Vitamin B12 an essential vitamin required for good bone and cardiovascular health

Bone health maintenance is a dynamic mechanism where in the bone mass is achieved by an equilibrium of bone formation and bone resorption. In the early stages of life when the bone formation is more than the bone resorption, the body achieves its peak bone mass¹. Whereas, as an individual crosses his adolescent stage of life the same process tends to be reversed, when the bone starts becoming weaker. A very high bone loss rate as compared to the formation leads to weakening of the bone known as osteoporosis.

Vitamin D and calcium are often discussed as a supplementation to prevent and treat this situation from occurring, especially so in elderly individuals and post-menopausal females. However, the role of other micronutrients is also crucial to maintain the adequate bone health.

An adequate bone health is determined by both bone strength and bone quality. However, calcium and phosphorus help in forming the inorganic mineral support for the bones. The adequate deposition of the same is enhanced by various vitamins, one of which being Vitamin B 12. Elevated homocysteine levels, low vitamin B12 and folate levels have been found to be associated with low bone mineral density (BMD) and higher fracture risk in elderly². An elevated plasma homocysteine level (>15 μmol/L) is prevalent in 30–50% of people older than 60 years³. Vitamin B12 and folate are major determinants of homocysteine metabolism⁴. Positive effects of the supplementation of B vitamins on BMD have been found in a subgroup of osteoporotic patients with high tHcy and stroke patients at risk for osteoporosis⁵.

Metanalysis have shown that raised homocysteine levels not only affect the bone health but also have an impact on cardiovascular health. Each 5-μmol/L increase above 10 μmol/L of serum homocysteine is associated with a 20% increased risk of circulatory health problems⁶. Supplementation with vitamin B12 of doses ranging from 0.02–1 mg/d produces approximately 7% reduction in tHcy⁷. Vitamin B12 deficiency may negate the cardiovascular disease prevention benefits of vegetarian diets. In order to further reduce the risk of cardiovascular disease, vegetarians should be advised to use vitamin B12 supplements.

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References:

1. van Wijngaarden, J. P.,et al . (2013). Vitamin B12, Folate, Homocysteine, and Bone Health in Adults and Elderly People: A Systematic Review with Meta-Analyses. Journal of Nutrition and Metabolism, 2013, 1–19. https://doi.org/10.1155/2013/486186
2. K. L. Stone, D. C. Bauer, D. Sellmeyer, and S. R. Cummings, “Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: a prospective study,” Journal of Clinical Endocrinology and Metabolism, vol. 89, no. 3, pp. 1217–1221, 2004.
3. S. J. P. M. Eussen, L. C. P. G. M. De Groot, R. Clarke et al., “Oral cyanocobalamin supplementation in older people with vitamin B 12 deficiency: a dose-finding trial,” Archives of Internal Medicine, vol. 165, no. 10, pp. 1167–1172, 2005

4. J. Selhub, P. F. Jacques, P. W. F. Wilson, D. Rush, and I. H. Rosenberg, “Vitamin status and intake as primary determinants of homocysteinemia in an elderly population,” Journal of the American Medical Association, vol. 270, no. 22, pp. 2693–2698, 1993
5. Herrmann M., Umanskaya N., Traber L., Schmidt-Gayk H., Menke W., Lanzer G., Lenhart M., Peter Schmidt J., Herrmann W. The effect of B-vitamins on biochemical bone turnover markers and bone mineral density in osteoporotic patients: a 1-year double blind placebo controlled trial. Clin. Chem. Lab. Med. 2007;45:1785–1792.
6. Pawlak R. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? Am J Prev Med. 2015 Jun;48(6):e11-26. doi: 10.1016/j.amepre.2015.02.009. PMID: 25998928
7. O’Leary, Fiona, and Samir Samman. “Vitamin B12 in health and disease.” Nutrients vol. 2,3 (2010): 299-316. doi:10.3390/nu2030299