Post by kickingfrog on Mar 1, 2011 14:05:34 GMT
Causes of vitamin B12 or folate deficiency anaemia
Vitamin B12 deficiency and folate deficiency can be caused by a number of different factors. These factors can cause anaemia because they affect the body’s ability to produce fully functioning red blood cells (cells that carry oxygen around the body).
Some possible causes of vitamin B12 deficiency and folate deficiency are described below.
......
Vitamin B12 deficiency
Vitamin B12 deficiency can also be caused by a number of other factors, ....
Diet
The body usually stores enough vitamin B12 to last for approximately two to four years.
.......
Conditions affecting the intestines
Some conditions that affect your intestines (part of the digestive system) stop you from absorbing as much vitamin B12 as normal.
For example, Crohn's disease (a long-term condition that causes inflammation of the lining of the digestive system) can sometimes result in your body not having enough vitamin B12.
.......
Malabsorption
Sometimes your body may be unable to absorb folate as effectively as it should. This is usually the result of an underlying condition affecting your digestive system, such as irritable bowel syndrome (IBS) (a long-term disorder that causes abdominal pain, diarrhoea and constipation).
.....
www.nhs.uk/Conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Causes.aspx
************************
Am J Gastroenterol. 2001 Mar;96(3):745-50.
Vitamin B12 deficiency in untreated celiac disease.
Dahele A, Ghosh S.
Department of Medical Sciences, University of Edinburgh, Western General Hospital, Scotland.
Abstract
OBJECTIVES: Iron and folate malabsorption are common in untreated celiac disease as the proximal small intestine is predominantly affected. Vitamin B12 deficiency is thought to be uncommon, as the terminal ileum is relatively spared. This study aims to investigate the prevalence of vitamin B12, deficiency in patients with untreated celiac disease.
METHODS: Prospective study of 39 consecutive biopsy-proven celiac disease patients (32 women, seven men; median age 48 yr, range 22-77 yr) between September 1997 and February 1999. The full blood count, serum vitamin B12, red blood cell folate, and celiac autoantibodies (IgA antigliadin and IgA antiendomysium antibodies) were measured before and after a median of 4 months (range 2-13 months) of treatment with a gluten-free diet. In vitamin B12-deficient patients, intrinsic factor antibodies and a Schilling test, part 1, were performed.
RESULTS: A total of 16 (41%) patients were vitamin B12 deficient (<220 ng/L) and 16 (41%) patients (11 women and live men) were anemic. Concomitant folate deficiency was present in only 5/16 (31%) of the vitamin B12 patients.
The Schilling test, performed in 10 of the vitamin B12-deficient patients, showed five low and five normal results.
Although only five patients received parenteral vitamin B12, at follow-up the vitamin B12 results had normalized in all patients.
Acral paraesthesia at presentation in three vitamin B12-deficient patients resolved after vitamin B12 replacement.
CONCLUSIONS:
Vitamin B12 deficiency is common in untreated celiac disease, and concentrations should be measured routinely before hematinic replacement.
Vitamin B12 concentrations normalize on a gluten-free diet alone, but symptomatic patients may require supplementation.
PMID: 11280545 [PubMed - indexed for MEDLINE]
****************
Aliment Pharmacol Ther. 2009 Apr 15;29(8):811-6. Epub 2008 Jan 20.
Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet.
Hallert C, Svensson M, Tholstrup J, Hultberg B.
Coeliac Centre, Norrköping Hospital, Norrköping, Sweden. Claes.Hallert@lio.se
Abstract
BACKGROUND: Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status.
AIM: To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease.
METHODS: In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45-64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status.
RESULTS: Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 micromol/L (7.4-23.0), significantly higher than in matched population controls [10.2 micromol/L (6.7-22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being.
CONCLUSIONS: Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.
PMID: 19154566 [PubMed - indexed for MEDLINE
***********
Titre du document / Document title
Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis
Auteur(s) / Author(s)
DICKEY William (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Gastroenterology, Altnagelvin Hospital, Londonderry, ROYAUME-UNI
Résumé / Abstract
Objective Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported.
This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis.
Design Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients.
Setting Gastroenterology department of a large district general hospital.
Interventions If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion.
Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured.
Main outcome measures
Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12.
Results Of 159 patients, 13 had low serum B12 at diagnosis.
A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients).
Only 2/ 19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia.
There was no relationship between low B12 and clinical characteristics.
Conclusions
Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started.
Revue / Journal Title
European journal of gastroenterology & hepatology ISSN 0954-691X
Source / Source
2002, vol. 14, no4, pp. 425-427 (17 ref.)
Langue / Language
Anglais
Editeur / Publisher
Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS (1989) (Revue)
******************
Scand J Gastroenterol. 1988 Nov;23(9):1105-8.
Selective vitamin B12 malabsorption in adult coeliac disease.
Report on three cases with associated autoimmune diseases.
Stene-Larsen G, Mosvold J, Ly B.
Medical Dept., Lovisenberg Hospital, Olso, Norway.
Abstract
Three cases of adult coeliac disease with severe vitamin B12 deficiency not accompanied by folate or iron depletion are presented.
Two of the patients had the extremely rare combination of coeliac disease and lack of intrinsic factor and autoimmune thrombocytopenic purpura.
A close association between coeliac disease and autoimmunity is indicated by the development of autoimmune thyroiditis in the third patient.
Vitamin B12 malabsorption caused by coeliac disease is emphasized as a pathogenetic mechanism of megaloblastic anaemia.
