| Customization: | Available |
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| Certification: | ISO, FDA |
| Assay Method: | HPLC, UV |
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Description Vitamin B12 is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement and a prescription medication. Because vitamin B12 contains the mineral cobalt, compounds with vitamin B12 activity are collectively called cobalamins [1]. Methylcobalamin and 5-deoxyadenosylcobalamin are the metabolically active forms of vitamin B12. However, two others forms, hydroxycobalamin and cyanocobalamin, become biologically active after they are converted to methylcobalamin or 5-deoxyadenosylcobalamin [1-3]. Vitamin B12 is required for the development, myelination, and function of the central nervous system; healthy red blood cell formation; and DNA synthesis [1,4,5]. Vitamin B12 functions as a cofactor for two enzymes, methionine synthase and L-methylmalonyl-CoA mutase [1-3,5]. Methionine synthase catalyzes the conversion of homocysteine to the essential amino acid methionine [1,2]. Methionine is required for the formation of S-adenosylmethionine, a universal methyl donor for almost 100 different substrates, including DNA, RNA, proteins, and lipids [3,5]. L-methylmalonyl-CoA mutase converts L-methylmalonyl-CoA to succinyl-CoA in the metabolism of propionate, a short-chain fatty acid [2]. Vitamin B12 is bound to protein in food and must be released before it is absorbed [5]. The process starts in the mouth when food is mixed with saliva. The freed vitamin B12 then binds with haptocorrin, a cobalamin-binding protein in the saliva. More vitamin B12 is released from its food matrix by the activity of hydrochloric acid and gastric protease in the stomach, where it then binds to haptocorrin [1]. In the duodenum, digestive enzymes free the vitamin B12 from haptocorrin, and this freed vitamin B12 combines with intrinsic factor, a transport and delivery binding protein secreted by the stomach's parietal cells. The resulting complex is absorbed in the distal ileum by receptor-mediated endocytosis [1,5]. If vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and therefore does not require the separation step. Vitamin B12 status is typically assessed by measurements of serum or plasma vitamin B12 levels. The cutoff between normal vitamin B12 levels and deficiency varies by method and laboratory, but most laboratories define subnormal serum or plasma values as those lower than 200 or 250 pg/mL (148 or 185 pmol/L) [2]. Levels of serum methylmalonic acid (MMA), a vitamin B12-associated metabolite, are the most sensitive markers of vitamin B12 status, and an MMA level greater than 0.271 micromol/L suggests vitamin B12 deficiency [6-8]. However, MMA levels also rise with renal insufficiency and tend to be higher in older adults [6,9,10]. Another marker is total plasma homocysteine levels, which rise quickly as vitamin B12 status declines; a serum homocysteine level higher than 15 micromol/L, for example, suggests vitamin B12 deficiency [11]. However, this indicator has poor specificity because it is influenced by other factors, such as low folate levels and, especially, by declines in kidney function [6]. Experts suggest that if a patient's serum vitamin B12 level is less than 150 pg/ml (111 pmol/L), the patient's serum MMA levels should be checked to confirm a diagnosis of vitamin B12 deficiency [7,9]. |
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