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Curr Osteoporos Rep. 2013 Sep;11(3):213-8. doi: 10.1007/s11914-013-0155-2.

Vitamin B12, folic acid, and bone.

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Department of Epidemiology and Biostatistics and the EMGO Institute of Health and Care Research, VU University Medical Center, Van de Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.


Vitamin B12 and folic acid deficiency are associated with a higher serum concentration of homocysteine. A high serum homocysteine is a risk factor for fractures. Both vitamins play a role in the remethylation of homocysteine to methionine. The pathophysiology from a high serum homocysteine to fractures is not completely clear, but might involve bone mineral density, bone turnover, bone blood flow, DNA methylation, and/or physical function and fall risk. Genetic variation, especially polymorphisms of the gene encoding for methylenetetrahydrofolate reductase may play a role in homocysteine metabolism and fracture risk. It is uncertain whether supplementation with vitamin B12 and folate can decrease fracture incidence. One double blind clinical trial in post-stroke patients showed that these B vitamins could decrease hip fracture incidence, but the results of further clinical trials should be awaited before a definite conclusion can be drawn.

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