Don't Ignore Low Serum Cobalamin (Vitamin B12) Levels
- 1 August 1988
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Internal Medicine
- Vol. 148 (8), 1705-1707
- https://doi.org/10.1001/archinte.1988.00380080009003
Abstract
The frequency of "routine" low serum cobalamin levels in populations over age 50 years is high, being about 5% in one recent large midwestern study.1Because a low serum cobalamin level in someone over age 50 years raises the diagnostic probability of pernicious anemia (PA), ie, the vitamin B12deficiency disease due to an inadequate or absent gastric secretion of intrinsic factor (IF) of "unknown" cause, a classic Schilling test is often done in such cases to determine if the diagnosis is in fact early PA in the premegaloblastic anemia stage.2 See also p 1712. Since the Schilling test results are usually normal, the conclusion is drawn that the low serum cobalamin level was an artifact (an error). In fact, often it is the normal Schilling test result that is misleading, and the low cobalamin level was in fact a signal that PA was developing, but inKeywords
This publication has 2 references indexed in Scilit:
- The 1986 Herman award lecture. Nutrition science as a continually unfolding story: the folate and vitamin B-12 paradigmThe American Journal of Clinical Nutrition, 1987
- Inhibitory Effect of Eggs on Vitamin B12 Absorption: Description of a Simple Ovalbumin 57Co‐Vitamin B12 Absorption TestBritish Journal of Haematology, 1976