vitamin-b-12 and Anorexia-Nervosa

Calcium and vitamin D are the mainstays of nutritional intervention for the prevention and treatment of osteoporosis. However, conditions that alter nutritional status as well as other nutrients should be considered when diagnosing and treating osteoporosis and osteopenia. Current research supports the early diagnosis and treatment of anorexia nervosa to prevent associated bone loss and increased risk of fracture. Weight restoration in patients with anorexia nervosa is central to bone mass stabilization. Other nutritional considerations include nutrients such as vitamin B-12 and vitamin K that may reduce fracture risk by increasing bone mineral density as well as the improvement of bone microarchitecture. Diets high in fruits and vegetables contribute nutrients such as magnesium associated with bone health and may also produce an alkaline environment, reducing calcium excretion and thus improving bone density.

Topics: Anorexia Nervosa; Bone Density; Diet; Dietary Supplements; Fruit; Homocysteine; Humans; Nutritional Requirements; Osteoporosis; Randomized Controlled Trials as Topic; Vegetables; Vitamin B 12; Vitamin K

Topics: Alanine Transaminase; Anorexia Nervosa; Biomarkers; Female; gamma-Glutamyltransferase; Humans; Liver; Transcobalamins; Vitamin B 12; Vitamins

Vitamin B12 (B12) deficiency is known to be associated with various neurological manifestations. Although central manifestations such as dementia or subacute combined degeneration are the most classic, neurological manifestations also include sensory neuropathies. However, B12 deficiency is still rarely integrated as a potential cause of sensory neuronopathy. Moreover, as many medical conditions can falsely normalize serum B12 levels even in the context of a real B12 deficiency, some cases may easily remain underdiagnosed. We report the illustrating case of an anorexic patient with sensory neuronopathy and consistently normal serum B12 levels. After all classical causes of sensory neuronopathy were ruled out, her clinical and electrophysiological conditions first worsened after folate administration, but finally improved dramatically after B12 administration. B12 deficiency should be systematically part of the etiologic workup of sensory neuronopathy, especially in a high risk context such as anorexia nervosa.

Topics: Adult; Anorexia Nervosa; Female; Folic Acid; Humans; Motor Neuron Disease; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin E

Anorexia nervosa (AN) is a complex disorder involving severe psychological manifestations and multiple organ damage, including liver dysfunction. The primary aim of this study consisted in assessing plasma levels of vitamin B12 and folates with respect to liver function enzymes considering the liver-storage properties of this vitamin.. We recruited 70 restrictive type AN adolescents and the severity of psychopathological traits was assessed using EDI-3 scale. Plasma levels of vitamin B12 , folates, transaminases (AST, ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and cholinesterase (CHE) were determined.. About 38.5% of patients displayed vitamin B12 values (H-B12) above the upper range of normal reference; 4.3% of patients had increased values of folates; 20 and 11.4% of patients displayed ALT and AST values above reference limits; none had GGT values above normal range. Albeit low CHE and ALP values were found in 55 and 20% of patients, respectively, a linear correlation with both transaminases was present only for vitamin B12 and folates; furthermore, H-B12 patients had both higher AST and ALT values. EDI- 3 subscores significantly correlated with vitamin B12 and folates plasma values and H-B12 patients displayed EDI-3 higher values.. These data suggest that plasma levels of vitamin B12 might be an early marker of liver dysfunction, possibly also related to more severe psychopathological aspects. The identification of patients with higher fasting plasma vitamin B12 levels could therefore lead to earlier and more careful refeeding interventions. Further studies will clarify the potential role of this vitamin in AN clinical practice.

