RE: Vit B-12 =Elevated due to liver, cancer, bone dis, acute illness

[Guest guest]

That also brings up a question pertaining to Albumin levels being WNL when the

pt is dehydrated. I guess the solution would be to have the dehydration/ (in

your case) acute illness resolve and repeat test.

Quan MS, RD, CDN

>

> Thanks Crystal for the link to that article. I learned something new:

>

> Serum B12 levels can be significantly increased due to liver disease,

> certain cancers, chronic bone disease, or acute illness (7).

>

> However, NOW this has me wondering. IF B-12 can be elevated due to " acute

> illness " - if levels are MEASURED when a client is sick, will it appear

> " normal " when in fact it's low?

>

> Would love to know more about this! Found the following as well.

> Interesting.

>

>

> _Clin Biochem._ (javascript:AL_get(this, 'jour', 'Clin Biochem.') 2003

> Nov;36(8):585-90.

> Significance of elevated cobalamin (vitamin B12) levels in blood.

> _Ermens AA_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Ermens%20AA " [Author])

> , _Vlasveld LT_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Vlasveld%20LT " [Author]) , _Lindemans

J_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Lindemans%20J " [Author]) .

> Clinical Laboratory, Amphia Hospital, lokatie Langendijk, Breda,

> Netherlands. aermens@...

>

> Abstract

> Elevated levels of serum cobalamin may be a sign of a serious, even

> life-threatening, disease. Hematologic disorders like chronic myelogeneous

> leukemia, promyelocytic leukemia, polycythemia vera and also the

> hypereosinophilic syndrome can result in elevated levels of cobalamin. Not

surprisingly, a

> rise of the cobalamin concentration in serum is one of the diagnostic

> criteria for the latter two diseases. The increase in circulating cobalamin

> levels is predominantly caused by enhanced production of haptocorrin. Several

> liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and

> metastatic liver disease can also be accompanied by an increase in

> circulating cobalamin. This phenomenon is predominantly caused by cobalamin

> release during hepatic cytolysis and/or decreased cobalamin clearance by the

> affected liver. Altogether it can be concluded that an observed elevation of

> cobalamin in blood merits the a full diagnostic work up to assess the presence

> of disease.

> PMID: 14636871 [PubMed - indexed for MEDLINE]

> _Rev Med Interne._ (javascript:AL_get(this, 'jour', 'Rev Med Interne.')

> 2008 Mar;29(3):187-94. Epub 2007 Sep 21.

> [Clinical implications of high cobalamin blood levels for internal

> medicine].

> [Article in French]

> _Chiche L_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Chiche%20L " [Author]) ,

> _R_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Jean%20R " [Author]) ,

> _Romain F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Romain%20F " [Author]) ,

> _Roux F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Roux%20F " [Author]) ,

_

> G_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " %20G " [Author]) ,

> _Canavese S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Canavese%20S " [Author])

,

> _Branger S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Branger%20S " [Author]) ,

> _Harlé JR_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Harlé%20JR " [Author]) ,

> _Durand JM_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Durand%20JM " [Author]) .

> Service de médecine interne, hôpital de la Conception, 147, boulevard

> Baille, 13005 Marseille, France. laurentchiche@...

>

> Abstract

> PURPOSE: The high incidence of cobalamin (vitamin B12) deficiency results

> in frequent dosages of this vitamin in a department of internal medicine

> may reveal paradoxically high blood levels of cobalamin. The objective of the

> study was to estimate underlying diseases and potential diagnostic

> relevance of high cobalamin blood levels in internal medicine.

> METHODS: A retrospective study was conducted, including in-patients from

> December 2005 to July 2006 presenting high cobalamin blood levels, as

> determined with our laboratory normal values (200-950 pg/mL).

> RESULTS: High cobalamin blood level is not unusual (18.5% of all dosages)

> and, most of time, it is associated with one or several diseases, among

> which acute and chronic liver diseases (often of alcoholic origin), various

> neoplasias, malignant hemopathies (myelodysplasia, myeloproliferative

> diseases, multiple myeloma), renal insufficiency and transient hematologic

> abnormalities (neutrophilic hyperleucocytosis, hypereosinophilia). Vitamin

B12

> supplementation and chronic myeloid leukemia represent less than 5% of all

> hypervitaminemia. There is no correlation between the level of cobalamin

blood

> level and the number of underlying diseases for each patients. However,

> very high cobalamin blood levels (>1275 pg/mL) are significantly associated

> to malignant hemopathies (p<0.05). It is noteworthy that most of diagnosed

> neoplasia were unknown and at a non-metastatic stage.

