Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-05-07T23:51:27 RDF description of Vitamin B12 deficiency in resettled Bhutanese refugees--United States, 2008-2011 - http://repository.healthpartners.com/individual/document-rn19617 public Racial Groups Immigrants Vitamin B12 deficiency in resettled Bhutanese refugees--United States, 2008-2011 60 24870 11 Dietary Supplements 2022-02-21T22:48:57.408-06:00 Diet <p>Since 2008, approximately 30,000 Bhutanese refugees have been resettled in the United States. Routine medical examinations of refugees after arrival in resettlement states indicated hematologic and neurologic disorders caused by vitamin B12 deficiency. These cases were reported by examining physicians and state health departments to CDC, which initiated an investigation. This report summarizes the results of that investigation. Sera from overseas medical examinations, postarrival examinations in three state health departments (Minnesota, Utah, and Texas), and medical records and interviews at a health clinic in St. Paul, Minnesota, were evaluated. Vitamin B12 deficiency, defined as serum vitamin B12 concentration <203 pg/mL, was found in 64% (63 of 99) of overseas specimens, 27% (17 of 64) of postarrival medical screenings, and 32% (19 of 60) of Bhutanese refugees screened for vitamin B12 deficiency at the St. Paul clinic. Although the deficiencies might be multifactorial, the main cause is thought to be the diet consumed by these refugees for nearly two decades in Nepal, which lacked meat, eggs, and dairy products, the major dietary sources of vitamin B12. Additionally, infection with Helicobacter pylori might play a role. Clinicians should be aware of the risk for vitamin B12 deficiency in Bhutanese refugees. All Bhutanese refugees should be given nutrition advice and should receive supplemental vitamin B12 upon arrival in the United States. In addition, refugees with clinical manifestations suggestive of deficiency should be tested for adequate serum vitamin B12 concentrations and, if found to have a B12 deficiency, screened for underlying causes, treated with parenteral vitamin B12 or high-dose oral supplements, and evaluated for response to therapy.<p> MMWR: Morbidity and Mortality Weekly Report 15145 document-rn19617