Factors correlating to the propensity of general practitioners to substitute borderline vitamin B12 deficiency (original) (raw)
Related papers
An FGD Report on Vitamin B12 Deficiency in Medical Professionals
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Vitamin B12 Deficiency has become an important health concern in the recent times. Acknowledging the health of medical professionals shall improve the health status of the community as they form a classified population of the society. The present study was done with an aim to assess the treatment seeking behavior of the doctors in RNT Medical College, Udaipur who were found deficient in Vitamin B12 levels. Material and methods: Two focused group discussions were conducted in the department of Community Medicine with a strength of 13 and 17 each, few pre-decided questions were asked to the groups by the moderator and answers were reported by the recorder in the form of tally sheets. Results: Maximum doctors were interested in taking Oral treatment by self, most of them were consuming Reverse Osmosis water and most common clinical feature they expressed were weakness and fatigue. Conclusion: Vitamin B12 deficiency is becoming a silent epidemic which needs to be addressed as it is affecting all the groups of the society and thus further large scale multicentric studies are needed to address this issue at the global level.
Food and Nutrition Bulletin, 2024
Background: Vitamin B12 deficiency is a critical medical condition that, if left untreated, can lead to severe symptoms and potentially serious and life-threatening complications. Clinical guidelines are designed to provide a standardized approach to diagnosis and treatment, aiming for consistency and effectiveness. However, it is well-established that not all patients fit into general guidelines. Objective: To investigate the clinical relevance of the submitted research to support these protocols for diagnosing and treating a B12 deficiency. Approach: Conducting a literature review of the references focused and used on diagnosing and treating vitamin B12 deficiency in adults and children. Results: No robust clinical trial nor RCT has been found to back up the current protocols. The research used is primarily based on assumptions rather than solid clinical evidence. Conclusion: Existing guidelines for vitamin B12 deficiency need to be significantly revised and improved through clinical research and clinical experience by experts in the field with input from patient groups worldwide.
The prevalence of vitamin B12 deficiency in a random sample from the Australian population
Journal of Investigational Biochemistry, 2014
Objective: Vitamin B 12 deficiency is common in older adults, and may increase the risk of cognitive impairment. The distribution of vitamin B 12 insufficiency in younger age groups is less studied. This study aims to assess the prevalence of vitamin B 12 deficiency (<156 ρmol/L) and subclinical low-normal levels (156-250 ρmol/L) in a large, random sample of the Australian population across the adult life span. Methods: We examined serum vitamin B 12 levels in a random sample of 1085 men and 1125 women aged 20-97 years between 1994 and 2006; in the Barwon statistical division, a regional area in southeastern Australia that is representative of the socioeconomic status of the Australian population. Results: The age-standardized prevalence of vitamin B 12 deficiency in this cohort of men and women was 3.6%. Subclinical low-normal vitamin B 12 levels (156-250 ρmol/L) were found in 26%. Serum vitamin B 12 levels declined with age among men (P < 0.001) and were lower in men than women (P < 0.001). Vitamin B 12 levels were higher among supplements users (8.0% of the cohort). Conclusions: Vitamin B 12 levels decline with age, and have been associated with neurodegenerative diseases and cognitive decline. Early intervention by diet education or supplement use to address this age-associated decline in vitamin levels may be an effective strategy to prevent cognitive decline in a significant segment of the population. Such intervention may need to start in mid-life (from 50-years of age) before the onset of age-related decline in vitamin B 12 levels.