> CONCLUSION: Very high cobalamin blood levels are significantly associated

> to malignant hemopathies among the population of a department of internal

> medicine. Referent laboratory should actively advertise the numerous

> diseases involved with high cobalamin blood levels.

> PMID: 17981373 [PubMed - indexed for MEDLINE]

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corporation

> Telecommuting Nationwide

> (Mountain Time) office and cell

> Fax:

> DineRight4@...

>

>

> " Though no one can go back and make a brand new start, anyone can start

> from now and make a brand new ending. "

> ~Carl Bard

>

> Specialist in IBS, migraine, fibromyalgia and inflammatory conditions

> which are often triggered by adverse reactions to foods and chemicals.

> Co-author of the Certified LEAP Therapist Training Course.

>

>

> In a message dated 1/11/2011 5:56:29 A.M. Mountain Standard Time,

> rd-usa writes:

>

> There is a great article in Practical Gastroenterology Jan '09 discussing

> B12 deficiency and supplementation link below:

> http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarti

> cles/pg_jan09_dasilvaarticle.pdf

> They state that anything below 221 is indicative of deficiency.

> Why not take oral B12 (minimum 1,000 ug if deficiency due to

> malabsorption) as there is no downside to this but there is a major downside

to b12

> deficiency.

> Also, it is clear that oral B12 can be very effective at replenishing

> levels see article below:

> http://www.bcguidelines.ca/gpac/pdf/b12.pdf

> Crystal s MSc, RD

>

>

>

>

[Guest guest]

That also brings up a question pertaining to Albumin levels being WNL when the

pt is dehydrated. I guess the solution would be to have the dehydration/ (in

your case) acute illness resolve and repeat test.

Quan MS, RD, CDN

>

> Thanks Crystal for the link to that article. I learned something new:

>

> Serum B12 levels can be significantly increased due to liver disease,

> certain cancers, chronic bone disease, or acute illness (7).

>

> However, NOW this has me wondering. IF B-12 can be elevated due to " acute

> illness " - if levels are MEASURED when a client is sick, will it appear

> " normal " when in fact it's low?

>

> Would love to know more about this! Found the following as well.

> Interesting.

>

>

> _Clin Biochem._ (javascript:AL_get(this, 'jour', 'Clin Biochem.') 2003

> Nov;36(8):585-90.

> Significance of elevated cobalamin (vitamin B12) levels in blood.

> _Ermens AA_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Ermens%20AA " [Author])

> , _Vlasveld LT_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Vlasveld%20LT " [Author]) , _Lindemans

J_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Lindemans%20J " [Author]) .

> Clinical Laboratory, Amphia Hospital, lokatie Langendijk, Breda,

> Netherlands. aermens@...

>

> Abstract

> Elevated levels of serum cobalamin may be a sign of a serious, even

> life-threatening, disease. Hematologic disorders like chronic myelogeneous

> leukemia, promyelocytic leukemia, polycythemia vera and also the

> hypereosinophilic syndrome can result in elevated levels of cobalamin. Not

surprisingly, a

> rise of the cobalamin concentration in serum is one of the diagnostic

> criteria for the latter two diseases. The increase in circulating cobalamin

> levels is predominantly caused by enhanced production of haptocorrin. Several

> liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and

> metastatic liver disease can also be accompanied by an increase in

> circulating cobalamin. This phenomenon is predominantly caused by cobalamin

> release during hepatic cytolysis and/or decreased cobalamin clearance by the

> affected liver. Altogether it can be concluded that an observed elevation of

> cobalamin in blood merits the a full diagnostic work up to assess the presence

> of disease.

> PMID: 14636871 [PubMed - indexed for MEDLINE]

> _Rev Med Interne._ (javascript:AL_get(this, 'jour', 'Rev Med Interne.')

> 2008 Mar;29(3):187-94. Epub 2007 Sep 21.

> [Clinical implications of high cobalamin blood levels for internal

> medicine].

> [Article in French]

> _Chiche L_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Chiche%20L " [Author]) ,

> _R_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Jean%20R " [Author]) ,

> _Romain F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Romain%20F " [Author]) ,

> _Roux F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Roux%20F " [Author]) ,

_

> G_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " %20G " [Author]) ,

> _Canavese S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Canavese%20S " [Author])

,

> _Branger S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Branger%20S " [Author]) ,

> _Harlé JR_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Harlé%20JR " [Author]) ,

> _Durand JM_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Durand%20JM " [Author]) .

