vitamin-b-12 and Asthenia

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Analysis of Variance; Asthenia; Bilirubin; Blood Pressure; Blood Proteins; Child; Clinical Trials as Topic; Dyspepsia; Feeding and Eating Disorders; Humans; Liver Extracts; Liver Function Tests; Middle Aged; Pyridoxine; Statistics as Topic; Vitamin B 12; Wit and Humor as Topic

Topics: Anemia, Pernicious; Asthenia; Disease Management; Humans; Jaundice; Male; Middle Aged; Pallor; Prognosis; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Approximately 15% of people aged more than 60 years old have a cobalamin (vitamin B12) deficiency, mainly in relation with food-cobalamin malabsorption (FCM). To date, no study has documented this disorder in the elderly. There is also little information on clinical consequences.. We studied 92 elderly patients with well-established FCM who were extracted from an observational cohort study (1995-2004) of 172 consecutive elderly patients with documented cobalamin deficiency.. The median patient age was 76 +/- 8 years; 60 patients were women. The most common clinical manifestations were neurologic or psychologic: mild sensory polyneuropathy (44.6%), confusion or impaired mental functioning (22.8%), and physical asthenia (20.7%). Hematologic abnormalities were reported in at least one third of the patients: anemia (21%), leukopenia (10.9%), thrombopenia (8.7%), and pancytopenia (6.5%). All patients had low serum vitamin B12 levels (<200 pg/mL), with a mean value (+/- standard deviation) of 131 +/- 38 pg/mL and total serum homocysteine level of 22.1 +/- 9.3 micromol/L. The mean hemoglobin level was 10.9 +/- 2.5 g/dL and the mean erythrocyte cell volume 95.7 +/- 12.7 fL. Correction of the serum vitamin B12 levels and hematologic abnormalities was achieved equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin.. This study suggests that in elderly patients, FCM may be associated with significant neurologic, psychologic, and hematologic abnormalities, which seem to respond equally well to either oral or parenteral vitamin B12 therapy.

Topics: Aged; Aged, 80 and over; Asthenia; Cognition Disorders; Cohort Studies; Confusion; Edema; Erythrocyte Indices; Female; Follow-Up Studies; Gastritis, Atrophic; Hematologic Diseases; Hemoglobins; Homocysteine; Humans; Jaundice; Malabsorption Syndromes; Male; Paresthesia; Polyneuropathies; Reflex, Abnormal; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Approximately 15% of people over 60 years old have a cobalamin (Cbl) deficiency in relation with a food-cobalamin malabsorption (FCM). But to date, only case reports or small series have been reported. The aim of this study was to describe the clinical characteristics of the FCM in old subjects.. Sixty patients, at least 65 years old, presenting a Cbl deficiency related to FCM, were extracted from a cohort study of the Hôpitaux universitaires de Strasbourg, France (n = 169). All these patients had an established diagnosis of Cbl deficiency and met the Carmel's criteria of FCM. Their clinical data were retrospectively analysed.. The median age of the 60 patients was 75 years and the female/male ratio was 2.3. The principal clinical symptoms were peripheral neuropathy (35%), confusion and dementia (30%) and anemia-related manifestations such as asthenia and edemas of the legs (20%). Average hemoglobin was 10.7 +/- 2.5 g/dl and average mean erythrocyte cell volume was 95.5 +/- 13.8 fl. There was an anemia, a leucopenia, a thrombocytopenia and a pancytopenia in respectively 27%, 18%, 15% and 8% of the cases. Average serum vitamin B(12) and homocystein levels were with 138 +/- 42 pg/ml and 22.5 +/- 15.2 micro mol/l. No patient had anti-intrinsic factor antibody and the Schilling's test was normal in all patients. Main disorders associated with FCM were atrophic gastritis (59%), long-term metformin or antiacid intake (17%), chronic alcohol intake (8%) and idiopathic FCM (n = 10). Sixteen patients have been successfully treated with oral crystalline cyanocobalamin (500 +/- 280 micro g/d).. This study shows that: firstly, the Cbl deficiency related to FCM may be responsible of severe neurological and hematologic manifestations in approximately 20% of the elderly patients; secondly, the disorders associated with the FCM are multiple in old age, with mainly atrophic gastritis; and thirdly, in clinical practice, oral cyanoCbl treatment may be successful.

