Status of Vitamin B12 among Healthy Adult and Elderly Population in India: A Review

Abstract

Vitamin B₁₂ is a water soluble micronutrient found in animal foods. Its deficiency is not uncommon in India owing to vegetarianism but often unrecognized due to diverse clinical manifestations. This review aims to collate the current data on vitamin B₁₂ status in healthy Indian adult and elderly population. Online database Pubmed was searched for articles published in English between 2000 and 2019. Inclusion criteria consisted of original studies conducted on apparently healthy adult and elderly Indian population reporting serum/plasma vitamin B₁₂ levels. Comprehensive literature search identified 14 studies eligible for inclusion. The deficiency prevalence reached 78.5% and 61.7% among adults and elderly, respectively, based on varying cut offs. Higher vitamin B₁₂ levels were reported in women than men. Hyperhomocysteinemia (Hcy >15 μmol/L) was lower in females as compared to males (60% vs 90%, 14.9% vs 57.4% and 3.6% vs 20.9% respectively in three studies). Vitamin B₁₂ deficiency was higher in vegetarians. The results indicate that inadequate vitamin B₁₂ status is a wide spread problem in the Indian population. However, variety of laboratory methods and cut-offs of vitamin B₁₂ deficiency and the heterogeneity in results pose challenges to draw clear conclusions on the extent of vitamin B₁₂ deficiency in India. This review, therefore, highlights the need for more evidence based research to define age and sex specific cut offs for defining vitamin B₁₂ deficiency.

Keywords: Indian; cobalamin; geriatric; homocysteine; prevalence.