Vitamin B12, also known as cobalamin or extrinsic factor, is a water-soluble vitamin involved in metabolism. One of eight B vitamins, it serves as a vital cofactor in DNA synthesis and both fatty acid and amino acid metabolism. It plays an essential role in the nervous system by supporting myelin synthesis and is critical for the maturation of red blood cells in the bone marrow. Animals require B12 but plants do not, relying instead on alternative enzymatic pathways. Vitamin B12 is the most chemically complex of all vitamins, and is synthesized exclusively by certain archaea and bacteria. Natural food sources include meat, shellfish, liver, fish, poultry, eggs, and dairy products. It is also added to many breakfast cereals through food fortification and is available in dietary supplement and pharmaceutical forms. Supplements are commonly taken orally but may be administered via intramuscular injection to treat deficiencies. In healthy adults, vitamin B12 deficiency is not common, mainly because body stores of the vitamin are substantial and turnover is slow, with relatively low dietary requirements. However, B12 deficiency in the elderly is a significant concern, and is related to dementia. The most common cause in developed countries is impaired absorption due to loss of gastric intrinsic factor (IF), required for absorption. A related cause is reduced stomach acid production with age or from long-term use of proton-pump inhibitors, H2 blockers, or other antacids, and interaction with metformin. Elderly people – due to impaired intestinal absorption – and children, premenopausal women, and pregnant women whose diets are low in animal foods are all at increased risk. Deficiency is especially harmful in pregnancy, childhood, and older adults. It can lead to neuropathy, megaloblastic anemia, and pernicious anemia, causing symptoms including fatigue, paresthesia, depression, cognitive decline, ataxia, and even irreversible nerve damage. In infants, untreated deficiency may result in neurological impairment and anemia. Maternal deficiency increases the risk of miscarriage, neural tube defects, and delayed development in offspring. Folate levels may modify the presentation of symptoms and disease course.
Definition Vitamin B12 is a coordination complex of cobalt, which occupies the center of a corrin ligand and is further bound to a benzimidazole ligand and adenosyl group. Several related species behave similarly to function as vitamins. This collection of compounds is sometimes referred to as "cobalamins". These chemical compounds have a similar molecular structure, each of which shows vitamin activity in a vitamin-deficient biological system. They are referred to as vitamers having vitamin activity as a coenzyme, meaning that its presence is required for some enzyme-catalyzed reactions.
adenosylcobalamin cyanocobalamin, the adenosyl ligand in vitamin B12 is replaced by cyanide. hydroxocobalamin, the adenosyl ligand in vitamin B12 is replaced by a hydroxide. methylcobalamin, the adenosyl ligand in vitamin B12 is replaced by a methyl group. Cyanocobalamin is a manufactured form of B12. Bacterial fermentation creates AdoB12 and MeB12, which are converted to cyanocobalamin by the addition of potassium cyanide in the presence of sodium nitrite and heat. Once consumed, cyanocobalamin is converted to the biologically active AdoB12 and MeB12. The two bioactive forms of vitamin B12 are methylcobalamin in cytosol and adenosylcobalamin in mitochondria. Cyanocobalamin is the most common form used in dietary supplements and food fortification because cyanide stabilizes the molecule against degradation. Methylcobalamin is also offered as a dietary supplement. There is no advantage to the use of adenosylcobalamin or methylcobalamin forms for the treatment of vitamin B12 deficiency. Hydroxocobalamin can be injected intramuscularly to treat vitamin B12 deficiency. It can also be injected intravenously for the purpose of treating cyanide poisoning, as the hydroxyl group is displaced by cyanide, creating a non-toxic cyanocobalamin that is excreted in urine.
Pseudovitamins and antivitamins Pseudovitamin B12 refers to compounds that are corrinoids with a structure similar to the vitamin, but without vitamin activity. Pseudovitamin B12 is the majority corrinoid in spirulina, an algal dietary supplement sometimes erroneously claimed as having this vitamin activity. Antivitamin B12 compounds (often synthetic B12 analogues) not only have no vitamin action, but also actively interfere with the activity of true vitamin B12. The design of these compounds mainly involves the replacement of the metal ion with rhodium, nickel, or zinc, or may have an inactive ligand attached, such as 4-ethylphenyl. These compounds have the potential for use in analyzing B12 pathways or even attacking B12-dependent pathogens.
Deficiency
Vitamin B12 deficiency can potentially cause severe and irreversible damage, especially to the brain and nervous system. At levels only slightly below normal, deficiency can result in fatigue, headaches, feeling faint, rapid breathing, pale skin, numbness or tingling, poor appetite, heartburn, poor balance, difficulty walking, poor reflexes, blurred vision, memory problems, depression, irritability, inattention, cognitive decline, dementia, and even psychosis. Among other problems, weakened immunity, reduced fertility and interruption of blood circulation in women may occur. It has also been linked to optic nerve atrophy and neuritis. The main type of vitamin B12 deficiency anemia is pernicious anemia, characterized by a triad of symptoms:
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