Vitamin B 12: the hidden ingredient of stroke

Mehul Prajapati, Labani M. Ghosh


Background: Study aimed to evaluate the relationship between vitamin B12 and acute cerebral stroke in this study.

Methods: Blood samples drawn within 24 hours after the stroke from hospitalized patients (n=100) and from 100 control cases matched for age, sex and other modifiable risk factors of stroke were analyzed. With a competitive, ECLIA, serum levels of vitamin B12 were measured. The quantitative data of the groups was compared using Analysis of Varience and Tukeys HSD post hoc test for comparison. Chi-square tests were used.

Results: Median serum vitamin B12 levels were significantly lower in the patients than in the control subjects, 188.71 and 256.25 pg/ml respectively (p=0.0001). This difference was independent from other risk factors. The mean age in case group was 62.49 (SD: 12.45 years) and 56.62 (SD: 13.05 years) in control group with p=0.001. Therefore, prevalence of stroke is more between 6th and 7th decade of life. Mean serum vitamin B12 levels were lower in males (201.8pg/ml) than the females ( in the case group.

Conclusions: Low vitamin B12 is associated with an increased risk of stroke, and its relationship is independent from the other known modifiable stroke risk factors.


Stroke, Transient Ischemic Attack, Vitamin B12 deficiency

Full Text:



Brattström L, Lindgren A, Israelsson B, Malinow MR, Norrving B, Upson B, et al. Hyperhomocysteinaemia in stroke: prevalence, cause, and relationships to type of stroke and stroke risk factors. Euro J Clini Investiga. 1992 Mar;22(3):214-21.

Selhub J, D'Angelo A. Relationship between homocysteine and thrombotic disease. Am J Med Sci. 1998 Aug 1;316(2):129-41.

Verhoef P, Stampfer MJ, Buring JF, Gaziano JM, Allen RH, Stabler SP, et al. Homocysteine metabolism and risk of myocardial infarction: relation with vitamins B6, B12, and folate. Am J Epidemiol. 1996 May 1;143(9):845-59.

Dalery K, Lussier-Cacan S, Selhub J, Davignon J, Latour Y, Genest Jr J. Homocysteine and coronary artery disease in French Canadian subjects: relation with vitamins B12, B6, pyridoxal phosphate, and folate. Am J Cardiol. 1995 Jun 1;75(16):1107-11.

Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. Recognizing subtle symptoms in older adults. Geriatrics (Basel, Switzerland). 2003 Mar;58(3):30-4.

Robinson K, Arheart K, Refsum H, Brattström L, Boers G, Ueland P, et al. Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circula. 1998 Feb 10;97(5):437-43.

Yilmaz N, Yilmaz M, Pence S, Ozaslan J, Koçoğlu H, Yilmaz G. Determination of serum B12 vitamin and folic acid levels in patient with stroke. Acta Med (Hradec Kralove). 2001;44(1):37-9.

Kocer A, Ince N, cabulat EC, Sargin M. Serum vitamin B12 and folic acid levels in Acute cerebral Atherothrombotic Infarction. Tohoku J Exp Med. 2004;204(2):155-61.

Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Willett WC. Dietary folate, vitamin B6, vitamin B12 intake and risk of CHD among a large population of men. Circula. 1996;93:625.

Biswas A, Ranjan R, Meena A, Akhter MS, Yadav BK, Munisamy M, et al. Homocystine levels, polymorphisms and the risk of ischemic stroke in young Asian Indians. J stroke Cerebrovasc Dis. 2009;18:103-10.

Engman M. Homocysteinemia: new information about an old risk factor for vascular disease. J Insurance Med (New York, NY). 1998;30(4):231-6.