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Vitamin B12 deficiency.
Am Fam Physician. 2003 Mar 01; 67(5):979-86.AF

Abstract

Vitamin B12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. The role of B12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored. Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels; however, about 50 percent of patients with subclinical disease have normal B12 levels. A more sensitive method of screening for vitamin B12 deficiency is measurement of serum methylmalonic acid and homocysteine levels, which are increased early in vitamin B12 deficiency. Use of the Schilling test for detection of pernicious anemia has been supplanted for the most part by serologic testing for parietal cell and intrinsic factor antibodies. Contrary to prevailing medical practice, studies show that supplementation with oral vitamin B12 is a safe and effective treatment for the B12 deficiency state. Even when intrinsic factor is not present to aid in the absorption of vitamin B12 (pernicious anemia) or in other diseases that affect the usual absorption sites in the terminal ileum, oral therapy remains effective.

Authors+Show Affiliations

U.S. Army Health Clinic, Darmstadt, Germany. roboh98@yahoo.comNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12643357

Citation

Oh, Robert, and David L. Brown. "Vitamin B12 Deficiency." American Family Physician, vol. 67, no. 5, 2003, pp. 979-86.
Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician. 2003;67(5):979-86.
Oh, R., & Brown, D. L. (2003). Vitamin B12 deficiency. American Family Physician, 67(5), 979-86.
Oh R, Brown DL. Vitamin B12 Deficiency. Am Fam Physician. 2003 Mar 1;67(5):979-86. PubMed PMID: 12643357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin B12 deficiency. AU - Oh,Robert, AU - Brown,David L, PY - 2003/3/20/pubmed PY - 2003/6/19/medline PY - 2003/3/20/entrez SP - 979 EP - 86 JF - American family physician JO - Am Fam Physician VL - 67 IS - 5 N2 - Vitamin B12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. The role of B12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored. Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels; however, about 50 percent of patients with subclinical disease have normal B12 levels. A more sensitive method of screening for vitamin B12 deficiency is measurement of serum methylmalonic acid and homocysteine levels, which are increased early in vitamin B12 deficiency. Use of the Schilling test for detection of pernicious anemia has been supplanted for the most part by serologic testing for parietal cell and intrinsic factor antibodies. Contrary to prevailing medical practice, studies show that supplementation with oral vitamin B12 is a safe and effective treatment for the B12 deficiency state. Even when intrinsic factor is not present to aid in the absorption of vitamin B12 (pernicious anemia) or in other diseases that affect the usual absorption sites in the terminal ileum, oral therapy remains effective. SN - 0002-838X UR - https://www.unboundmedicine.com/medline/citation/12643357/Vitamin_B12_deficiency_ L2 - https://www.aafp.org/link_out?pmid=12643357 DB - PRIME DP - Unbound Medicine ER -