Vitamin B12 Research Today is a free monthly online journal that collates and summarizes the latest research about Vitamin B12, including details on cyanocobalamin, benefits, supplements, deficiency, side-effects, sources.

Disorders of cobalamin (vitamin B12) metabolism: emerging concepts in pathophysiology, diagnosis and treatment.

Solomon LR

Section of Hematology, Department of Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, CT 06520, United Kingdom. lawrence.solomon@yale.edu <lawrence.solomon@yale.edu>

Although cobalamin (vitamin B12) was isolated almost 60 years ago, its biochemical, physiologic and neurologic effects remain incompletely defined. New observations suggest renal regulation of cobalamin metabolism; actions of cobalamin on nucleic acid and protein function; and a role for cobalamin in cytokine and growth factor regulation. Clinically, no gold standard has emerged for the diagnosis of cobalamin deficiency. Moreover, cobalamin resistance may occur in diabetes, renal insufficiency and advanced age, leading to functional cobalamin deficiency despite adequate cobalamin nutriture. Finally, high-dose cobalamin therapy may have salutary pharmacologic effects on neurologic function in a variety of disorders. Many studies lacked appropriate control groups. However, at this time, therapeutic trials with pharmacologic doses of cobalamin are suggested when findings consistent with cobalamin deficiency are present regardless of the results of diagnostic tests. While oral cobalamin immediate-release is adequate for many patients, its effectiveness in reversing neurologic abnormalities has yet to be established.

Published 10 April 2007 in Blood Rev, 21(3): 113-30.
Full-text of this article is available online (may require subscription).

© 2004-2008 Vitamin B12 Research Today. All Rights Reserved.