THE VITAMIN B12 AND FOLATE PATHOLOGY INVESTIGATION
THE INVESTIGATION OF ERRORS IN PATHOLOGY TESTS
FOR VITAMIN B12 AND FOLATE DEFICIENCY
BY MEANS OF MEDICAL EXPERIMENTS
B12 AND FOLATE INFORMATION
B12 EXPERT OPINION
B12 Expert Opinion
Misdiagnosis
Lindenbaum et al, reference CA12:

 

Oh and Brown, reference DA01:

Use of methylmalonic acid and homocysteine levels in the diagnosis of vitamin B12 deficiency has led to some surprising findings. If increased homocysteine or methylmalonic acid levels and a normalization of these metabolites in response to replacement therapy are used as diagnostic criteria for vitamin B12 deficiency, approximately 50 percent of these patients have serum vitamin B12 levels above 200 pg per mL.1 This observation suggests that use of a low serum vitamin B12 level as the sole means of diagnosis may miss up to one half of patients with actual tissue B12 deficiency. Other studies have shown similar findings, with the rate of missed diagnosis ranging from 10 to 26 percent when diagnosis is based on low serum vitamin B12 levels alone.3

 

Snow, reference DA02:

 

Amador, reference CA01:

 

Elin and Winter, reference DA09:

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