Profile of Vitamin B12 Deficiency and Analysis of Contributory Factors among Inpatients in a Tertiary Care Hospital in Madurai, South India

BACKGROUND It is well known that Vitamin B12 deficiency is common among vegetarians as Vitamin B12 is obtained predominantly from animal sources. However, recent reports show that Vitamin B12 deficiency is becoming more common among nonvegetarians too and surprisingly the major factor attributing to this is found to be due to dietary deficiency. We hypothesized that this could also be due to the type of non-vegetarian food consumed, cooking methods, type of utensil used, and other modifiable risk factors like smoking, alcohol and diseases causing Vitamin B12 deficiency. We wanted to assess the proportion of vegetarians and nonvegetarians with vit. B12 deficiency and analyse the contributing factors among inpatients with vitamin B12 deficiency in a tertiary care hospital in South India. METHODS This observational, prospective study was done between June and September 2019 & involved 200 Vitamin B12 deficiency patients in the age group of 20 - 50 years of both the genders. Patients were identified after reviewing their medical records and laboratory tests for MCV, MCH, MCHC, Hb & vitamin B12. A detailed history of their food habits, practices & other relevant factors was obtained using a questionnaire. Statistical analysis was done using Mann Whitney U test. RESULTS There was no statistical difference (p = 0.379) in the vitamin B12 levels among vegetarians and non-vegetarians. 54.6 % of participants consumed poultry, 32.5 % consumed fruits & vegetables less than 4 times a week, 36 % & 42 % consumed fried & boiled food, 58 % used ever-silver vessels for cooking, 70.6 % used packaged milk, 23 % consumed alcohol & 21 % were smokers. CONCLUSIONS Vitamin B12 deficiency is common both among vegetarians and non-vegetarians. Among non-vegetarians, deficiency is seen more with poultry eaters, packaged milk consumers, with fried / boiled method of cooking using ever-silver vessels. Alcoholism, caffeinated beverages, smoking, presence of other diseases like diabetes, hypertension, peptic ulcer, drug intake also contributes to Vitamin B12 deficiency. KEYWORDS Vitamin B12 Deficiency, Non-Vegetarians, Vegetarians, Contributing Factors