Determination of Vitamin B12 Deficiency Status in Vegan and Non-Vegan Thais by Assessment of Homocysteine Level

Main Article Content

Sant Chaiyodsilp, MD
Sirada Phuriwattanapong, MD
Weerapong Chaiyaphak, MD
Somwong Chaiyodsilp, MD
Phasuk Pruisart, MSc

Abstract

OBJECTIVES: To determine vitamin B12 status, by using level of serum homocysteine, in three adult groups consisting of one hundred participants in each: (1) non-vegan; (2) ordinary vegan who consume vegan diets for less than twenty years; (3) high risk vegan who consume vegan diets for more than twenty years or those over 65 years old or those who have signs or symptoms suggesting vitamin B12 deficiency.


MATERIALS AND METHODS: This study is a descriptive cross sectional study designed to determine homocysteine level of the total 300 participants in vegan and non-vegan Thais performed in October 2018. The study used a Chemiluminescent microparticle immunoassay (CMIA) by Architec machine to determine their blood homocysteine level. Their level of homocysteine then was analyzed and compared with each other.


 RESULTS: 300 Thai participants(105 males & 195 females)  included in this study were 100 of non-vegans, 100 of ordinary vegans and 100 of high risk vegans. Among 100 non-vegans, there was only one (1%) who had high homocysteine level(more than 15.4 Umol/L.).  Among 100 ordinary vegans, fifty two (52%) had high homocysteine level while among 100 of high risk vegans, seventy of them (70%) had high homocysteine level. 


CONCLUSION: Vegan Thais have a higher risk of vitamin B12 deficiency as reflected in accumulation of their homocysteine in comparison with non vegans (p 0.001). We recommend that all strict Thai vegans should take vitamin B12 supplement regularly. The dosage recommended by the American Vegetarian Medical Association is 50-100 microgram per day or 500-1,000 microgram per week.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Chaiyodsilp, MD S, Phuriwattanapong, MD S, Chaiyaphak, MD W, Chaiyodsilp, MD S, Pruisart, MSc P. Determination of Vitamin B12 Deficiency Status in Vegan and Non-Vegan Thais by Assessment of Homocysteine Level. BKK Med J [Internet]. 2021Feb.27 [cited 2021Sep.24];17(1):15-9. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/216161
Section
Original Article

References

1.Allen, L.H. Causes of vitamin B12 and folate deficiency. Food Nutr. Bull. 2008, 29 (Suppl. 1), S20–S34.

2.Center for Disease Control and Prevention (CDC). Vitamin B12 Deficiency. Accessed on July10, 2018 at https://www.cdc.gov/ncbddd/b12/table6.html

3.Pennypacker LC, Allen RH, Kelly JP, Matthews LM, Grigsby J, Kaye K, et al. High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992;40:1197–204.

4.Majchrzak D., Singer I., Manner M., Rust P., Genser D., Wagner K.H., Elmadfa I. B-vitamin status and concentrations of homocysteine in Austrian omnivores, vegetarians and vegans. Ann. Nutr. Metab. 2006;50:485–491.

5.Bissoli L., di Francesco V., Ballarin A., Mandragona R., Trespidi R., Brocco G., Caruso B., Bosello O., Zamboni M. Effect of vegetarian diet on homocysteine levels. Ann. Nutr. Metab. 2002;46:73–79. doi: 10.1159/000057644.

6.Koebnick C., Hoffmann I., Dagnelie P.C., Heins U.A., Wickramasinghe S.N., Ratnayaka I.D., Gruendel S., Lindemans J., Leitzmann C. Long-term ovo-lactovegetarian diet impairs vitamin B-12 status in pregnant women. J. Nutr. 2004;134:3319–3326.

7.Hokin B.D., Butler T. Cyanocobalamin (vitamin B-12) status in the seventh-day advenstist ministers in Australia. Am. J. Clin. Nutr. 1999;70(Suppl. 3):576S–578S. doi: 10.1001/jamainternmed.2013.6473

8.Oberley MJ, Yang DT. Laboratory testing for cobalamin deficiency in megaloblastic anemia. Am J Hematol 2013; 88:522.

9.Amos R, Dawson D, Fish D, Leeming R, Linnell J. Guidelines on the investigation and diagnosis of cobalamin and folate deficiencies. A publication of the British Committee for Standards in Haematology. BCSH General Haematology Test Force. Clin Lab Haematol. 1994 Jun;16(2):101-15.

10.Savage DG, Lindenbaum J, Stabler SP, Allen RH. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994;96:239–46.

11. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol. 1990;34:99–107.

12. Key TJ, Appleby PN, Davey GK, Allen NE, Spencer EA, Travis RC. Mortality in British vegetarians: review and preliminary results from EPIC-Oxford. Am J Clin Nutr. 2003 Sep; 78(3 Suppl):533S-538S.

13. Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J, McPherson K. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999 Sep; 70(3 Suppl):516S-524S.

14. Orlich MJ, MD, Singh PN et. al, Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Intern Med. 2013 Jul 8; 173(13): 1230–1238. doi: 10.1001/jamainternmed.2013.6473

15. Oberley MJ, Yang DT. Laboratory testing for cobalamin deficiency in megaloblastic anemia. Am J Hematol 2013; 88:522.

16. Amos R, Dawson D, Fish D, Leeming R, Linnell J. Guidelines on the investigation and diagnosis of cobalamin and folate deficiencies. A publication of the British Committee for Standards in Haematology. BCSH General Haematology Test Force. Clin Lab Haematol. 1994 Jun;16(2):101-15.

17. Savage DG, Lindenbaum J, Stabler SP, Allen RH. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994;96:239–46.

18. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol. 1990;34:99–107.

19. Duangkamol Virunudomphol, Phokporn Hanrungroj, Siriwan Triayakulkul, Saowanee Kanchanachumpon. Vitamin B12 levels, folate and homocysteine in smokers and non-smokers who receiving cigarette smoke. Journal of Medical Technology. No.41 Issue: 3. December 2013.

20. Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, et al. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988;318:1720–8.

21. Zittoun J. Anemias due to disorder of folate, vitamin B12 and transcobalamin metabolism. Rev Prat. 1993 Jun 1; 43(11):1358-63.

22. Wilcken DE1, Wilcken B. B vitamins and homocysteine in cardiovascular disease and aging. Ann N Y Acad Sci. 1998 Nov 20;854:361-70.