       Document 0337
 DOCN  M9630337
 TI    An update of vitamin B12 metabolism and deficiency states.
 DT    9603
 AU    Swain R; Department of Family/Sports Medicine, West Virginia;
       University-Charleston Division 25301, USA.
 SO    J Fam Pract. 1995 Dec;41(6):595-600. Unique Identifier : AIDSLINE
       MED/96099332
 AB    Vitamin B12 deficiency may be underestimated in the general population.
       High-risk groups for the deficiency syndrome include the elderly,
       patients taking ulcer medications over long periods, patients with
       acquired immunodeficiency syndrome, vegetarians, patients who have
       undergone stomach resection or small bowel resection, or both, and
       patients with dementia. The vitamin B12 deficiency syndrome is
       characterized by five stages, the fifth of which results in irreversible
       neuropsychiatric manifestations. Although the deficiency is easily
       treated, diagnosis is somewhat complicated by the shortcomings of the
       various tests. Current state-of-the-art testing uses serum cobalamin
       levels as a screening test and serum or urine homocysteine and
       methylmalonic acid determinations as confirmatory tests. Vitamin B12
       deficiency is treatable with monthly injections, large doses of daily
       oral supplement tablets, or an intranasal gel, which is far better
       absorbed than comparable oral supplements.
 DE    Administration, Intranasal  Age Factors  Dementia/ETIOLOGY  Human
       Infusions, Parenteral  Risk Factors  Vitamin B 12/ADMINISTRATION &
       DOSAGE/*METABOLISM/THERAPEUTIC USE  Vitamin B 12
       Deficiency/COMPLICATIONS/*DIAGNOSIS/DRUG THERAPY  JOURNAL ARTICLE
       REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