Evaluation of Vitamin Prescribing by Physicians at a University Hospital
Ankara Medical Journal
Objectives: Vitamins are frequently included in physicians' prescriptions. Our study aims to determine the physicians' knowledge about vitamins and nutrition, detect the factors affecting their vitamin prescribing, and gain information about their vitamin prescribing behaviors. Materials and Methods: Our study included 368 physicians who volunteered to participate in the study. We prepared and used a questionnaire, which consisted of 7 questions about sociodemographic data, 13 questions about nutrition knowledge, 13 questions about physicians' attitudes towards prescribing vitamins, and seven questions about the factors affecting the vitamin prescribing behaviors of physicians. Results: The most frequently recommended supplements by physicians were vitamin D (62.50%), vitamin C (56.25%), and vitamin B12 (54.89%). Physicians with 11 years or more years in the profession (p<0.001) and internal medical sciences physicians (p<0.001) gave more correct answers to the knowledge questions. About the frequency of prescribing and recommending vitamins to their patients as supplements, 93 (25.27%) participants said they never did that, 242 (65.76%) said they rarely did that, and 33 (8.97%) said they frequently did that. 90 physicians (24.46%) stated that they prescribed vitamins only upon the patient's request. Only 37 (10.05%) participants considered themselves competent in terms of nutrition knowledge about vitamins. Female physicians used vitamin supplements more (p<0.001). Moreover, 305 (82.88%) physicians said that patients who requested vitamin supplements were mostly women. Conclusion: We found that the majority of our participants gave a negative response to the requests to prescribe vitamins as supplements. Participants considered themselves lacking in nutrition knowledge about vitamins.
Public Health Nutrition, 2009
ObjectiveTo explore the association between vitamin B12 (B12)-containing supplement use, low B12 concentrations and biochemically defined B12 deficiency in US adults.DesignA cross-sectional study with adjustment for survey design. Prevalence ratios for two age groups (18–50 and >50 years) were estimated using unconditional logistic models. Outcome measures included prevalence of low serum B12 concentration (<148 pmol/l) and biochemical B12 deficiency (serum B12 < 148 pmol/l with concomitant homocysteine > 10 μmol/l).SettingA population survey of health and nutritional measures.SubjectsSubjects were non-institutionalized adults, aged 18 years and older, who participated in Phase 2 of NHANES III (Third National Health and Nutrition Examination Survey).ResultsLow B12 concentrations were less prevalent among persons consuming B12-containing supplements (P = 0·001) with an adjusted prevalence ratio of 0·6 (95 % CI 0·3, 1·0). Biochemical B12 deficiency showed a similar trend (...
2012
Background: The oral administration of vitamin B12 offers a potentially simpler and cheaper alternative to parenteral administration, but its effectiveness has not been definitively demonstrated. The following protocol was designed to compare the effectiveness of orally and intramuscularly administered vitamin B12 in the treatment of patients ≥65 years of age with vitamin B12 deficiency. Methods/design: The proposed study involves a controlled, randomised, multicentre, parallel, non-inferiority clinical trial lasting one year, involving 23 primary healthcare centres in the Madrid region (Spain), and patients ≥65 years of age. The minimum number of patients required for the study was calculated as 320 (160 in each arm). Bearing in mind an estimated 8-10% prevalence of vitamin B12 deficiency among the population of this age group, an initial sample of 3556 patients will need to be recruited. Eligible patients will be randomly assigned to one of the two treatment arms. In the intramuscular treatment arm, vitamin B12 will be administered as follows: 1 mg on alternate days in weeks 1 and 2, 1 mg/week in weeks 3-8,and
Food and Nutrition Bulletin, 2024
Abstract Background: It is difficult to recognize vitamin B12 deficiency and to evaluate the effect of B12 treatment due to a broad range of variable clinical symptoms overlapping with other diseases and diagnostic biomarkers that quickly normalize during treatment. This poses a risk of delay in diagnosis and a challenge to uniformly monitor the effect of B12 treatment. There is a need for a new clinical outcome measure suitable for clinical practice and clinical evaluation studies. Objective: To develop a Patient-Reported Outcome Measure (PROM) which measures the severity of vitamin B12 deficiency symptoms. Methods: The B12 PROM was developed by (1) gathering input from experts and literature review to define a construct and develop a conceptual model, (2) processing input from health care providers, scientists, and patients to develop items and response options, and (3) improving items based on the feedback from laypersons, test interviews, semi-structured cognitive interviews with patients, and forward and backward translation (ENG-NL). Results: The B12 PROM includes 62 items grouped into 8 categories of symptoms related to vitamin B12 deficiency (General, Senses, Thinking, In limbs and/or face, Movement, Emotions, Mouth & Abdomen, Urinary tract & Reproductive organs). Cognitive interviews demonstrated good comprehensibility and comprehensiveness. Conclusions: This study is the first step in the development of a disease-specific PROM for vitamin B12 deficiency to measure the burden of symptoms. Further validation and reliability testing are necessary before the PROM can be applied in clinical practice and research.