Vitamin B₁₂and its Relationship to Age of Onset of Multiple Sclerosis

Abstract

Attention has been focused recently on the association between vitamin B12 metabolism and the pathogenesis of multiple sclerosis (MS). Several recent reports have documented vitamin B12 deficiency in patients with MS. The etiology of this deficiency in MS is unknown. The majority of these patients do not have pernicious anemia and serum levels of the vitamin are unrelated to the course or chronicity of the disease. Moreover, vitamin B12 does not reverse the associated macrocytic anemia nor are the neurological deficits of MS improved following supplementation with vitamin B12. It has been suggested that vitamin B12 deficiency may render the patient more vulnerable to the putative viral and/or immunologic mechanisms widely suspected in MS. In the present communication, we report that serum vitamin B12 levels in MS patients are related to the age of onset of the disease. Specifically, we found in 45 MS patients that vitamin B12 levels were significantly lower in those who experienced the onset of first neurological symptoms prior to age 18 years (N = 10) compared to patients in whom the disease first manifested after age 18 (N = 35). In contrast, serum folate levels were unrelated to age of onset of the disease. As vitamin B12 levels were statistically unrelated to chronicity of illness, these findings suggest a specific association between the timing of onset of first neurological symptoms of MS and vitamin B12 metabolism. In addition, since vitamin B12 is required for the formation of myelin and for immune mechanisms, we propose that its deficiency in MS is of critical pathogenetic significance.

Association between Anemia and Multiple Sclerosis

“…Among the various conditions suspected to be associated with MS, vitamin B12 deficiency and pernicious anemia have been extensively studied, confirming essentially their comorbidity [2,3,4,5]. Several case reports regarding drug-related hemolytic anemia in MS patients have also been described in the literature [6,7,8,9,10,11,12,13,14].…”

Vitamin B12 Intake Correlated to Physical and Mental Improvements in Multiple Sclerosis Specific Quality of Life

“…The serum B 12 levels of MS patients are lower than those seen in healthy individuals [6; 7], and multiple researchers have recommended further exploration of this connection. Previous findings have suggested there may be an association between the time of onset for the first neurological symptoms, and a person's vitamin B 12 status [8]. Vitamin B 12 and Folate serum levels are typically taken initially during introductory MS diagnosis to rule out nutritional micronutrient deficiencies [9].…”

Immunomodulation by vitamin B12: augmentation of CD8+ T lymphocytes and natural killer (NK) cell activity in vitamin B12-deficient patients by methyl-B12 treatment

“…Sandyk et al reported a relationship between vit.B12 and onset of multiple sclerosis (MS) [17]. They discussed the possibility of involvement of vit.B12 as a cause of MS through effects on immune system regulation.…”