Research article

Study of the Relationship of Vitamins B12 Deficiency and Effect on Children

Noor Nemia Hafed

Biology Department, College of Science, University of Waist, Iraq.

Received | June 27, 2024 Accepted | July 10, 2024; Published | July 25, 2024

*Correspondence | Noor Nemia Hafed, Biology Department, College of Science, University of Waist, Iraq; Email: qaisrlahhob@gmail.com

Citation: Hafed NN (2024). Study of the relationship of vitamins b12 deficiency and effect on children. S. Asian J. Life Sci. 12: 53-58.

DOI | http://dx.doi.org/10.17582/journal.sajls/2024/12.53.58

ISSN | 2311–0589

Introduction

A child normally gains about 5 pounds in weight and two to three inches in height from the time they are one year old until they reach adolescence. Children during this time spontaneously alter their dietary intake to match during periods of rapid growth they consume more food. Than during slow periods and during periods of rapid growth they appear to be voracious at times, but not always they appear to survive on water and air growing steadily as a youngster involves gradually the demand for all vitamins and minerals is rising. Unfortunately, some time children’s food lacks essential nutrients diets are occasionally and not usually regularly absolutely unhealthy (Van et al., 2021).

Cobalamin, often known as vitamin B12, is a water-soluble vitamin that is necessary for the body to synthesize both DNA and RNA. Both erythropoiesis and the myelination of the central nervous system depend on it. Since the body cannot generate it, the food must contain it. Only foods with an animal origin have enough of this vitamin (Riggs et al., 1996).

One of the most prevalent vitamin deficiencies is a vitamin B12 insufficiency. It occurs more frequently in underdeveloped nations. In fact, 40% of children are affected by it. The deficiency can happen at any age, especially in people who need high nutritional intake. It could be caused by a flaw in intracellular usage, an anomaly in its absorption, or a lack of intake (Dror and Allen, 2008).

 

Water -soluble B-complex vitamin called biotin aids in the body’s metabolization of proteins and the breakdown of glucose. Vitamin B7 or vitamin H is other names for biotin (Bailey et al., 1994).

The human body can benefit from biotin in many ways, including lowering cholesterol, controlling blood sugar, improving skin health, and strengthening hair and nail (Craig, 2009).

Cobalamin, also known as vitamin B12 (vitB12), is essential for the production of DNA, hematopoiesis, and myelination. Thus, sometime vitamin B12 insufficiency results in a variety of symptoms, including megaloblastic anemia. Pancytopenia, neurologic symptoms or anemia. Although it could be severe B12 deficiency can manifest without any symptoms.

The creation and repair of genetic DNA, the production of red blood cells and nerve cells, as well as the maintenance of healthy hair, skin, and nails are all made possible by vitamin B12 (Umasanker et al., 2020).

It also contributes by generating energy from carbs, supporting healthy neuron function, balancing appetite, encouraging development, and maintaining excellent muscular tone. Additionally, it affects how electrolytes enter and exit muscle and nerve cells. There are specific enzymes, thiamine phosphor transferees, quickly convert thiamin to its active form, thiamin pyrophosphate (TPP), in the brain and liver (Jain et al., 2015).

In addition to preventing difficulties in the neurological system, brain, muscles, heart, stomach, and intestines, vitamin B12 aids in the body’s production of the primary energy-carrying molecule ATP.

The human body is an amazing mechanism, but in order for it to work properly, it needs specific supplements. Among the most vital components for the body are vitamins. There are certain nutrients that the body can produce on its own, and other nutrients the body cannot. Among the nutrients that the body cannot produce on its own are vitamins, which mean that you have to get them from food. Vitamins are chemical molecules that are necessary for an organism’s metabolism to operate as micronutrients (Kirik and Catak 2021).

