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Vitamin B12, Cobalamin

Cyanocobalamin (sye" an oh koe bal' a min) is a water soluble B vitamin found in dairy products and meat.

Chemistry of B12 vitamin

The cobalamins are complex organometallic compounds with a central cobalt atom within a porphyrin-like corrin ring.

Metabolic role of B12 vitamin

Cobalamins act as essential cofactors for several enzymes including methionine synthase and methylmalonyl-coenyzme A-mutase. The activities of these enzymes are important in RNA, protein and lipid metabolism and in hemoglobin synthesis.

Sources of Vitamin B12

Cobalamin cannot be synthesized by humans and its presence in meat and eggs is due to its synthesis by microorganisms in the intestines of animals.

Factors affecting absorption of B12

Vitamin B12 absorption from the diet requires a cofactor (intrinsic factor) produced by parietal cells of the stomach.

Cause of B12 deficiency

The major cause of cobalamin deficiency in humans is lack of intrinsic factor due to gastric atrophy caused by autoimmune destruction of parietal cells.

Symptoms of B12 deficiency

Classic vitamin B12 deficiency causes profound anemia and symptoms of anorexia, irritability, apathy, weakness and a distinctive neurologic syndrome with paresthesias in the hands and feet, unsteady gait, moodiness, confusion and memory loss.

Recommended daily dietary allowance of B12

The recommended daily dietary allowance of vitamin B12 is 2.4 µg in adults which is well within the concentrations found in the average American diet. Normal serum levels range from 200 to 900 pg/mL (150 to 660 picomoL).

Formulations for B12 vitamin

Vitamin B12 is available in multiple over-the-counter oral forms and it is included in most multivitamin preparations in typical concentrations of 1 to 6 µg.

IV and IM B12 injections

Parenteral formulations are available by prescription and treatment of vitamin B12 deficiency usually requires parenteral administration, typically in doses of 1000 µg intramuscularly once monthly. Neither oral nor parenteral forms of vitamin B12 have been linked to significant side effects or toxicity. The parenteral forms can cause local injection reactions and hypersensitivity and should be given intramuscularly or by deep subcutaneous injection and not intravenously.

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