Vitamin B12

Overview Vitamin B12 (cyanocobalamin and hydroxocobalamin) is essential to growth, cell reproduction, hematopoesis, and nucleoprotein and myelin synthesis. It works in close concert with olate in the synthesis o the building blocks or !"# and $"# synthesis. It is also essential or the maintenance o the integrity o the ner%ous system and or the synthesis o molecules in%ol%ed in atty acid biosynthesis, amino acid metabolism, and the production o energy. &he cobalt'containing B12 molecule is the largest molecule to be trans erred across the intestinal mucosa and trans er occurs only in the ileum. B12 is generally absent rom plant and %egetable ood sources, unless the ood is contaminated by microbes. Ingested B12 is bound to $'proteins and must be liberated by calcium, proteases, and bicarbonate in the duodenum be ore it can be absorbed. (ree B12 then attaches to intrinsic actor (I() to be transported across ileal cells as a dimer. It is then transported to the li%er in the bloodstream bound to transcobalamin'2 (&)'2). &he li%er is a rich repository or B12 and releases it, as needed into the systemic blood stream. (rank de iciency o B12 or gastric, intestinal, or pancreatic disorders that a ect the absorption o B12 will lead to B12 de iciency. !e iciency o B12 causes pernicious (megaloblastic) anemia by a ecting !"# production. #lso, since B12 is in%ol%ed in the synthesis o lipid and protein components o myelin, demyelination and ner%e degeneration will occur in se%ere B12 de iciency. &he most important reactions in the body in which B12 is in%ol%ed are* a) rearrangement o methylmalonyl')o# to succinyl')o# or use in gluconeogenesis b) trans er o a methyl group rom "+'methyl tetrahydro olate to homocysteine in the ormation o methionine ,under the in luence o methlycobalamin synthase- with resultant ormation o tetrahydro olate. &etrahydro olate is in%ol%ed in purine, pyrimidine, and nucleic acid biosynthesis. )linical signs o B12 de iciency include inappetance, lethargy, and ailure to thri%e. .ematological signs include non'regenerati%e megaloblastic anemia, anisocytosis, poikilocytosis, and neutropenia with hypersegmentation, Biochemical signs o B12 de iciency include reduced serum cobalamin le%els, increased serum methylmalonic acid le%els, homocystinuria and methylmalonuria. # congenital B12 malabsorption syndrome has been reported in giant schnau/ers, border collies, beagles, and in cats. Brand Names and Other Names &his %itamin is registered or use in humans. .uman ormulations* Big 0hot'121 ("aturally), )rystamine1 (!unhall), )yano2et1 (3ayrand), )yomin1 ((orest), $ubesol1 ()entral), .ydro')rsyti'121 ($oberts .auck), 4#'121 (.yrex), "ascobal1 ("astech), and generic Vitamin B12 (in2ectable and oral preparations). Veterinary ormulations* "one (except as part o multi%itamin ormulations) Uses of B12 &reatment o primary or secondary B12 de iciency. Precautions and Side Effects Vitamin B12 is essentially non'toxic but it should not be gi%en to animals with known

hypersensiti%ity to it or to cobalt. #naphylactic shock and death ha%e been reported in humans ollowing administration o %itamin B12 by in2ection. Drug Interactions # number o drugs are known to a ect the absorption o %itamin B12, including neomycin, potassium chloride, p'aminosalicylic acid, and colchicine. How B12 is Su !ied

Vitamin B12 is supplied in a %arity o methods, including* )yanocobalamin 5ral* 166 mcg, 2+6 mcg, +66 mcg, 1666 mcg, and +666 mcg tablets )yanocobalamin Intranasal* 7el, intranasal* +66 mcg86.1 m4 in + m4 bottles )yanocobalamin )rystalline* +66 mcg and 1666 mcg tablets9 166 mcg8m4 in2ection (:6ml %ial)9 1666 mcg8m4 in2ection (16 and :6 m4 %ials). .ydroxocobalamin )rystalline* 1666 mcg8m4 in2ection (:6m4 %ial) Dosing Information !og* By in2ection* +6 mcg8kg e%ery 2 weeks (e ecti%e in one study) 5ral treatment o B12 de iciency is not always e ecti%e, depending on the cause. Intrinsic actor (I() may ha%e to be supplied to acilitate B12 absorption. It can be dosed at 166 to 266 mcg8kg once daily. )at* "o good data are a%ailable 5ral treatment unlikely to be o much bene it in malabsorption states (e.g. pancreatic disease inter ering with the production and release o pancreatic I(). Vitamin B12 can be dosed at +6 to 166 mcg8kg once daily. "ote* the human $!# o B12 is approximately 2 mcg per day.