 

Table 1: lists the daily recommended intakes of each B vitamin in milligrams (mg) or micrograms (mcg) (mg)

Vitamins	Intake for adults and children ages
Thiamin (B1)	1.2 mg
Pyridoxine (B6)	1.7 mg
Cobalamin (B12)	2.4 mcg

 

Methods

Samples were taken from 30 (child boys and girls) with vitamin deficiencies, whose ages ranged from 5 - 15 years. Along with some symptoms in children are weakness, loss of appetite, stunted development, uncontrollable movements, and other symptoms of vitamin B12 deficiency, such as delayed speech, difficulty interacting with others, tremor, seizures, behavioral issues, and other some symptoms have them been identified.

These symptoms do not appear completely in every child who has the deficiency. It was the period of work 4 month’s period in the AL-Zahra teaching hospital (April 2022 to July 2022).

The children were divided into two groups according to age. The first group ranges from boys and girls between 5 -10 years of old, and the second group is between 10 -15 years old.

The results were compared with the normal ones, whose ages also ranged from 5-10 years and 10-15 for both sex’s boys and girls, taking into account the need to diagnose the symptoms of vitamin deficiency.

Meanwhile, a B12 deficit was identified. Additionally, measurements were made of ferritin, hemoglobin, white blood cells, and platelets in both sexes and in both sick and healthy children. 1.5 ml of venous blood was taken in to Complete blood counts (CBC), and serum vitamin B12 levels are all measured using EDTA vials.

Result

The poverty and malnutrition and many factors can lead to vitamin B12 deficiency. The lack of vitamin B12 in children is a serious preventable health problem. Issue with public health that could have long-term neurological effects repercussions if not diagnosed in time. It frequently goes unreported. The majority of the kids were vegetarians, and some of them showed signs of lethargy and weight loss, which are frequent in vitamin B12 deficiency, with younger kids showing more weight loss. In older kids, hematological anomalies were more common. Despite diverse dietary habits, estimation of vitamin B12 levels is a crucial part of evaluating kids with anemia.

Samples were taken from both male and female sick children for 30 patients, and then compared to healthy 15 healthy controls. According to age, the children were split into two groups. Boys and girls in the first group ranged in age from 5 to 10 years, while those in the second group ranged in age from 10 to 15 years, following the specialized physician diagnosis of the illness , and the most prevalent problematic the patient suffers hypotonic and fading were noted as physical examination findings. A lack of growth and development in the skin and mucosa.

After a complete blood picture was done, it was found , Regarding white blood cells, White blood cell (WBC) counts ranged from the average are (7.6 ± 2.5) in the age group of 5-10 years old youngsters. When compared to healthy subjects of the same age and sex, these values are viewed as low.

Results for aged 10 to 15 years ranged for white blood cell (WBC) are (6.9 ± 2.5) respectively were also judged low when compared to healthy males and females of the same age.

Children between the ages of 5 -10 had hemoglobin (Hb) average values are (7.3 ± 2.9) while children between the ages of 10 - 15 had (Hb) average values are (6.3 ± 3.3).

When compared to the children of the same age who are in good health, these levels are viewed as poor. When compared to healthy children of the same ages, Age-related hemoglobin readings were used to define anemia.

For children 5 - 10 years old ferritin average values ranged from (37.8 ± 3.3). Youngster’s ferritin average readings varied from 10 - 15 years and from (36.1 ± 2.3).

Mean corpuscular volume (MCV) when compared to healthy children of the same age and sex, the values MCV, which average ranged from (66±3.5) for age 5-10 years and average are (57±9.1) for Children between the ages of 10 - 15, are seen to be low when compared to healthy control.

Mean corpuscular hemoglobin (MCH) when compared to the healthy control of the same age and sex the average of values are (27.2 ± 3.5) for age 5-10 years and (25.3 ± 4.5) for age 10-15 years this value is very low when compared with healthy controls.

Hematocrit (HCT) when compared to the healthy control of the same age and sex the average of values are (18.4 ± 4.1) for age 5-10 years and (14.4 ± 3.1) for age 10-15 years this value is low when compared with healthy controls.

