Evidence supporting the use of: Vitamin B12 (adenosylcobalamin)
For the health condition: Confusion

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Vitamin B12 (specifically in its active forms such as adenosylcobalamin and methylcobalamin) is scientifically validated for use in treating confusion when that confusion is due to B12 deficiency. B12 deficiency can cause a range of neurological and psychiatric symptoms, including cognitive disturbances, memory impairment, and confusion. The evidence is particularly strong in populations at risk for deficiency, such as the elderly, individuals with malabsorption syndromes (e.g., pernicious anemia, Crohn’s disease), vegans, and patients with certain gastrointestinal surgeries. Multiple clinical studies and case reports have documented the reversal of confusion and cognitive deficits following B12 supplementation in deficient individuals. The mechanism involves B12’s essential role in myelin synthesis and methylation processes in the nervous system. However, for cases of confusion unrelated to B12 deficiency, there is no evidence that B12 supplementation is beneficial. Thus, B12 should not be used broadly for confusion unless deficiency is confirmed or strongly suspected. Major medical guidelines (such as those from the National Institutes of Health and UpToDate) recommend screening for B12 deficiency in cases of unexplained cognitive decline, particularly in at-risk groups, and treating confirmed deficiency with B12 supplementation.

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