recent studies have demonstrated the pleiotropic action of vitamin D and identified its effects on multiple biological processes in addition to bone health. VDD is more prevalent in chronic childhood conditions such as long-standing systemic illnesses affecting the renal, liver, gastrointestinal, skin, neurologic and musculoskeletal systems. VDD superimposed on the underlying disease process and treatments that can adversely affect bone turnover can all add to the disease burden in these groups of children. The current review outlines the causes and mechanisms underlying poor bone health in certain groups of children and young people with chronic diseases with an emphasis on the proactive screening and treatment of VDD.
Topics: Adult; Child; Humans; Adolescent; Vitamin D Deficiency; Rickets; Vitamin D; Bone and Bones; Osteomalacia; Vitamins
PubMed: 37375708
DOI: 10.3390/nu15122805 -
Journal of Cystic Fibrosis : Official... Oct 2019Vitamin D deficiency is a common finding in individuals with cystic fibrosis (CF), despite routine supplementation. Hypovitaminosis D is often the result of fat... (Review)
Review
Vitamin D deficiency is a common finding in individuals with cystic fibrosis (CF), despite routine supplementation. Hypovitaminosis D is often the result of fat malabsorption, but other contributors include increased latitude, poor nutritional intake, decreased sun exposure, impaired hydroxylation of vitamin D, and non-adherence to the prescribed vitamin D regimen. Vitamin D is critical for calcium homeostasis and optimal skeletal health, and vitamin D deficiency in CF can lead to skeletal complications of osteopenia and osteoporosis. Over time, our understanding of treatment regimens for vitamin D deficiency in CF has evolved, leading to recommendations for higher doses of vitamin D to achieve target levels of circulating 25-hydroxyvitamin D. There is also some evidence that vitamin D deficiency may have non-skeletal consequences such as an increase in pulmonary exacerbations. The exact mechanisms involved in the non-skeletal complications of vitamin D deficiency are not clearly understood, but may involve the innate immune system. Future clinical studies are needed to help address whether vitamin D has a role in CF beyond skeletal health.
Topics: Cystic Fibrosis; Humans; Vitamin D Deficiency
PubMed: 31679731
DOI: 10.1016/j.jcf.2019.08.022 -
Veterinary Medicine and Science Mar 2021The high incidence of disease in captive pangolins is a major obstacle in pangolin-conservation breeding programs. Therefore, elucidating pangolins' susceptibility to...
The high incidence of disease in captive pangolins is a major obstacle in pangolin-conservation breeding programs. Therefore, elucidating pangolins' susceptibility to disease is the key to conservation progress. At the Pangolin Research Base for Artificial Rescue and Conservation Breeding of South China Normal University (PRB-SCNU), vitamin A deficiency was diagnosed in 14 captive Sunda pangolins. Typical eye signs included lacrimal eyes, keratopathy and a blank, milky orb. The afflicted pangolins were treated with vitamins A and D for 15-30 days; all individuals recovered. We report the detection and treatment of vitamin A deficiency in captive Sunda pangolins at the PRB-SCNU. Our results could provide guidance for the future prevention and treatment of vitamin A deficiency and associated diseases in pangolin species, both to reduce the incidence of these diseases in captive pangolins and to aid conservation efforts.
Topics: Animals; Animals, Zoo; China; Conservation of Natural Resources; Pangolins; Vitamin A; Vitamin A Deficiency; Vitamins
PubMed: 33058569
DOI: 10.1002/vms3.367 -
Fertility and Sterility May 2021
Topics: Humans; Leiomyoma; Vitamin D Deficiency
PubMed: 33743958
DOI: 10.1016/j.fertnstert.2021.02.040 -
Schizophrenia Research Sep 2022Over the last half century, a body of convergent evidence has accumulated linking disruption of early brain development with an increased risk of mental disorders,... (Review)
Review
Over the last half century, a body of convergent evidence has accumulated linking disruption of early brain development with an increased risk of mental disorders, including schizophrenia. The orderly cascade of brain development may be disrupted by exposure to suboptimal concentrations of a range of biological substrates and micronutrients. We hypothesized that those exposed to vitamin D deficiency during early life, have an increased risk of neurodevelopmental disorders, including schizophrenia. The hypothesis was based on the link between an increased risk of schizophrenia in (a) those born in winter and spring, when vitamin D deficiency is more prevalent, and (b) the offspring of dark-skinned migrants living in cold climates, who have a markedly increased risk of vitamin D deficiency. In this review, we summarize evidence from analytic epidemiology related to this hypothesis. Two case-control studies based on Danish neonatal dried blood spots have found that neonatal vitamin deficiency is associated with an increased risk of schizophrenia. However, recent genetic analyses have also suggested that common variants linked to schizophrenia may lead to lower vitamin D concentrations (possibly mediated via reduced outdoor activity). We summarize limitations of the current evidence and outline suggestions that can guide future research. Based on currently available data, there is insufficient evidence to support public health recommendations related to this topic. However, we cannot reject the hypothesis that the provision of vitamin D supplementation to pregnant women and/or offspring in groups vulnerable to vitamin D deficiency may subsequently reduce the incidence of schizophrenia in the offspring.
