Vitamin B12 deficiency and anemia in 140 Taiwanese female lacto-vegetarians

J Formos Med Assoc. 2021 Nov;120(11):2003-2009. doi: 10.1016/j.jfma.2021.04.007. Epub 2021 Apr 25.

Abstract

Background/purpose: Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had significantly higher frequencies of microcytosis, macrocytosis, and of blood hemoglobin (Hb), red blood cell (RBC), and serum vitamin B12 deficiencies than 140 healthy control subjects (HCSs).

Methods: The complete blood count and serum vitamin B12 level in 140 female LVs and 140 female HCSs were measured and compared.

Results: We found that 8.6%, 4.3%, 22.9%, 20.0%, and 11.4% of 140 LVs had microcytosis, macrocytosis, and blood Hb, RBC, and serum vitamin B12 deficiencies, respectively. The 140 LVs, 16 B12D/LVs, and 124 non-B12D/LVs had significantly higher frequencies of microcytosis as well as blood Hb and RBC deficiencies than 140 HCSs (all P-values < 0.005). Moreover, both 140 LVs and 124 non-B12D/LVs had significantly higher frequencies of macrocytosis than 140 HCSs. In this study, 32 (22.9%) of 140 LVs including 5 B12D/LVs and 27 non-B12D/LVs had anemia. Of the 5 anemic B12D/LVs, three had normocytic anemia, one had iron deficiency anemia (IDA), and one had thalassemia trait-induced anemia. Moreover, of the 27 anemic non-B12D/LVs, 18 had normocytic anemia, one had IDA, one had thalassemia trait-induced anemia, and 7 had microcytic anemia other than IDA and thalassemia trait-induced anemia.

Conclusion: LVs have significantly higher frequencies of microcytosis, macrocytosis, blood Hb, RBC, and serum vitamin B12 deficiencies than HCSs. Normocytic and microcytic anemias are the two most common types of anemia in our LVs.

Keywords: Lacto-vegetarians; Microcytic anemia; Normocytic anemia; Vitamin B12 deficiency.

MeSH terms

  • Anemia* / epidemiology
  • Anemia* / etiology
  • Anemia, Iron-Deficiency* / epidemiology
  • Anemia, Iron-Deficiency* / etiology
  • Autoantibodies
  • Erythrocyte Indices
  • Female
  • Folic Acid
  • Hemoglobins / analysis
  • Humans
  • Hyperhomocysteinemia*
  • Iron
  • Parietal Cells, Gastric
  • Vegetarians
  • Vitamin B 12
  • Vitamin B 12 Deficiency* / complications
  • Vitamin B 12 Deficiency* / epidemiology

Substances

  • Autoantibodies
  • Hemoglobins
  • Folic Acid
  • Iron
  • Vitamin B 12