Topics: Administration, Oral; Age Distribution; Aged; Aged, 80 and over; Asthenia; Carrier Proteins; Cohort Studies; Confusion; Diagnosis, Differential; Female; Food-Drug Interactions; France; Humans; Malabsorption Syndromes; Male; Middle Aged; Peripheral Nervous System Diseases; Retrospective Studies; Schilling Test; Sex Distribution; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Asthenia; Calcitonin; Female; Gangliosides; Humans; Kidney Transplantation; Male; Middle Aged; Nervous System Diseases; Paresthesia; Renal Dialysis; Restless Legs Syndrome; Uremia; Vitamin B 12

Topics: Acrylates; Adult; Anemia; Asthenia; Calcium; Chemical Phenomena; Chemistry, Physical; Creatinine; Female; Filtration; Humans; Kidneys, Artificial; Male; Membranes, Artificial; Middle Aged; Molecular Weight; Nitriles; Peritoneal Dialysis; Permeability; Polyneuropathies; Renal Dialysis; Succinates; Time Factors; Urea; Uremia; Uric Acid; Vitamin B 12

Topics: Anemia, Macrocytic; Animals; Asthenia; Body Weight; Diarrhea; Feeding and Eating Disorders; FIGLU Test; Folic Acid; Folic Acid Deficiency; Gingivitis; Humans; Leukopenia; Liver; Male; Malonates; Papio; Thrombocytopenia; Vitamin B 12

Topics: Adenosine; Adrenal Glands; Adult; Aged; Asthenia; Cytidine; Drug Combinations; Female; Guanosine; Hepatitis A; Humans; Liver; Liver Diseases; Liver Extracts; Liver Function Tests; Male; Middle Aged; Nucleosides; Tissue Extracts; Uridine; Vitamin B 12

Topics: Adult; Aged; Anemia; Asthenia; Body Weight; Cachexia; Chronic Disease; Cytidine; Diabetes Complications; Female; Heart Diseases; Humans; Hyperthyroidism; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; Vitamin B 12

Topics: Adjustment Disorders; Adrenal Cortex Hormones; Adult; Aged; Asthenia; Diabetes Complications; DNA; Drug Combinations; Female; Humans; Intrinsic Factor; Male; Middle Aged; Neurasthenia; Vitamin B 12

Topics: Age Factors; Aged; Asthenia; Blood Proteins; Body Weight; Coenzymes; Feeding and Eating Disorders; Humans; Metabolism; Vitamin B 12

Topics: Adjustment Disorders; Adolescent; Adrenal Cortex Hormones; Adult; Aged; Asthenia; Biliary Tract Diseases; Female; Gastrointestinal Diseases; Hematologic Diseases; Humans; Hypotension; Leukemia; Lung Diseases; Male; Middle Aged; Porphyrins; Pyridoxine; Urologic Diseases; Vitamin B 12

Topics: Aged; Amino Acids; Asthenia; Dementia; Depression; Female; Humans; Male; Memory Disorders; Protein Deficiency; Vitamin B 12

Topics: Adult; Aged; Asthenia; Coenzymes; Deficiency Diseases; Emaciation; Humans; Liver Diseases; Middle Aged; Neoplasms; Respiratory Tract Diseases; Vitamin B 12

Topics: Alcoholic Intoxication; Alcoholism; Anemia; Aspartic Acid; Asthenia; Humans; Liver Cirrhosis; Liver Diseases; Liver Extracts; Magnesium; Nutrition Disorders; Postoperative Care; Potassium; Vitamin B 12; Yeast, Dried

Topics: Amino Acids; Ascorbic Acid; Asthenia; Corrinoids; Glycine; Hematinics; Humans; Vitamin A; Vitamin B 12; Vitamin K; Vitamins

Topics: Amino Alcohols; Asthenia; Corrinoids; Depression; Humans; Niacin; Nicotinic Acids; Vitamin B 12; Vitamin B 6; Vitamin B Complex

Topics: Asthenia; Folic Acid; Humans; Pain Management; Thiamine; Vitamin B 12; Vitamin B Complex