Serum levels of ferritin and vitamin B12 in a cohort of healthy non-anemic female medical students

Suleen Kanan  Bakir; Rawand Polus  Shamoon; Ranan Kardagh  Polus

doi:10.56056/amj.2025.317

Authors

Suleen Kanan Bakir M.B.Ch.B. Candidate of KHCMS of Hematology, Ministry of Health, Erbil, Kurdistan Region, Iraq
Rawand Polus Shamoon M.B.Ch.B, MSc, PhD, Department of Pathology, College of Medicine, Hawler Medical University, Erbil Iraq & Department of Laboratory Medical Sciences, College of Health Sciences, Catholic University, Erbil, Iraq
Ranan Kardagh Polus M.B.Ch.B, MSc, PhD, Department of Basic Sciences, College of Medicine, Hawler Medical University, Erbil, Iraq

DOI:

https://doi.org/10.56056/amj.2025.317

Keywords:

Anaemia, Ferritin, Vitamin B12, Young female

Abstract

Background and objectives: Iron and Vitamin B12 are essential for the development of the nervous system, erythropoiesis, and several metabolic functions. This study aimed to assess serum levels of ferritin and vitamin B12 in a cohort of apparently normal young non-pregnant females.

Methods: Between October 2022 and February 2023, a descriptive cross-sectional study was carried out at Knowledge University in Erbil, Kurdistan, Iraq. 400 young female college students who appeared normal and non-anemic underwent tests for vitamin B12, serum ferritin, and total blood count. Their eating habits and menstrual history were investigated and connected to the biochemical findings.

Results: A statistically significant correlation between low ferritin and B12 levels was found in 48 (12%) of the students. Additionally, among the participated students, 96 (24%) and 114 (28.5%) had low serum levels of vitamin B12 and ferritin, respectively. Between 4 and 120 ng/L, the mean serum ferritin level was 44.46 ng/L. Between 67 and 600 pg/mL, the mean vitamin B12 level was 257.9 pg/mL. The average hemoglobin, corpuscular volume, and hemoglobin of the students who were enrolled were 12.88 g/dL, 85.98 fL, and 27.43 pg, respectively.

Conclusion: Low vitamin B12 levels were mostly found in vegetarians and people on non-ketogenic diets, while low serum ferritin levels were much more common in people with abnormal menstruation. Iron and vitamin B12 deficiencies are frequent in otherwise healthy girls with normal hemoglobin and red blood cell indices.

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References

Netz DJ, Mascarenhas J, Stehling O, Pierik AJ, Lill R. Maturation of cytosolic and nuclear iron – sulfur proteins. Trends Cell Biol. 2014;24(5):30312.

Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1): 16–25.

World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: WHO, 2020. <https://www.who.int/publications-detail-redirect/9789240000124>

Koperdanova M, Cullis J O. Interpreting raised serum ferritin levels. BMJ 2015; 22(3): 351-59.

Al-Naseem A, Sallam A, Choudhury S, and Thachil J. Iron deficiency without anaemia: a diagnosis that matters. Clin Med (Lond). 2021;21(2):107-13.

Green R, Mitra A. Megaloblastic Anemias: Nutritional and Other Causes. Med Clin North Am. 2017;101(2):297-317.

Ray J, Meier C, Vermeulen M, Boss S, Wyatt P, Cole DEC. Association of Neural Tube Defects and Folic Acid Food Fortification in Canada. The Lancet, 2002. 360(9350):2047-8.

Wilhelm S, Rjater R, Kale-Pradhan P. Perils and Pitfalls of Long-term Effects of Proton Pump Inhibitors. Expert Rev. Clin. Pharmacol.2013, 6(4):443-51.

Hinkel J, Schmitt J, Wurm M, Rosenbaum-Fabian S, Schwab KO, et.al. Elevated Plasma Vitamin B12 in Patients with Hepatic Glycogen Storage Diseases. J Clin Med. 2020; 9(8):2326-36.

Hunt A, Harrington D and Robinson S. Vitamin B12 deficiency. BMJ. 2014; 10(3): 349-59.

Stabler S. Vitamin B12 deficiency. N Engl J Med, 2013; 368:149-60.

Pawlak R, Lester SE and Babatunde T. The Prevalence of Cobalamin Ceficiency Among Vegetarians Assessed by Serum Vitamin B12: A Review of Literature. Eur J. Clin Nutr. 2014;68(5):541-48.

Azzini E, Raguzzini A and Polito A. A Brief Review on Vitamin B12 Deficiency Looking at Some Case Study Reports in Adults. Int J Mol Sci., 2021;22(18):9694-710.

Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, et al. Ketosis and Appetite-mediating Nutrients and Hormones after Weight Loss. Eur J Clin Nutr. 2013;67(7):759-64.

Molloy AM. Should vitamin B12 status be considered in assessing risk of neural tube defects? Ann N Y Acad Sci. 2018:1414(1):109-125.

Allen LH, Miller JW, de Groot L, Rosenberg IH, Smith AD, Refsum H, et al. Biomarkers of Nutrition for Development (BOND): Vitamin B-12 Review. J Nutr. 2018 1;148(4):1995S-2027S.

Karaka? NM. The Prevalence of Low Serum Levels of Vitamin D, Vitamin B12, Folate and Ferritin in Adolescents: Single Center Experience. Sci Prog. 2021;104(2). 368-99.

Samani RO, Hashiani AA, Razavi M, Vesali S, Rezaeinejad M, Maroufizadeh S., et al. The Prevalence of Menstrual Disorders in Iran: A Systematic Review and Meta-Analysis. Int J Reprod Biomed. 2018;16(11):665-78.

Soppi E. Iron deficiency without anemia–common, important, neglected. Clin. Case Rep. Rev, 2019; 5:1–7.

Karabulut A, Güler ÖT, Karahan HT, Özkan S, Koyuncu H, Demirciler I. Premarital screening of 466 Mediterranean women for serum ferritin, vitamin B12, and folate concentrations. Turk J Med Sci. 2015;45(2):358-63.

Kocaoz S, Cirpan R, Degirmencioglu AZ. The Prevalence and Impacts Heavy Menstrual Bleeding on Anemia, Fatigue and Quality of Life in Women of Reproductive Age. Pak J Med Sci. 2019;35(2):365-70.

El-Khateeb M, Khader Y, Batieha A, Jaddou H, Hyassat D, et.al. Vitamin B12 Deficiency in Jordan: A Population-based Study. Ann Nutr Metab. 2014;64(2):101-5.

Al-Musharaf S, McTernan PG, Hussain SD, Aleisa KA, Alnaami AM, et.al. Prevalence and Indicators of Vitamin B12 Insufficiency among Young Women of Childbearing Age. Int J Environ Res Public Health. 2020;18(1):1-17.