ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Vitamin B12 Deficiency and Its Impact on Healthcare: A Population-Level Analysis and Call for Action
Provisionally accepted
Leonardo P de Carvalho1*Nelson Akamine1Marcelo S Di Pietro1
Carolina Nunes França2Rodrigo Oliveira3Renato D Lopes4*- 1Universidade Federal de Sao Paulo, São Paulo, Brazil
- 2Universidade Santo Amaro, São Paulo, Brazil
- 3Brazilian Clinical Research Institute, São Paulo, Brazil
- 4Duke University Duke Clinical Research Institute, Durham, United States
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This study aims to evaluate the pattern of vitamin B12 deficiency in a large health care system and assess its impact on hospitalizations and associated diseases. This is a retrospective observational study. Vitamin B12 test results were collected from administrative datasets of Brazil's public and private health care systems between 2016 and 2023. Data from health campaigns measuring vitamin B12 levels across the country were used to calculate the percentage of abnormal test results. The Mann-Kendall test was applied to assess trends in hospitalizations over time, while the Pearson correlation test was used to evaluate the association between vitamin B12 deficiency and other hospitalization causes. A total of 84 million vitamin B12 measurements were analyzed, revealing a 12-fold increase in tests performed, rising from two million to 25 million over the study period. Of these, 35 million measurements were from the public and 47·8 million from private health care system. The trend of hospitalizations associated with vitamin B12 deficiency increased by 32% over the study period (p-value < 0·05). Hospitalizations associated with vitamin B12 deficiency were correlated with other B vitamin deficiencies (B1 and B6), as well as hospitalizations due to cardiovascular, hematological, neurological, psychological, and gastrointestinal diseases. This population-based study highlights a progressive increase in vitamin B12 deficiency-related hospitalizations, suggesting a previously underrecognized public health burden. Additionally, these findings underscore the correlation between vitamin B12 deficiency, other B vitamin deficiencies, and relevant clinical diseases.
Keywords: Vitamin B12, Health Care, Hospitalization, Public health burden, Clinical diseases
Received: 08 Sep 2025; Accepted: 04 Dec 2025.
Copyright: © 2025 de Carvalho, Akamine, Di Pietro, França, Oliveira and Lopes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Leonardo P de Carvalho
Renato D Lopes
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