Patients with unexplained neurological symptoms and signs should be screened for vitamin B12 deficiency regardless of haemoglobin levels

Maghsoudlou, Panagiotis; Varlamova, Jekaterina; Pandit, Jyotin C

doi:10.1038/s41433-021-01589-9

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…Neuropsychiatric conditions are common in patients with B12 deficiency, although the available studies are heterogeneous regarding patient characteristics and the diagnostic tools employed [3][4][5]29,33,[82][83][84][85][86][87]. This variability in particular concerns the differentiation between peripheral sensory neuropathy and sensory neuronopathy (gangliopathy) alone or as part of the subacute combined spinal cord degeneration (SCD) syndrome.…”

Section: Vitamin B12 Deficiency In the Medical Literaturementioning

confidence: 99%

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Obeid,

Andrès,

Češka

et al. 2024

JCM

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Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker and methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history, and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing the diagnosis of B12 deficiency. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency, and the treatment goals govern decisions regarding the route and dose of B12 therapy.

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Section: Vitamin B12 Deficiency In the Medical Literaturementioning

confidence: 99%

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Obeid,

Andrès,

Češka

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

Section: Vitamin B12 Deficiency In the Medical Literaturementioning

confidence: 99%

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Obeid,

Andrès,

Češka

et al. 2024

Preprint

View full text Add to dashboard Cite

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker, whereas methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing a diagnosis. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency and the treatment goals govern decisions regarding the route and dose of B12 therapy.

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“…In infants, neglecting vitamin B12 deficiency can contribute to developmental setbacks, movement irregularities, and failure to thrive. Importantly, symptoms associated with vitamin B12 deficiency have the potential to be reversed through the administration of vitamin B12 supplements [14,15]. Therefore, a prompt diagnosis and effective management of vitamin B12 deficiency are of utmost importance in preventing prolonged complications.…”

Section: Mechanism Of Long-term Metformin--induced Vitamin B12 Defici...mentioning

confidence: 99%

Beyond Diabetes Management: Unraveling Metformin’s Long-Term Effects on Vitamin B12

Bahl,

Hussain,

Saraswat

et al. 2023

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Patients with unexplained neurological symptoms and signs should be screened for vitamin B12 deficiency regardless of haemoglobin levels

Cited by 6 publications

References 2 publications

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Beyond Diabetes Management: Unraveling Metformin’s Long-Term Effects on Vitamin B12

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