Journal Club: Vitamin B12 deficiency may be a risk factor for enuresis

Low serum B12 levels are associated with primary monosymptomatic nocturnal enuresis, according to results of an observational case-control study, suggesting that such low levels may be an independent risk factor for developing bedwetting. The study was conducted in a Turkish pediatric outpatient clinic in 184 children from 5 to 15 years old with enuresis and 167 age- and sex-matched controls.

Investigators measured and recorded serum B12 levels and family history of enuresis. B12 levels <200 pg/mL were considered a “deficiency,” 200-300 pg/mL as “borderline deficiency,” and >300 pg/mL as “normal.” Serum B12 levels were lower in children with enuresis than in the healthy controls. Specifically, 12.5% of the enuresis group had B12 deficiency compared with 9.6% of the controls. Further, while 41.3% of the enuresis group had borderline deficiency, this rate was 29.3% in the control group. Finally, while 61.1% of the controls had normal B12 levels, the rate of normal levels was only 46.1% in the control group. Family history of enuresis was also found to play a role in its development, as those with this history were approximately 8.6 times more likely than those without such a history to have the condition.

THOUGHTS FROM DR. FARBER

I would have preferred to see a study showing if supplementing with vitamin B12 actually helped. I suspect we would not see this many patients with deficiencies in this country, but if a family wanted to try oral B12 (I wouldn’t bother with a blood test), that would be reasonable.

Reference

Gulyuz A. Relationship between serum vitamin B12 levels and primary monosymptomatic nocturnal enuresis: a prospective case-control study. J Pediatr Urol. 2025; Jul 30:S1477-5131(25)00417-6. Doi:10.1016/j.jpurol.2025.07.032