Topics: Adolescent; Anorexia Nervosa; Biomarkers; Child; Esterases; Female; Folic Acid; Humans; Liver; Liver Diseases; Liver Function Tests; Male; Transferases; Vitamin B 12

Like any other patient, a schizophrenic patient can get a physical illness, too. As such patients tend to ignore reality and neglect themselves and are stigmatized by society, due to which their physical symptomatology is often ignored, physical illness can remain undetected. If the schizophrenic patient is observed and adequate care is provided by the family, family doctor and a psychiatrist, it is possible to recognize the physical illness and intervene promptly. We are presenting a case of a female patient who has been treated for schizophrenia for a number of years. The treatment was mostly ambulatory (i.e. the patient was hospitalized twice) and consisted of first-generation antipsychotics. During the past two years, for reasons unknown, the patient stopped taking regular meals and as a result lost significant body weight, became apathetic and withdrawn, started avoiding social contacts and neglected personal hygiene. She reportedly took the psychopharmaca regularly, but rarely attended psychiatric follow-up consultations. Due to substantial weight loss and hypotonia, correction of antipsychotic was made and internist treatment administered. The choice of olanzapine was not an accidental one. We decided to take advantage of its side effect for the treatment of an anorectic syndrome. Interdisciplinary cooperation proved to be a justified decision.

Topics: Adult; Anorexia Nervosa; Antipsychotic Agents; Apathy; Benzodiazepines; Comorbidity; Cooperative Behavior; Disease Progression; Dose-Response Relationship, Drug; Drug Substitution; Drug Therapy, Combination; Female; Humans; Interdisciplinary Communication; Mobility Limitation; Olanzapine; Paroxetine; Schizophrenia; Schizophrenic Psychology; Social Isolation; Vitamin B 12; Weight Loss

The measurement of plasma total-homocysteine (tHcy) as a marker of folate and cobalamin status in patients with anorexia nervosa.. Plasma tHcy, folate, cobalamin and other determinants of tHcy of a random group of patients with anorexia nervosa were compared with our own reference values.. The study was performed at the tertiary children's Hospital Sant Joan de Déu.. All the female adolescents (n=43) coming to the Hospital during a one-year period, who were diagnosed with anorexia nervosa. Reference values for tHcy were simultaneously performed with apparently healthy adolescents (by history and analytical data) who underwent presurgical analysis for minor interventions, and other magnitudes we used our own reference values.. Plasma tHcy was measured by reverse phase HPLC with fluorescence detection of the SBDF derivatives. Folate and cobalamin concentrations were determined by radioimmunoassay.. tHcy was significantly increased in anorexic patients compared to reference values (Mann-Whitney, P < 0.0001-0.001). Values were above reference range in 34% of patients, and high-normal range in 53% of patients. tHcy concentrations lowered in 8 and 11 patients after nutritional rehabilitation. Cobalamin and folate were in the reference range except for one case. No significant correlation was found among tHcy, vitamins and other determinants of tHcy concentration.. tHcy concentrations appear significantly increased in adolescents with anorexia nervosa, most probably owing to subclinical folate deficiency. This might be caused by both, intracellular folate deficiency and impaired availability. Abnormal plasma tHcy values were completely corrected after nutritional rehabilitation.

Topics: Adolescent; Aging; Anorexia Nervosa; Child; Chromatography, High Pressure Liquid; Creatinine; Female; Folic Acid; Homocysteine; Humans; Reference Values; Vitamin B 12

The first case of polyglandular autoimmune syndrome (PAS) in a patient with anorexia nervosa is reported. The association of pernicious anemia with vitiligo and endocrine hypofunction (PAS) is reviewed. Eating disorder patients with B12 deficiency who have vitiligo or a history of endocrine hypofunction should have a Schilling test to exclude pernicious anemia.

Topics: Adult; Anemia, Pernicious; Anorexia Nervosa; Diagnosis, Differential; Female; Humans; Polyendocrinopathies, Autoimmune; Vitamin B 12

A 32-year-old patient with anorexia nervosa since adolescence was admitted because of diffuse bone pain, increasing during the 2 preceding winters. She had a special aversion to dairy products and all forms of dietary fat. Low normal serum calcium and very low calciuria were noted, with a highly elevated bone fraction of alkaline phosphatase, and severe hypovitaminosis D and B12. Apart from a recent spontaneous fracture of the clavicle, Looser lines and pseudofractures were noted in a finger, fibula and malleolus. In particular, magnetic resonance imaging of the knee showed additional evidence of a pseudofracture in the femur, and medullary changes were found. Evidence for secondary hyperparathyroidism was described. Apart from the well known occurrence of osteoporosis, our case shows that osteomalacia may exceptionally occur in anorexia nervosa.

