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Vitamin B12
Aka: Vitamin B12, Cyanocobalamin, Cobalamin
- See Also
- Vitamin B12 Deficiency
- Physiology
- B12 dependent reactions in humans
- Methylmalonic acid converted to succinyl-CoA
- Homocysteine converted to methionine
- 5-Methyltetrahydrofolate converted to tetrahydrofolate
- Required for DNA synthesis and RBC production
- Normal B12 absorption pathway
- Requires ingestion (animal source or fortified cereal) as cannot be synthesized in humans
- Acidic Stomach environment breaks down food-bound B12
- Insufficient acid decreases B12 absorption
- Proton Pump Inhibitors suppress B12 absorption
- Intrinsic factor (IF) binds B12 in duodenum
- Intrinsic factor produced in Stomach parietal cells
- Pernicious Anemia is autoimmune parietal cell death
- Insufficient IF results in decreased B12 absorption
- Vitamin B12 absorption via 2 pathways
- Primary B12 absorption
- Vitamin B12 with intrinsic factor absorbed in ileum
- Absorbed Vitamin B12 binds Transcobalamin II
- Alternate B12 absorption
- Pathway independent of intrinsic factor and ileum
- Absorption of up to 1% of large oral B12 dose
- Allows for oral B12 supplementation
- Vitamin B12 storage
- Vitamin B12 is stored in the liver
- Large hepatic stores may delay B12 Vitamin Deficiency presentation more than 5 years
- Signs: Deficiency
- See Vitamin B12 Deficiency
- Megaloblastic Macrocytic Anemia
- Sources: Animal sources only
- Liver
- Muscle Meats
- Fish
- Eggs
- Dairy products
- Vitamin B12 fortified foods (Cereals)
- Doses
- See Vitamin B12 Supplementation
- Recommended daily allowance: 2.4 mcg/day
- Elderly:
- B12 Fortified foods (Cereals)
- Daily dietary supplement up to Vitamin B12 1000 mcg orlly daily
- References
- Babior in Wilson (1991) Harrisons, McGraw, p. 1523-9
- Oh (2003) Am Fam Physician 67(5):979-86