What is the role of vitamin B12 (cobalamin) supplementation in patients with malaria?

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Last updated: June 6, 2025View editorial policy

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From the Research

Vitamin B12 supplementation is not routinely recommended as a specific treatment for malaria patients, but it may be considered in cases of concurrent B12 deficiency or severe anemia. The most recent and highest quality study on this topic is from 2023 1, which found that haemolysis and presumably transient bone marrow suppression contribute to anaemia in malaria, but pre-existing nutritional deficiencies do not predispose to severe malaria. However, vitamin B12 supplementation may be beneficial in patients with malaria who have concurrent B12 deficiency or who develop severe anemia, as it is essential for red blood cell formation and DNA synthesis.

Some key points to consider:

  • Malaria often causes hemolytic anemia, and patients with pre-existing nutritional deficiencies may have impaired recovery from malarial anemia.
  • Vitamin B12 supplementation might be given alongside iron and folate as part of nutritional support during recovery.
  • Healthcare providers should assess individual patients for signs of deficiency (such as macrocytic anemia, neurological symptoms) before initiating supplementation.
  • Routine B12 administration without documented deficiency has not been shown to improve malaria outcomes.

It's also worth noting that other studies have investigated the relationship between vitamin B12 and malaria, but the 2023 study 1 provides the most recent and highest quality evidence on this topic. Additionally, studies on folic acid supplementation and malaria susceptibility and severity 2 and vitamin B12 deficiency 3, 4, 5 provide further context and support for the potential benefits of vitamin B12 supplementation in certain cases.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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