Topics: Adult; Alkaline Phosphatase; Anorexia Nervosa; Bone and Bones; Calcium; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Osteomalacia; Osteoporosis; Radionuclide Imaging; Vitamin B 12; Vitamin D

The effects of carnitine and cobamamide were studied at the unspecific stage of anorexia nervosa treatment. Carnitine and cobamamide accelerated the amelioration of the patients' somatic state (body weight gain, gastrointestinal functions normalization). Experimental psychological technique of involved deciphering discovered that latent fatigue disappeared and mental performance sharply increased under carnitine and cobamamide treatment. Experimental model of anorexia nervosa was used for electron microscopy and morphometry of neocortical tissue structure after starvation period and in feeding rehabilitation with carnitine and cobamamide. These drugs were shown to promote cerebral mass growth, increase in neocortical layers thickness, pyramidal neurons volume, that led to full restoration of normal structure of neocortex. The data provide a basis suitable to recommend carnitineand cobamamide to treat patients with relevant anorexia.

Topics: Animals; Anorexia Nervosa; Body Weight; Carnitine; Cerebral Cortex; Disease Models, Animal; Drug Evaluation, Preclinical; Drug Synergism; Drug Therapy, Combination; Mice; Mice, Inbred CBA; Microscopy, Electron; Organ Size; Vitamin B 12

Topics: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Adolescent; Adult; Agranulocytosis; Anemia; Anorexia Nervosa; Blood Platelet Disorders; Blood Volume; Bone Marrow; Bone Marrow Cells; Bone Marrow Diseases; Female; Folic Acid; Glycosaminoglycans; Hematopoiesis; Hemolysis; Humans; Iron; Lymphopenia; Starvation; Vitamin B 12

Topics: Adult; Aged; Anorexia Nervosa; Cobamides; Coenzymes; Drug Combinations; Evaluation Studies as Topic; Feeding and Eating Disorders; Female; Humans; Liver Diseases; Male; Middle Aged; Polyneuropathies; Pyridoxal Phosphate; Thiamine; Thiamine Pyrophosphate; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Macrocytic; Anemia, Pernicious; Anorexia Nervosa; Bone Marrow Examination; Child; Female; Folic Acid; Folic Acid Deficiency; Histamine; Humans; Male; Mass Screening; Mental Disorders; Middle Aged; Neurocognitive Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Anorexia Nervosa; Blood; Blood Proteins; Body Weight; Cobamides; Coenzymes; Evaluation Studies as Topic; Feeding and Eating Disorders; Female; Gastrointestinal Diseases; Hemoglobinometry; Humans; Liver Diseases; Male; Middle Aged; Neoplasms; Respiratory Tract Diseases; Vitamin B 12

Topics: Adolescent; Animals; Anorexia Nervosa; Body Weight; Child, Preschool; Cobalt; Coenzymes; Feeding and Eating Disorders; Female; Humans; Imidazoles; Infant; Infant, Newborn; Male; Proteins; Rabbits; Rats; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Anorexia Nervosa; Ascorbic Acid; Avitaminosis; Celiac Disease; Deficiency Diseases; Diet; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Sprue, Tropical; United Kingdom; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins; Vomiting

Topics: 17-Ketosteroids; Anorexia Nervosa; Cortisone; Endotoxins; Hematinics; Hepatitis; Liver Diseases; Liver Glycogen; Liver Regeneration; Mental Disorders; Stress, Physiological; Toxicology; Vitamin B 12

Topics: Anorexia; Anorexia Nervosa; Corrinoids; Gastric Juice; Hematinics; Humans; Intrinsic Factor; Reserpine; Thiamine; Vitamin B 12; Vitamins