During three decades of neurological practice I have witnessed a remarkable change in attitudes to the benefits and risks of folic acid therapy in nervous system disorders. In the 1960s all that was known and taught was that folic acid was harmful to the nervous system, especially in precipitating or exacerbating the neurological complications of vitamin B12 deficiency. So deeply held was this ...

Multiple Sclerosis (MS) and vitamin B12 deficiency share common inflammatory and neurodegenerative pathophysiological characteristics. Due to similarities in the clinical presentations and MRI findings, the differential diagnosis between vitamin B12 deficiency and MS may be difficult. Additionally, low or decreased levels of vitamin B12 have been demonstrated in MS patients. Moreover, recent st...

OBJECTIVES Many patients with vitamin B12 deficiency do not have anemia or macrocytosis, but the prevalence of B12 deficiency in patients without macrocytosis is not known. METHODS We investigated the prevalence of B12 deficiency among patients with normocytosis and microcytosis and recommended a screening strategy. All patients (n = 3714) with serum B12 measured at the Prince of Wales Hospit...

A 90-year-old woman with orthostatic hypotension and near-syncope was found to have a low-normal level of vitamin B(12) and no other medical findings that could explain her orthostasis. Her symptoms responded to vitamin B(12) replacement therapy. This case shows that vitamin B(12) deficiency can induce orthostatic hypotension and syncope that are correctable by vitamin B(12) replacement.

In most countries, the classic treatment for cobalamin deficiency is based on parenteral administration as intramuscular injections in the form of cyanocobalamin and, more rarely, hydroxylor methylcobalamin [1]. In USA and UK, doses ranging from 100 to 1,000 μg per month (or every 2-3 months when hydroxocobalamin is given) are used for the duration of the patient’s life [2]. In France, treatmen...

BACKGROUND Vitamin B12 deficiency is associated with many adverse health outcomes and is highly prevalent worldwide. The present study assesses the prevalence and socio-demographic factors associated with vitamin B12 deficiency in a representative sample of pregnant women in Colombia. METHOD We used data from the cross-sectional, nationally representative survey (ENSIN, 2010). A total of 1.78...

1. Bartram L et al. Survey of training in geriatric medicine in UK undergraduate medical schools. Age Ageing 2006; 35: 533–5. 2. Harden RM, Sowden S, Dunn WR. Some educational strategies in curriculum development. The SPICES model. Med Educ 1984; 18: 284–97. 3. Harden RM, Davis MH, Crosby JR. The new Dundee medical curriculum: a whole that is greater than the sum of the parts. Med Educ 1997; 31...

This review apprises the reader of recent advances in cobalamin absorption and transport since 1970. This field has been of interest to gastroenterologists, hematologists, and biochemists as well as nutritionists. Clinical conditions leading to cobalamin deficiency present especially to the first two of these specialties. Many recent advances involve biochemical definition of the specific trans...

We report the case of a 7-month-old breast fed infant who presented with a nose bleed and bruises. Investigation showed severe nutritional B12 deficiency anemia with a pancytopenia. It is important to take the nutritional history of both the infant and the mother for early prevention and treatment.

Anemia is a common complication of human malaria. Since micronutrient deficiencies are highly prevalent in malaria-endemic areas and appear to contribute to anemia etiology, we conducted a cross-sectional study in Tumaco, Colombia, to examine the associations between plasma vitamin B12 or erythrocyte folate concentrations and hemoglobin (Hb) among 96 adults with predominantly Plasmodium falcipa...