Efficacy and safety of fortification and supplementation with vitamin B12: biochemical and physiological effects

Food and Nutrition Bulletin
R Carmel

Abstract

Long known as an uncommon but serious medical disorder requiring medical management, vitamin B12 deficiency is now seen to be common worldwide, but it is in a quite different form than traditionally envisioned. Most of the newly recognized deficiency is subclinical in nature, its health impact and natural history are uncertain, and its prevalence has been greatly inflated by also including persons with "low-normal" vitamin B12 levels, few of whom are deficient. The spread of folic acid fortification has also introduced concerns about folate's potentially adverse neurologic consequences in persons with undetected vitamin B12 deficiency. Fortification with vitamin B12 may prove more complicated than fortification with folic acid, however, because the bioavailability of vitamin B12 is limited. Bioavailability for those who need the vitamin B12 the most is especially poor, because they often have malabsorption affecting either classical intrinsic factor-mediated absorption or food-vitamin B12 absorption. Moreover, new evidence shows that many elderly persons respond poorly to daily oral doses under 500 microg (1 microg = 0.74 nmol), even if they do not have classical malabsorption, which suggests that proposed fortification with 1 ...Continue Reading

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Citations

Jul 9, 2008·Blood·Ralph Carmel
Jul 11, 2012·Annals of Nutrition & Metabolism·Madhavi DhobaleSadhana Joshi
Jul 12, 2016·Paediatrics & Child Health·Noam AmiUNKNOWN Canadian Paediatric Society, Drug Therapy and Hazardous Substances Committee
Jan 30, 2018·Annals of the New York Academy of Sciences·Anne M Molloy
Oct 9, 2018·Current Medicinal Chemistry·Renata Kozyraki, Olivier Cases
Nov 12, 2009·Current Opinion in Clinical Nutrition and Metabolic Care·Patrick J Stover
Jan 14, 2012·Current Opinion in Gastroenterology·Ralph Carmel
Mar 14, 2018·Annals of the New York Academy of Sciences·Homero MartinezKenneth H Brown
Jul 19, 2013·Seminars in Dialysis·Catherine M ClaseRachel M Holden
Jan 21, 2019·Central European Journal of Public Health·Ines Banjari, Snježana Kožić
Jun 26, 2010·Journal of Inherited Metabolic Disease·Ralph Carmel
Sep 17, 2016·Advances in Nutrition·Sudha VenkatramananJulia L Finkelstein
Feb 7, 2021·Molecular Nutrition & Food Research·Alexandra K Loedin, Dave Speijer
Apr 15, 2011·Metabolism: Clinical and Experimental·Kamini D DangatSadhana R Joshi
Mar 30, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Dhruv JhunjhnuwalaWilliam Huynh
Sep 24, 2008·Seminars in Hematology·Ralph Carmel

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