Summary
This narrative review, published in the New England Journal of Medicine, provides a comprehensive clinical overview of vitamin B12 deficiency, covering its epidemiology, pathophysiology, presenting symptoms, and therapeutic approaches. Stabler synthesises existing evidence on at-risk groups including older adults, vegetarians, vegans, and individuals with malabsorption conditions such as pernicious anaemia or post-gastric surgery. The paper is a widely cited clinical reference for understanding the systemic consequences of inadequate B12 status and guiding diagnostic and treatment decisions.
UK applicability
The clinical and diagnostic guidance in this review is broadly applicable to UK practice, particularly given rising numbers of individuals following plant-based diets and an ageing population at elevated risk of B12 malabsorption. UK dietary reference values and NHS prescribing practice for B12 supplementation align with the clinical context described.
Key measures
Serum vitamin B12 concentration (pmol/L or pg/mL); methylmalonic acid and homocysteine levels; haematological indices; neurological symptom presentation
Outcomes reported
The paper reviews the prevalence, aetiology, clinical manifestations, diagnostic criteria, and treatment of vitamin B12 deficiency across populations. It likely reports on haematological and neurological outcomes associated with deficiency, as well as serum biomarker thresholds used in diagnosis.
Topic tags
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