> Service de médecine interne, hôpital de la Conception, 147, boulevard

> Baille, 13005 Marseille, France. laurentchiche@...

>

> Abstract

> PURPOSE: The high incidence of cobalamin (vitamin B12) deficiency results

> in frequent dosages of this vitamin in a department of internal medicine

> may reveal paradoxically high blood levels of cobalamin. The objective of the

> study was to estimate underlying diseases and potential diagnostic

> relevance of high cobalamin blood levels in internal medicine.

> METHODS: A retrospective study was conducted, including in-patients from

> December 2005 to July 2006 presenting high cobalamin blood levels, as

> determined with our laboratory normal values (200-950 pg/mL).

> RESULTS: High cobalamin blood level is not unusual (18.5% of all dosages)

> and, most of time, it is associated with one or several diseases, among

> which acute and chronic liver diseases (often of alcoholic origin), various

> neoplasias, malignant hemopathies (myelodysplasia, myeloproliferative

> diseases, multiple myeloma), renal insufficiency and transient hematologic

> abnormalities (neutrophilic hyperleucocytosis, hypereosinophilia). Vitamin

B12

> supplementation and chronic myeloid leukemia represent less than 5% of all

> hypervitaminemia. There is no correlation between the level of cobalamin

blood

> level and the number of underlying diseases for each patients. However,

> very high cobalamin blood levels (>1275 pg/mL) are significantly associated

> to malignant hemopathies (p<0.05). It is noteworthy that most of diagnosed

> neoplasia were unknown and at a non-metastatic stage.

> CONCLUSION: Very high cobalamin blood levels are significantly associated

> to malignant hemopathies among the population of a department of internal

> medicine. Referent laboratory should actively advertise the numerous

> diseases involved with high cobalamin blood levels.

> PMID: 17981373 [PubMed - indexed for MEDLINE]

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corporation

> Telecommuting Nationwide

> (Mountain Time) office and cell

> Fax:

> DineRight4@...

>

>

> " Though no one can go back and make a brand new start, anyone can start

> from now and make a brand new ending. "

> ~Carl Bard

>

> Specialist in IBS, migraine, fibromyalgia and inflammatory conditions

> which are often triggered by adverse reactions to foods and chemicals.

> Co-author of the Certified LEAP Therapist Training Course.

>

>

> In a message dated 1/11/2011 5:56:29 A.M. Mountain Standard Time,

> rd-usa writes:

>

> There is a great article in Practical Gastroenterology Jan '09 discussing

> B12 deficiency and supplementation link below:

> http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarti

> cles/pg_jan09_dasilvaarticle.pdf

> They state that anything below 221 is indicative of deficiency.

> Why not take oral B12 (minimum 1,000 ug if deficiency due to

> malabsorption) as there is no downside to this but there is a major downside

to b12

> deficiency.

> Also, it is clear that oral B12 can be very effective at replenishing

> levels see article below:

> http://www.bcguidelines.ca/gpac/pdf/b12.pdf

> Crystal s MSc, RD

>

>

>

>

[Guest guest]

That also brings up a question pertaining to Albumin levels being WNL when the

pt is dehydrated. I guess the solution would be to have the dehydration/ (in

your case) acute illness resolve and repeat test.

Quan MS, RD, CDN

>

> Thanks Crystal for the link to that article. I learned something new:

>

> Serum B12 levels can be significantly increased due to liver disease,

> certain cancers, chronic bone disease, or acute illness (7).

>

> However, NOW this has me wondering. IF B-12 can be elevated due to " acute

> illness " - if levels are MEASURED when a client is sick, will it appear

> " normal " when in fact it's low?

>

> Would love to know more about this! Found the following as well.

> Interesting.

>

>

> _Clin Biochem._ (javascript:AL_get(this, 'jour', 'Clin Biochem.') 2003

> Nov;36(8):585-90.

> Significance of elevated cobalamin (vitamin B12) levels in blood.

> _Ermens AA_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Ermens%20AA " [Author])

> , _Vlasveld LT_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Vlasveld%20LT " [Author]) , _Lindemans

J_

> (http://www.ncbi.nlm.nih.gov/pubmed?term= " Lindemans%20J " [Author]) .

> Clinical Laboratory, Amphia Hospital, lokatie Langendijk, Breda,

> Netherlands. aermens@...

