concept

Vitamin b12 / cobalamin

Vitamin B12 is utilized in many parts of the body and metabolism. Vitamin B12, also known as cobalamin, is absorbed by the body in the intestine. Once food containing vitamin B12 is in the intestine, it binds to the protein R-binder, which is a protein in phagocytes and in the plasma. R-binder protein then takes releases vitamin B12 to the intrinsic factor (IF), which is produced by the parietal cells of the stomach. Lastly, vitamin B12 is transferred to transcobalamin II, which is secreted into circulation.1 Vitamin B12 is then used rapidly in the bone marrow, liver, and brain. Vitamin B12 deficiency can be caused at each one of these stages. First, a deficiency may occur if the protein R-binder is not be able to bind vitamin B12, which results in decreased vitamin B12 absorption and an increase in vitamin B12 excretion.2 Second, if the parietal cells in the stomach are damaged or are not secreting the IF to bind vitamin B12 from the R-binder protein, then vitamin B12 will never reach circulation. Last, if there is a problem with trans-vitamin B12 II then vitamin B12 will not get to the organs that require it. In addition to the problems in vitamin B12 uptake, some patients have pernicious anemia. Pernicious anemia occurs when the body cannot take up enough vitamin B12, which results in a decrease in the red blood cell count. Pernicious anemia is detected by the Schilling test, but in recent years it has been deemed inadequate.2 Serologic testing for parietal cell and IF is used in vitamin B12 uptake, which is a much more effective method. It is still unclear whether pernicious anemia is a direct cause of multiple sclerosis, but further research into the processes of vitamin B12 transport might yield fruitful results.

Ref:
S.P. Kalarn, Ronald Ross Watson, in Nutrition and Lifestyle in Neurological Autoimmune Diseases, 2017

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Added on Feb 1, 2022 by Barbara Van De Keer
Edited on Aug 17, 2022 by Barbara Van De Keer

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