all things vitamin b12

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Re: all things vitamin b12

Postby jimmylegs » Thu Apr 17, 2014 12:42 pm

Vitamin B12 Deficiency and Multiple Sclerosis; Is there Any Association? (2012)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354399/

Background: Vitamin B12 (Cobalamin) deficiency can result in some clinical and paraclinical characteristics similar to what is seen in multiple sclerosis (MS) patients. This study aimed to evaluate the controversial association between vitamin B12 deficiency and MS.

Methods: We measured serum vitamin B12 in 60 patients with MS and 38 healthy controls. Clinical disability was evaluated according to the Extended Disability Status Scale (EDSS). Serum B12 concentration was measured with Radioimmunoassay Dual Isotope method. The cutoff value for low serum vitamin B12 concentrations was 75 pg/mL. [jl edit: interesting - my lab must have used this assay too; my cleanest b12 test from '06 came back with the result "less than 75"] Patients were in remission at the time of blood draw.

Results: There were 13 (21.6%) MS patients and 10 (26.3%) controls with low serum B12 concentration with no significant difference between the groups; P>0.05. The mean serum vitamin B12 concentration in MS patients (108.9±45.3 pg/mL) was not significantly different compared with controls (98.9±44.4 pg/mL); P=0.284. Likewise, there was no correlation between the concentration of serum vitamin B12 and disease’ age of onset, duration, subtypes, or disability status.

Conclusions: In contrast to some previous reports, our findings did not support any association between B12 deficiency and MS.

first, let's play 'spot the methodological flaws'. in the abstract, one stands out to me. any thoughts?

here's the study data, showing patients with higher levels than controls: http://www.ncbi.nlm.nih.gov/pmc/article ... /table/T1/
http://www.sciencedirect.com/science/ar ... 6808002622

they're all pretty bad though, across the board.

another study:

Serum vitamin B12, folate, and homocysteine levels and their association with clinical and electrophysiological parameters in multiple sclerosis
http://www.sciencedirect.com/science/ar ... 6808002622
We aimed to evaluate serum vitamin B12, folate, homocysteine, mean corpuscular volume (MCV), hemoglobin (Hb), and hematocrit (Hct) levels in patients with MS. ... These parameters were evaluated in 35 patients during an acute attack and compared to data collected from 30 healthy individuals (control subjects).

Table 2
Vitamin B12, folate, homocysteine, Hb, and Hct levels and MCV in patients with
multiple sclerosis and healthy control subjects
.............................Patients with MS..............Control group
Vitamin B12 (pg/mL)....221.26 ± 72.75...........257.43 ± 105.67
No statistically significant differences (mean ± SD) were observed for vitamin B12, folate, or homocysteine levels

but
Subjects who exhibited prolonged (>116 ms) VEP latencies had lower vitamin B12 levels compared to normal subjects (212.22 ± 66.72 pg/mL vs. 251.75 ± 88.30 pg/mL, respectively). Patients who exhibited posterior tibial SEP P1 latencies longer than 42.1 ms also had lower vitamin B12 levels compared to normal subjects (221.95 ± 69.92 pg/mL vs. 244.57 ± 97.84 pg/mL). Similarly, subjects who exhibited prolonged (> 63 ms) posterior tibial SEP P2 latencies had lower vitamin B12 levels compared to normal subjects (214.67 ± 63.76 pg/mL vs. 246.87 ± 98.06 pg/mL)
We found a significant association between MS and vitamin B12 deficiency, and therefore suggest that all patients with MS should be screened for vitamin B12 deficiency.

grr using what standard :S moving on..

just looking for general healthy controls serum levels now... found this which sidetracked me neatly:

Folate, vitamin B12, and neuropsychiatric disorders.
http://www.lef.org/protocols/abstracts/abstr-077.htm
Folate and vitamin B12 are required both in the methylation of homocysteine to methionine and in the synthesis of S-adenosylmethionine. S-adenosylmethionine is involved in numerous methylation reactions involving proteins, phospholipids, DNA, and neurotransmitter metabolism. Both folate and vitamin B12 deficiency may cause similar neurologic and psychiatric disturbances including depression, dementia, and a demyelinating myelopathy. A current theory proposes that a defect in methylation processes is central to the biochemical basis of the neuropsychiatry of these vitamin deficiencies.

i'm on board with the methylation defect.. went looking for other players

Effect of zinc deficiency on methionine metabolism, methylation reactions and protein synthesis in isolated perfused rat liver.
http://europepmc.org/abstract/MED/3968590
the methyl group of the S-adenosylmethionine turned over much more slowly in the livers from zinc-deficient rats than in either control group. This was reflected in the depressed rates of methylation of various macromolecules, particularly DNA and histones.