>

> Abstract

> Elevated levels of serum cobalamin may be a sign of a serious, even

> life-threatening, disease. Hematologic disorders like chronic myelogeneous

> leukemia, promyelocytic leukemia, polycythemia vera and also the

> hypereosinophilic syndrome can result in elevated levels of cobalamin. Not

surprisingly, a

> rise of the cobalamin concentration in serum is one of the diagnostic

> criteria for the latter two diseases. The increase in circulating cobalamin

> levels is predominantly caused by enhanced production of haptocorrin. Several

> liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and

> metastatic liver disease can also be accompanied by an increase in

> circulating cobalamin. This phenomenon is predominantly caused by cobalamin

> release during hepatic cytolysis and/or decreased cobalamin clearance by the

> affected liver. Altogether it can be concluded that an observed elevation of

> cobalamin in blood merits the a full diagnostic work up to assess the presence

> of disease.

> PMID: 14636871 [PubMed - indexed for MEDLINE]

> _Rev Med Interne._ (javascript:AL_get(this, 'jour', 'Rev Med Interne.')

> 2008 Mar;29(3):187-94. Epub 2007 Sep 21.

> [Clinical implications of high cobalamin blood levels for internal

> medicine].

> [Article in French]

> _Chiche L_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Chiche%20L " [Author]) ,

> _R_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Jean%20R " [Author]) ,

> _Romain F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Romain%20F " [Author]) ,

> _Roux F_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Roux%20F " [Author]) ,

_

> G_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " %20G " [Author]) ,

> _Canavese S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Canavese%20S " [Author])

,

> _Branger S_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Branger%20S " [Author]) ,

> _Harlé JR_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Harlé%20JR " [Author]) ,

> _Durand JM_ (http://www.ncbi.nlm.nih.gov/pubmed?term= " Durand%20JM " [Author]) .

> Service de médecine interne, hôpital de la Conception, 147, boulevard

> Baille, 13005 Marseille, France. laurentchiche@...

>

> Abstract

> PURPOSE: The high incidence of cobalamin (vitamin B12) deficiency results

> in frequent dosages of this vitamin in a department of internal medicine

> may reveal paradoxically high blood levels of cobalamin. The objective of the

> study was to estimate underlying diseases and potential diagnostic

> relevance of high cobalamin blood levels in internal medicine.

> METHODS: A retrospective study was conducted, including in-patients from

> December 2005 to July 2006 presenting high cobalamin blood levels, as

> determined with our laboratory normal values (200-950 pg/mL).

> RESULTS: High cobalamin blood level is not unusual (18.5% of all dosages)

> and, most of time, it is associated with one or several diseases, among

> which acute and chronic liver diseases (often of alcoholic origin), various

> neoplasias, malignant hemopathies (myelodysplasia, myeloproliferative

> diseases, multiple myeloma), renal insufficiency and transient hematologic

> abnormalities (neutrophilic hyperleucocytosis, hypereosinophilia). Vitamin

B12

> supplementation and chronic myeloid leukemia represent less than 5% of all

> hypervitaminemia. There is no correlation between the level of cobalamin

blood

> level and the number of underlying diseases for each patients. However,

> very high cobalamin blood levels (>1275 pg/mL) are significantly associated

> to malignant hemopathies (p<0.05). It is noteworthy that most of diagnosed

> neoplasia were unknown and at a non-metastatic stage.

> CONCLUSION: Very high cobalamin blood levels are significantly associated

> to malignant hemopathies among the population of a department of internal

> medicine. Referent laboratory should actively advertise the numerous

> diseases involved with high cobalamin blood levels.

> PMID: 17981373 [PubMed - indexed for MEDLINE]

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corporation

> Telecommuting Nationwide

> (Mountain Time) office and cell

> Fax:

> DineRight4@...

>

>

> " Though no one can go back and make a brand new start, anyone can start

> from now and make a brand new ending. "

> ~Carl Bard

>

> Specialist in IBS, migraine, fibromyalgia and inflammatory conditions

> which are often triggered by adverse reactions to foods and chemicals.

> Co-author of the Certified LEAP Therapist Training Course.

>

>

> In a message dated 1/11/2011 5:56:29 A.M. Mountain Standard Time,

> rd-usa writes:

>

> There is a great article in Practical Gastroenterology Jan '09 discussing

> B12 deficiency and supplementation link below:

> http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarti

> cles/pg_jan09_dasilvaarticle.pdf

> They state that anything below 221 is indicative of deficiency.

> Why not take oral B12 (minimum 1,000 ug if deficiency due to

> malabsorption) as there is no downside to this but there is a major downside

to b12

> deficiency.

> Also, it is clear that oral B12 can be very effective at replenishing

> levels see article below:

> http://www.bcguidelines.ca/gpac/pdf/b12.pdf

> Crystal s MSc, RD

>

>

>

>