Topics: Female; Humans; Infant, Newborn; Micronutrients; Pregnancy; Schizophrenia; Seasons; Vitamin D; Vitamin D Deficiency
PubMed: 34247885
DOI: 10.1016/j.schres.2021.06.004 -
The American Journal of Case Reports Mar 2019BACKGROUND Beriberi due to thiamine (vitamin B1) deficiency has two clinical presentations. Patients with dry beriberi present with neuropathy, and patients with wet...
Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature.
BACKGROUND Beriberi due to thiamine (vitamin B1) deficiency has two clinical presentations. Patients with dry beriberi present with neuropathy, and patients with wet beriberi present with heart failure, with or without neuropathy. Dry beriberi can mimic the most common form of Guillain-Barre syndrome (GBS), an acute inflammatory demyelinating polyradiculoneuropathy (AIDP). Severe thiamine deficiency results in Wernicke's encephalopathy. This report of a case of dry beriberi and Wernicke's encephalopathy due to thiamine deficiency includes a review of the literature. CASE REPORT A 56-year old woman with a history of gallstone pancreatitis and protein-calorie malnutrition was treated six months previously with total parenteral nutrition (TPN). She initially presented at another hospital with paresthesia of the lower limbs, arms, and neck, and symptoms of encephalopathy. Initial diagnosis of GBS was made, based on magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) findings. Despite five days of intravenous immunoglobulin (IVIG) treatment, her encephalopathy worsened, requiring transfer to our hospital, where she required intubation and treatment with vasopressors. A repeat MRI of her brain showed changes consistent with Wernicke's encephalopathy. Following treatment with high-dose intravenous thiamine, her mental status improved within 48 hours, and by the third hospital day, she no longer required intubation. CONCLUSIONS Symptoms and signs of dry beriberi due to thiamine deficiency can mimic those of acute or chronic GBS. However, thiamine repletion leads to rapid clinical improvement and can prevent irreversible neurologic sequelae, including Korsakoff syndrome. Clinicians should consider thiamine deficiency in malnourished patients presenting with symptoms and signs of GBS.
Topics: Beriberi; Diagnosis, Differential; Female; Guillain-Barre Syndrome; Humans; Middle Aged; Peripheral Nervous System Diseases; Thiamine Deficiency; Wernicke Encephalopathy
PubMed: 30862772
DOI: 10.12659/AJCR.914051 -
BMC Pediatrics Sep 2021We looked at existing recommendations and supporting evidence on the effectiveness of vitamin D supplementation in infancy for reducing vitamin D deficiency and for... (Review)
Review
We looked at existing recommendations and supporting evidence on the effectiveness of vitamin D supplementation in infancy for reducing vitamin D deficiency and for preventing rickets and infections. We also looked at optimal dose of vitamin D and the age until which vitamin D supplementation is beneficial.We conducted a literature search up to the 17th of July 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.A daily dose of 400 international units of vitamin D in infants has shown to be effective for improving bone health and preventing rickets. Evidence is more robust in groups of infants and children at risk. Vitamin D supplementation is well tolerated, and not associated with toxicity. Higher doses have not shown to add benefit while it could potentially cause toxic blood levels and hypercalcemia. Adequate levels of vitamin D might not be achieved with lower daily doses. Universal vitamin D supplementation starting shortly after birth, regardless of the mode of feeding and until 12 months of age, is strongly recommended. Beyond 12 months of age vitamin D supplementation is recommended only in groups of children at risk.
Topics: Child; Dietary Supplements; Humans; Infant; Rickets; Systematic Reviews as Topic; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 34496802
DOI: 10.1186/s12887-021-02776-z