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

[Guest guest]

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

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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