We conducted a study on ‘The clinical spectrum of presentation of Vitamin B12 deficiency in adult patients in a tertiary care hospital’. This was a descriptive cross sectional study of 12 months starting from May, 2014 to May, 2015 conducted in Max Super Specialty Hospital, Saket, and New Delhi. This study was done on the basis of laboratory values of serum Vitamin B12 <145 pg/ml which was requested by the physician on the basis of their clinical suspicion. The study is unique to the tertiary care set up in India where studies based on laboratory results have been published however not on the clinical spectrum of the deficiency.

The following observations were made

1.      There was a varied presentation of the deficiency from haematological, neurological, gastrointestinal, rheumatological, neurologica, cardiological, endocrine, respiratory disorders to association with infections

2.      Vitamin B12 deficiency was found more prevalent in the elderly age group.

3.      No significant correlation was found with socioeconomic  and educational status or gender.

4.      Vitamin B12 deficiency was found in 2% people who were lactose intolerant and the Vitamin B12 levels was lesser in people who did not take milk products.

5.      Vitamin B12 levels were found lesser in subjects who  consumed alcohol and who previously consumed  alcohol but had left now.

6.      Vitamin B12 levels were found lesser in smokers and past smokers.

7.      There was a high association of combined deficiency of Vitamin B12 and Vitamin D3

8.      There was a good correlation of cognitive impairment and generalised weakness and reduced stamina.

9.      Metformin usage showed lower Vitamin B12 levels in Type 11 Diabetics.