Vitamin B12 deficiency is a relatively common disorder that can have devastating effects, ranging from neurologic deficits to hematologic problems. The incidence of this deficiency in the general population is 3-5%, while in persons over the age of 65, it is 5-20%. Canadian physicians in urban Toronto noticed the prevalence of symptoms of B12 deficiency in patients of South Asian descent (from India or Pakistan). In an article published in Canadian Family Physician (2004;50:743-747), the authors examined the incidence of vitamin B12 deficiency among their South Asian patient population.
They state, "The main causes of B12 deficiency include lack of intrinsic factor and other intestinal factors (eg, malabsorption), rare genetic disorders, and inadequate intake. Absorption problems (due to lack of intrinsic or intestinal factors) are thought to be the most common cause of B12 deficiency." Low intake is not as common a problem, except in lactovegetarians (vegetarians who avoid dairy). However, this dietary practice is commonly employed in patients with South Asian ancestry.
The results of their retrospective chart review showed that of the 482 South Asian patients with documented B12 levels, 222 (46%) had at least one deficient result. Furthermore, in patients over 65 years of age, 82% were deficient. They also showed that vegetarianism was a substantial risk factor. This study suggests that patients who are South Asian, vegetarian and/or elderly should be assessed for vitamin B12 deficiency. Replacement of vitamin B12 is simple and affordable and can prevent the negative consequences. Depending on the cause of the deficiency (inadequate intake versus absorption problems), vitamin B12 administration can be via mouth or intra-muscular injection.
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