 

Table 2: Complete blood count and vitamin B12 parameters for boys and girls age 5-10 and healthy control

Parameter	Healthy control N=15 Age 5-10 mean±sd	Vitamin B12 Deficiency N=30 Age 5-10 meam±sd	P-value
B12 (ng/L)	300±24.2	61±3.1	<0.001
WBC (10*3/UL)	8.5±4.5	7.6 ± 2.5	<0.001
HB (g/dl)	11±1.4	7.3 ± 2.9	<0.001
MCV (fl)	81±1.4	66±3.5	<0.001
MCH (pg)	90±5.2	27.2 ± 3.5	<0.001
HCT (%)	33±6.1	14.4 ± 3.1	<0.001
LYMPHOCYTE (10*3/UL)	9±4.4	5.2 ± 1.8	<0.001
FERRITIN (µg/L)	89±5.6	37.8 ± 3.3	<0.001

 

Table 3: Complete blood count and vitamin B12 parameters for boys and girls age 10-14 and healthy control

Parameter	Healthy control N=15 Age 10-15 mean±sd	Vitamin B12 Deficiency N=30 Age 10-15 meam±sd	P-value
B12 (ng/L)	425±13.1	64±1.1	<0.001
WBC (10*3/UL)	9.3±4.2	6.9 ± 2.5	<0.001
HB (g/dl)	11±1.2	6.3 ± 3.3	<0.001
MCV (fl)	85±2.3	57±9.1	<0.001
MCH (pg)	93±4.2	25.3 ± 4.5	<0.001
HCT (%)	33±3.2	38.4 ± 4.1	<0.001
LYMPHOCYTE (10*3/UL)	10±4.1	4.1± 2.4	<0.001
FERRITIN (µg/L)	92±4.1	36.1 ± 2.3	<0.001

 

Lymphocytic when compared to the healthy control of the same age and sex the average of values are (5.2 ± 1.8) for age 5-10 years and (4.1± 2.4) for age 10-15 years this value is very low when compared with healthy controls.

Vitamin B12 average were (61±3.1) for the children from 5-10 years. And average (64±1.1) for age 10-15 These values are low when compared with healthy subjects When means were compared, mean serum B12 levels were significantly associated with, hemograma and platelet counts.

The diagnosis of vitamin B12 deficiency can be helped by measuring vitamin B12 levels. In general, normal serum B12 levels range from 200 to 900 pg/mL, and values below 80 are almost usually symptomatic of vitamin B12 insufficiency.

Discussion

Anemia is determined by the values of Hb, MCV and RBC in the complete blood count. Iron deficiency anemia is mostly indicated by low Hb levels in combination with reduced MCV levels, which are referred to as microcytic anemia (Antony, 2003).

Were examined and the children with deficiency found to have a severe vitamin B12 deficiency. These individuals had modifications in hematological markers as cytopenia elevated MCV, and MPV, which are typical and obvious in vitamin B12 insufficiency (Roumeliotis et al., 2012). The most likely cause of macrocytic anemia is a vitamin B12 deficiency; it is already known that B12 deficiency can lead to low results in other blood series besides anemia. Iron deficiency was present together with Vitamin B12. The prevalence of vitamin B12 insufficiency in kids is considerable (McLean et al., 2009).

Considered as a significant issue and a preventative factor in neurological morbidity 5 to 14-year-old kids were involved, and In order to prevent long-term effects of vitamin B12 insufficiency in the unborn child, testing for the condition and supplementing should start as early in pregnancy as possible, according to the rising occurrence in the young age groups (Balci et al., 2016).

The majority of the kids ate a varied diet. Unlike the well-known our research did not uncover any conclusive evidence of a relationship between vegetarianism and a tendency to vitamin B12 insufficiency. Link vitamin B12 deficiency and vegetarianism. This could be multiple-factored. Despite the fact that the family was used to the child may have only sometimes consumed non-vegetarian meals. Vegetarian diet and might have died from a lack of vitamin B12 (Jones et al., 2007). As well as with pyridoxine (vitamin B6) and folic acid (vitamin B9), vitamin B12 is a cofactor in the transformation of homocysteine into methionine. It also contributes to the structural and functional integrity of myelin, hematopoiesis, and DNA and RNA synthesis, among other things. Symptoms of its deficiency are primarily neurological and hemological. In children and adults with vitamin B12 deficiency, epilepsy is a rare illness. Other organs, however, might be impacted (Atay et al., 2014).

