Transient vitamin B12 malabsorption in a patient with mixed nutritional anemia

A 47-year-old nonvegan woman presented to my rural family practice with an anemia and was found to be deficient in iron, folate, and vitamin B12. Initial vitamin B12 malabsorption was documented by Schilling test and was reversed by nutritional repletion alone. This case illustrates that simple lack of intrinsic factor is not the only cause of vitamin B12 malabsorption in primary care patients and that inadequate diets may cause significant pathological consequences in ambulatory patients.