vitamin B12; cobalamin

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Introduction

Vitamin B12 assumes 3 biological forms, & a pharmaceutical form.

Co+2-containing cofactor in methyltransferase reactions including:

These are the only known functions of vitamin B12 in mammals[6].

* Also through this mechanism, plays a role in DNA synthesis

Absorption of vitamin B12:

Cobalamin is absorbed in association with intrinsic factor, a protein secreted by parietal cells in the gastric fundus. However, it is transcobalamin-1 that binds to vit B12 in the acidic environment of the stomach. Gastric acid facilitates release of cobalamin from binding in food sources. In the duodenum, transcobalamin-1 releases B12 for binding to intrinsic factor. The intrinsic factor/B12 complex is absorbed by attachment to specific receptors in the mucosal brush border of the ileum, i.e. cubilin. Amnionless is also necessary for efficient absorption of vitamin B12.

About 1% of an oral dose of vitamin B12 is absorbed by passive diffusion.[7] Within the ileal mucosa, the intrinsic factor is metabolized & cobalamin is transferred to transcobalamin-2. The transcobalamin-2/B12 complex is secreted into the portal circulation from which about 1/2 is taken up by the liver.

Most circulating vitamin B12 is bound to transcobalamin-1. However, it is probably metabolically inert since no cellular receptors for it have been identified.[10]

In plasma, transcobalamin-2/vit B12 (holo-TC2) is the metabolically active form of vit B12. 6-20% of plasma TC2 is saturated with vit B12. Elimination 1/2life of the holo-TC2 in plasma is 1 hour.[3] Most of the peripheral holo-TC2 clearance occurs via glomerular filtration followed by tubular uptake in the kidney. Tubular epithelium is abundant in TC2 receptors[4]

Liver stores of vitamin B12 are generally 2-5 mg.[9]

Other proteins that partipate in vitamin B12 metabolism include:

Dietary sources include:

Recommended daily allowance (adults)

See cyanocobalamin for pharmaceutical form of vitamin B12.

More general terms

More specific terms

Additional terms

Component of

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1017
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 411
  3. 3.0 3.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. 4.0 4.1 Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  6. 6.0 6.1 Stryer Biochemistry WH Freeman & Co, New York, 1988 pg 508
  7. 7.0 7.1 Prescriber's Letter 8(10):55 2001
  8. Harrison's Online, Chapter 107, McGraw Hill, 2002
  9. 9.0 9.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
    Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  10. 10.0 10.1 Carmel R, Clinical Chemistry. 48:407-409. 2002 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/11861432 <Internet> http://www.clinchem.org/cgi/content/full/48/3/407
  11. O'Leary F, Samman S. Vitamin B12 in health and disease. Nutrients. 2010 Mar;2(3):299-316. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22254022 Free PMC Article
  12. Malouf R, Areosa Sastre A. Vitamin B12 for cognition. Cochrane Database Syst Rev. 2003;(3):CD004326. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12918012
  13. 13.0 13.1 Khardori R Fast Five Quiz: Vitamin B12 Deficiency Medscape. December 22, 2020 https://reference.medscape.com/viewarticle/942750

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