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Vitamin B12 deficiency.

Ralph Green1, Joshua W Miller2

  • 1Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, United States.

Vitamins and Hormones
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PubMed
Summary
This summary is machine-generated.

Vitamin B12 (B12) is essential for human health, despite its low daily requirement. Deficiency can arise from absorption issues or poor diet, impacting DNA synthesis and nervous system function.

Keywords:
CobalaminHaptocorrinHomocysteineIntrinsic factorMegaloblastic anemiaMethylmalonic acidNeurodegenerationPernicious anemiaTranscobalaminVitamin B12

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Area of Science:

  • Biochemistry
  • Human Physiology
  • Nutrition Science

Background:

  • Vitamin B12 (B12) has the lowest daily requirement among water-soluble vitamins.
  • B12 possesses a complex absorption and assimilation pathway involving gastric and intestinal function, an enterohepatic circulation, and specific binding proteins.
  • Causes of B12 deficiency are diverse, including malabsorption, cellular delivery defects, and inadequate dietary intake.

Purpose of the Study:

  • To explore the multifaceted aspects of vitamin B12 (B12) metabolism and deficiency.
  • To detail the unique properties and complex physiological roles of B12.
  • To discuss the causes, consequences, and diagnostic approaches for B12 deficiency.

Main Methods:

  • Review of B12's biochemical functions as a cofactor in methionine synthase and methylmalonyl CoA mutase reactions.
  • Analysis of B12 absorption, assimilation, and enterohepatic pathways.
  • Examination of clinical manifestations, diagnostic laboratory testing, and the relationship with folate.

Main Results:

  • B12 is crucial for two key human reactions: cytosolic methionine synthase and mitochondrial methylmalonyl CoA mutase.
  • Disruption of these reactions leads to B12 deficiency, affecting DNA synthesis (megaloblastic anemia) and myelin repair (neurological issues).
  • B12 deficiency impacts major organ systems, including blood, bone marrow, and the nervous system, with variable severity.

Conclusions:

  • Vitamin B12 (B12) deficiency, though often associated with aging and malabsorption, affects all age groups, particularly those facing food insecurity.
  • Diagnosis relies on clinical suspicion supported by a comprehensive panel of laboratory tests.
  • Understanding B12's intricate metabolism and its interplay with folate is vital for addressing deficiency and its wide-ranging health consequences.