will continue reviewing the literature, to establish an actual optimal serum cobalamin range seen in healthy controls across multiple studies.
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Re: all things vitamin b12

Postby jimmylegs » Fri Apr 18, 2014 4:00 pm

continuing the quest for a reasonable approximation of healthy serum cobalamin status

Cobalamin status in sickle cell disease
http://www.ncbi.nlm.nih.gov/pubmed/22830455
We analyzed blood samples from 86 subjects in two groups: SCD (n = 29) and non-SCD (n = 57). Serum cobalamin, folate, homocysteine, methylmalonic acid (MMA), anti-intrinsic factor antibody, Helicobacter pylori antibody, and gastrin were measured and compared.
Results
The median cobalamin was 235 pM in the SCD group vs. 292 pM in the non-SCD group (P-value = 0.014).

ugh now i have to worry about units ABBREVIATIONS on top of conversions? pM = pmol/L.

Vitamin and Mineral Status in Patients With Inflammatory Bowel Disease
http://journals.lww.com/jpgn/Abstract/2 ... th.21.aspx
Results: None of the 61 patients with IBD had folate or vitamin B12 deficiency. Vitamin D deficiency was found in 62% of the patients, vitamin A deficiency in 16%, vitamin E deficiency in 5%, and zinc deficiency in 40%. The control group had vitamin D and E and zinc deficiency in 75%, 8%, and 19% patients, respectively.

boo :( i don't have full text access to this journal. anyone else out there able to get into the serum levels for this one?

interesting:
Evaluation of Indicators of Cobalamin Deficiency Defined as Cobalamin-induced Reduction in Increased Serum Methylmalonic Acid
http://www.clinchem.org/content/46/11/1744.short
........................................Nondeficient (n = 136).......Deficient (n = 51)
Variable..........Units.............Range.....Mean.....SD........Range.....Mean.....SD
Cobalamin.......pmol/L...........51–300.......181....69........24–260.......108.....44

Signs of impaired cognitive function in adolescents with marginal cobalamin status
http://ajcn.nutrition.org/content/72/3/762.full.pdf
Characteristics, biochemical variables, and dietary intake of subjects who consumed a macrobiotic diet in early life and had a low or normal cobalamin status at the time of the study and in control subjects with normal cobalamin status

..............................................................Macrobiotic subjects
...............................................Cobalamin deficient.....Normal cobalamin.....Control subjects
Characteristic .................................(n = 31).....................(n = 17).................(n = 24)
Cobalamin (pmol/L)...................177 (136, 227).................291 (239, 331)......446 (352, 568)

"We found a significant association between cobalamin status and performance on tests measuring fluid intelligence, spatial ability, and short-term memory."

Serum Cobalamin and Transcobalamin Levels in Systemic Lupus Erythematosus
http://www.sciencedirect.com/science/ar ... 439090463N
The mean cobalamin level of the control group was 556.9 +/- 320.6 pg/mL ... The cobalamin levels of the entire SLE group (328.5 +/- 182.9 pg/mL) were significantly low in comparison to the control group (p <0.0005) (Figure 1).

Cobalamin Status and Its Biochemical Markers Methylmalonic Acid and Homocysteine in Different Age Groups from 4 Days to 19 Years
http://www.clinchem.org/content/49/12/2067.short
.................................................4 days.....6 wks–6 mos.....1–10 yrs.....10.5–15 yrs.....15.5–19 years
Serum cobalamin, pmol/L
Median........................................314.................217............551.............436................369

divide by .738 to convert to pg/ml... 369 converts to exactly 500 pg/ml
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Re: all things vitamin b12

Postby jimmylegs » Sat Apr 19, 2014 5:14 am

on the flip side:

High serum cobalamin levels in the clinical setting – clinical associations and holo-transcobalamin changes
http://www.ncbi.nlm.nih.gov/pubmed/11843883
High cobalamin levels (> 664 pmol/l; > 900 ng/l) occurred in 94 of 670 consecutive clinically requested assays (14%). The only independently significant associations with a high cobalamin level were renal failure among the clinical disorders (P=0.01), elevated serum creatinine (P=0.0001) and diminished albumin (P=0.0002) levels among laboratory tests. Both holo-TC I and holo-TC II levels were increased in renal failure (P=0.0001) but the increase was relatively greater in holo-TC II. The results indicate that high cobalamin levels are more frequent than low ones in clinical practice and appear to be associated often with renal failure.
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