Chronic spontaneous urticaria, characterized by burning welts and persistent itching, affects many individuals unpredictably. A recent study from the All India Institute of Medical Sciences in Bibinagar, Hyderabad, involving 57 adult patients from a dermatology department, examined the potential connection between vitamin B12 deficiency and the symptoms of this condition between September 2023 and August 2024.
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Researchers investigated the relationship between vitamin B12 levels and various factors such as the duration of hives, intensity of itching, presence of angioedema, and autoimmune components, assessed using an autologous serum skin test. Notably, patients with vitamin B12 deficiency, categorized as having levels below 200 pg/mL, experienced a significant extension in the duration of wheals. On average, these patients had visible hives for 120 minutes, compared to just 60 minutes for those with normal vitamin levels. This correlation between lower vitamin B12 and longer-lasting wheals was statistically significant.
While itchiness also showed a trend toward greater persistence in those with vitamin B12 deficiency, it did not achieve full statistical significance. Interestingly, vitamin B12 levels did not correlate with the overall disease duration, urticaria activity scores, presence of angioedema, positive autoimmune test results, or IgE levels.
Approximately 16 percent of participants demonstrated a true vitamin B12 deficiency, while most had normal levels. Autoimmunity tests returned positive for about 20 percent of patients, aligning with existing knowledge that autoimmune chronic urticaria tends to be more severe and resistant to standard antihistamines.
The researchers propose that vitamin B12's role in regulating the immune system and methionine metabolism might explain its impact on skin symptoms. A deficiency could lead to increased inflammation or alter immune pathways related to mast cell activation, though these mechanisms remain hypothetical and unverified in the study.
Despite the intriguing findings, the study has limitations, including a small sample size, a single center focus, and a cross-sectional design that prevents establishing cause-and-effect relationships. There is also limited data on diet and lifestyle choices that could influence results. The authors suggest that vitamin B12 supplementation could be beneficial for patients with severe, persistent forms of chronic spontaneous urticaria, but further research is necessary to determine whether supplementing vitamin B12 can effectively alleviate symptoms.