Vitamin B12 is essential for 1-carbon metabolism and cell division. Deficiency is a major public health issue and is widespread with estimates suggesting that as much as 20% of the elderly population may be deplete in B12.
Deficiency has been associated with neurodegenerative disease, probably as low vitamin B12 causes elevation of homocysteine, which is known to be a risk factor in Alzheimer's Disease.
Among other population groups at risk are pregnant women and their offspring, vegetarians and vegans and patients with intestinal diseases. Those taking H2 antagonists and proton pump inhibitors are also at risk due to the effect on absorption of Vitamin B12.
Identification of B12 deficiency is notoriously difficult. Haematological signs and symptoms may be absent or non-specific. Neurological symptoms may be the only manifestation of deficiency and can be irreversible if treatment is delayed. Early and accurate detection of vitamin B12 deficiency is therefore important.
Several publications verify assay superiority over total vitamin B12 determination.
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