Subclinical cobalamin deficiency

Abstract

The story of SCCD, which is severalfold times more common in the elderly than clinical cobalamin deficiency but also differs from it in arising only infrequently from severe malabsorption and thus being less likely to progress, continues to evolve. Preventive benefits need to be confirmed and expanded, and will require fuller understanding of SCCD pathophysiology, natural history, and health consequences.

Response to a Letter to the Editor Entitled “Low Serum B12 Level Does Not Mean Vit. B12 Deficiency-Problems Related to the Diagnosis of Vitamin B12 Deficiency”

“…However, the optimal testing for diagnosis of SCCD continues to be investigated. 3 As recently reported, all biomarkers can produce falsely abnormal results, and none is a diagnostic gold standard. 3,5 Secondly, Dr Grzybowski points out that the reason for vitamin B12 deficiency in our patients was not given and intrinsic factor (IF)-related malabsorption was not verified.…”

“…3 As recently reported, all biomarkers can produce falsely abnormal results, and none is a diagnostic gold standard. 3,5 Secondly, Dr Grzybowski points out that the reason for vitamin B12 deficiency in our patients was not given and intrinsic factor (IF)-related malabsorption was not verified. The cause of vitamin B12 deficiency and IF was not evaluated in our work because it has been shown that the causes of SCCD are unknown in more than 60% of cases.…”

“…The cause of vitamin B12 deficiency and IF was not evaluated in our work because it has been shown that the causes of SCCD are unknown in more than 60% of cases. 3 As Dr Grzybowski states, there are some problems with the diagnosis of vitamin B12 diagnosis. He has enriched our article by discussing these problems throughout his letter.…”

“…It is known that the anemia is not seen in the SCCD. 3 Biochemical markers of cobalamin status have largely confirmatory roles in the diagnosis of clinical deficiency of vitamin B12, whose clinical expressions provide the diagnostic quasi-gold standard. 3 Cobalamin measurement is generally sufficient for the diagnosis because it has more than 90-95% sensitivity in the clinical deficiency.…”

“…3 Biochemical markers of cobalamin status have largely confirmatory roles in the diagnosis of clinical deficiency of vitamin B12, whose clinical expressions provide the diagnostic quasi-gold standard. 3 Cobalamin measurement is generally sufficient for the diagnosis because it has more than 90-95% sensitivity in the clinical deficiency. 4,5 On the other hand, the diagnosis of SCCD depends completely on metabolic testing because the patients are clinically normal.…”