Pregnancy Use

Vitamin B12 is considered safe in pregnancy.

PRACTICE POINTS/PATIENT COUNSELLING

• Vitamin B12 (cobalamin) is a water-soluble vitamin obtained mostly from animal protein products in the diet.

• There is considerable evidence that oral vitamin B12 therapy is comparable in efficacy to parenteral therapy even when intrinsic factor is not present or in other diseases affecting absorption.

• As numerous studies have indicated that serum B12 levels are an inadequate guide to B12 status, a combination of total homocysteine and methylmalonic acid is probably the clearest indicator.

• Vitamin B12 deficiencies manifest primarily as haematological and neurological disturbances and is estimated to affect 10-1 5% of individuals over the age of 60 years.

• Traditionally, supplementation is recommended to treat deficiency states or prevent them in people at risk such as in pernicious anaemia or atrophic gastritis.

• When administered together with folic acid and vitamin B6 (pyridoxine), it is used to reduce homocysteine levels. In this way, vitamin B12 is sometimes recommended in conditions where homocysteine is implicated as a possible causative factor.

• Some evidence has shown supplementation can be useful in HIV and AIDS, depression, tinnitus and cognitive impairment when low vitamin B12 levels are also

present. Preliminary evidence also suggests a possible role for supplementation in diabetic retinopathy and sleep disturbances. • There are several commonly prescribed pharmaceutical medicines that can reduce vitamin B12 absorption when used long term.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this vitamin do for me?

Vitamin B12 is essential for healthy growth, development and health maintenance. It will reverse signs and symptoms of deficiency and can alleviate symptoms of tinnitus, poor memory, depression and HIV and AIDS when low vitamin B12 levels are also present. There is also some research suggesting some positive effects in diabetic retinopathy and sleep disturbances. When will it start to work?

In cases of pernicious anaemia, the classical deficiency state, correction of blood abnormalities occurs within 6 weeks; however, correction of nervous system changes is slower and may take up to 18 months. Are there any safety issues? Vitamin B12 is considered a very safe nutrient.

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