PMID: 3247590 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/3247590
*****************
Vitamin B12 deficiency and folate deficiency can be caused by a number of different factors. These factors can cause anaemia because they affect the body’s ability to produce fully functioning red blood cells (cells that carry oxygen around the body).
Some possible causes of vitamin B12 deficiency and folate deficiency are described below.
......
Vitamin B12 deficiency
Vitamin B12 deficiency can also be caused by a number of other factors, ....
Diet
The body usually stores enough vitamin B12 to last for approximately two to four years.
.......
Conditions affecting the intestines
Some conditions that affect your intestines (part of the digestive system) stop you from absorbing as much vitamin B12 as normal.
For example, Crohn's disease (a long-term condition that causes inflammation of the lining of the digestive system) can sometimes result in your body not having enough vitamin B12.
.......
Malabsorption
Sometimes your body may be unable to absorb folate as effectively as it should. This is usually the result of an underlying condition affecting your digestive system, such as irritable bowel syndrome (IBS) (a long-term disorder that causes abdominal pain, diarrhoea and constipation).
.....
www.nhs.uk/Conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Causes.aspx
************************
Am J Gastroenterol. 2001 Mar;96(3):745-50.
Vitamin B12 deficiency in untreated celiac disease.
Dahele A, Ghosh S.
Department of Medical Sciences, University of Edinburgh, Western General Hospital, Scotland.
Abstract
OBJECTIVES: Iron and folate malabsorption are common in untreated celiac disease as the proximal small intestine is predominantly affected. Vitamin B12 deficiency is thought to be uncommon, as the terminal ileum is relatively spared. This study aims to investigate the prevalence of vitamin B12, deficiency in patients with untreated celiac disease.
METHODS: Prospective study of 39 consecutive biopsy-proven celiac disease patients (32 women, seven men; median age 48 yr, range 22-77 yr) between September 1997 and February 1999. The full blood count, serum vitamin B12, red blood cell folate, and celiac autoantibodies (IgA antigliadin and IgA antiendomysium antibodies) were measured before and after a median of 4 months (range 2-13 months) of treatment with a gluten-free diet. In vitamin B12-deficient patients, intrinsic factor antibodies and a Schilling test, part 1, were performed.
RESULTS: A total of 16 (41%) patients were vitamin B12 deficient (<220 ng/L) and 16 (41%) patients (11 women and live men) were anemic. Concomitant folate deficiency was present in only 5/16 (31%) of the vitamin B12 patients.
The Schilling test, performed in 10 of the vitamin B12-deficient patients, showed five low and five normal results.
Although only five patients received parenteral vitamin B12, at follow-up the vitamin B12 results had normalized in all patients.
Acral paraesthesia at presentation in three vitamin B12-deficient patients resolved after vitamin B12 replacement.
CONCLUSIONS:
Vitamin B12 deficiency is common in untreated celiac disease, and concentrations should be measured routinely before hematinic replacement.
Vitamin B12 concentrations normalize on a gluten-free diet alone, but symptomatic patients may require supplementation.
PMID: 11280545 [PubMed - indexed for MEDLINE]
****************
Aliment Pharmacol Ther. 2009 Apr 15;29(8):811-6. Epub 2008 Jan 20.
Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet.
Hallert C, Svensson M, Tholstrup J, Hultberg B.
Coeliac Centre, Norrköping Hospital, Norrköping, Sweden. Claes.Hallert@lio.se
Abstract
BACKGROUND: Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status.
AIM: To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease.
METHODS: In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45-64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status.
RESULTS: Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 micromol/L (7.4-23.0), significantly higher than in matched population controls [10.2 micromol/L (6.7-22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being.
CONCLUSIONS: Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.
PMID: 19154566 [PubMed - indexed for MEDLINE
***********
Titre du document / Document title
Low serum vitamin B12 is common in coeliac disease and is not due to autoimmune gastritis
Auteur(s) / Author(s)
DICKEY William (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Gastroenterology, Altnagelvin Hospital, Londonderry, ROYAUME-UNI
Résumé / Abstract
Objective Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported.
This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis.
Design Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients.
Setting Gastroenterology department of a large district general hospital.
Interventions If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion.
Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured.
Main outcome measures
Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12.
Results Of 159 patients, 13 had low serum B12 at diagnosis.
A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients).
Only 2/ 19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia.
There was no relationship between low B12 and clinical characteristics.
Conclusions
Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started.
Revue / Journal Title
European journal of gastroenterology & hepatology ISSN 0954-691X
Source / Source
2002, vol. 14, no4, pp. 425-427 (17 ref.)
Langue / Language
Anglais
Editeur / Publisher
Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS (1989) (Revue)
******************
Scand J Gastroenterol. 1988 Nov;23(9):1105-8.
Selective vitamin B12 malabsorption in adult coeliac disease.
Report on three cases with associated autoimmune diseases.
Stene-Larsen G, Mosvold J, Ly B.
Medical Dept., Lovisenberg Hospital, Olso, Norway.
Abstract
Three cases of adult coeliac disease with severe vitamin B12 deficiency not accompanied by folate or iron depletion are presented.
Two of the patients had the extremely rare combination of coeliac disease and lack of intrinsic factor and autoimmune thrombocytopenic purpura.
A close association between coeliac disease and autoimmunity is indicated by the development of autoimmune thyroiditis in the third patient.
Vitamin B12 malabsorption caused by coeliac disease is emphasized as a pathogenetic mechanism of megaloblastic anaemia.
PMID: 3247590 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/3247590
*****************