Study Finds Higher Fracture Risk Among People With Vitamin B12 Deficiency After 50 - Video

Vitamin B12 deficiency was associated with a higher long-term fracture hazard in a large retrospective study published in Scientific Reports. However, researchers cautioned that the findings do not show that B12 deficiency causes or predicts fractures.

The study used electronic health records from the TriNetX Global Collaborative Network. Researchers analysed adults aged 50 years and older who underwent vitamin B12 testing between 2016 and 2023. The analysis included 115,735 people with B12 deficiency and more than 1.76 million with normal levels before matching.

B12 deficiency was defined as a concentration of 199 pg/mL or lower. After propensity-score matching, 115,735 people remained in each of the deficient and normal-B12 groups. Researchers began fracture follow-up one year after the initial B12 measurement to reduce the possibility that existing or imminent fractures influenced testing.

During follow-up, fractures occurred in 7.2% of people with B12 deficiency compared with 6% of those with normal levels. Adjusted analysis showed a 33% higher fracture hazard in the deficiency group. When researchers restricted analysis to years one through five after the initial measurement, the hazard was 37% higher.

Secondary analyses also found higher hazards of osteoporosis, osteoporotic fractures, lower-limb fractures, falls and repeated falls. The increase ranged from 22% for osteoporosis without fracture to 50% for repeated falls.

Vitamin B12 deficiency could theoretically affect fracture risk through several pathways. Deficiency may contribute to neurological problems such as neuropathy, muscle weakness and unstable gait, increasing fall risk. It may also affect bone health through altered homocysteine metabolism and changes in bone-forming cells.

However, the study was observational. B12 levels were measured only at baseline, and researchers lacked detailed information on factors such as diet, physical activity, muscle strength, bone mineral density, vitamin D, calcium and parathyroid hormone levels. Prospective studies are needed to clarify the relationship.

REFERENCE: Yang, C., Chang, L., Pang, Y., et al. (2026). Vitamin B12 status and long-term fracture risk in a multicenter propensity score–matched cohort. Scientific Reports. DOI: https://doi.org/10.1038/s41598-026-74010-8.