The most frequent reason for cobalamin insufficiency is malabsorption. diseases causing insufficient cobalamin absorption include atrophic gastritis, insufficient pepsin or gastric secretion, insufficient proteolytic digestion, and atrophy of the gastric parietal cells. Other causes of cobalamin deficiency due to malabsorpti include long-term anti-acid therapy, insufficient pepsin or gastric secretion, and insufficient pepsin or gastric secretion (Pawlak et al., 2013).

The health care professionals who are looking after pregnant or nursing mothers and their newborns should assess vitamin B12 status and take a comprehensive food history, especially in the case of vegetarian mothers and their children, in order to prevent vitamin B12 insufficiency (Duong et al., 2015).

Natural sources of vitamin B12 include dairy products, eggs, meat, particularly red meat. Fortified meals like infant formula, cereals, and soy products are among the additional sources, it is crucial to identify the condition because of the potentially harmful neurologic effects. As demonstrated in our two patients and several case studies, the majority of clinical symptoms of vitamin B12 insufficiency quickly go away when vitamin B12 is replaced. The neurologic abnormalities typically become better within a few weeks. Only a few case studies with ambiguous B12 supplementation duration are used to determine the developmental prognosis of these children months and years later; additional follow-up (Zeeshan et al., 2017).

For the synthesis of DNA and for the metabolism of fatty acids, B12 is necessary for the conversion of methyltetrahydrofolate to tetrahydrofolate. Megaloblastic anemia and potentially permanent neuropathy and neuropsychiatric abnormalities are prevented by the early detection and treatment of B12 deficiency.

It can be challenging because some kids have picky eating habits.to convince them to take a food supplement. A number of There are numerous chewable pills for kids on the market, additionally some liquid goods. Finding the trick is to one that your child enjoys sufficiently to take a conflict. Don’t anticipate one chewable multiples, either. vitamin to supply a proper amount of each essential nutrients (Chakraborty et al., 2018).

The plasma folate, ferritin, and hemoglobin were all lower in individuals with low levels of plasma vitamin B-12 than in those with appropriate levels. Economic status was a covariate, therefore larger households’ greater incomes are explained by complementary foods high in vitamin B-12 are methods for lowering the prevalence of insufficiency (De Bruyne and Ito, 2018).

However, the researchers created a ground beef dish that was well-accepted every day for nine months in the intervention study that followed, suggesting meat consumption from or before this age is undoubtedly doable and would increase these kids’ intakes of iron and vitamin B-12 (Randaccio et al., 2010). Following vitamin B12 replacement, hematological signs entirely disappear, but neurologic indications may linger; for this reason, prompt diagnosis and treatment are crucial.

There are only a few natural sources of B12 (milk, cheese, and eggs), as B12 can only be produced by bacteria. As a result, foods of plant origin do not contain B12. B12 deficiency is now found to be rather frequent in children and adults, despite earlier being thought to be incredibly rare (Reilly and Ilich, 2016).

Conclusion

Increasing emphasis in healthcare on disease prevention rather than disease treatment. The body requires two different types of vitamins: fat-soluble vitamins and water-soluble vitamins, both of which function well in the body. Nobody can dispute the importance of these vitamins for the body at all ages, and depending on the vitamin, age, and health state of the individual, a shortage of them can cause significant harm to certain body sections. Although nothing can replace a healthy, balanced diet, taking vitamin and mineral supplements on a daily basis may assist to ensure that you are getting enough of the essential nutrients especially for children who suffer from a deficiency B12. So we can avoid diseases in the long term.

Acknowledgments

We thank all the parents and guardians of children who participated in the study and to those who helped me work in the lab.

Conflict of interest

None.

Funding disclosure

Self-financing.

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