Vitamin B12

Vitamin B12 (Cobalamin)

• Sourced primarily from animal products

– Meat and meat products
– Dairy contains less, but absorption may be better
– Plant-derived foods sometimes fortified
• Supplements
 Vitamin B12 Digestion, Absorption
In the stomach
– Released from proteins/polypeptides (pepsin)
– Binds to an R protein
– Lack of stomach acid can impair absorption

In the duodenum
– R protein hydrolyzed – free B12
– Binds to intrinsic factor

In the ileum
– Absorbed via binding with receptors
– Binds to transcobalamin II for transport, basal side of the cell,
blood
Vitamin B12 Digestion, Absorption,
 Vitamin B12 Digestion, Absorption

1. Vitamin B12 is released from food in the acid

environment of the stomach and with the help of pepsin.
2. Vitamin B12 binds to R proteins found in saliva and
gastric juice. The B12•R protein complex travels from the
stomach to the duodenum.
3. Within the alkaline environment of the duodenum, R
protein is digested to release vitamin B12.
4. In the duodenum, vitamin B12 binds and forms a
complex with intrinsic factor (IF) which was made by
gastric parietal cells.
5. Within the ileum, vitamin B12.IF complex binds to a
specific receptor and is internalized by endocytosis.
 Vitamin B12 Transport, and Storage

• In blood, bound to one of three cobalamins

– TCI and TCIII – exact functions unknown
– TCII – main protein that carries newly absorbed
cobalamin in 1:1 ratio
• Can be stored and retained in the body for long
periods
 Vitamin B12

Functions and mechanisms of action

– Conversion of homocysteine to methionine
– Conversion of L-methylmalonyl CoA to succinyl CoA

Excretion
– Urine main route
– 0.1%/day excreted in bile
– Most reabsorbed in the ileum
 Vitamin B12 RDA and Deficiency
Recommended Dietary Allowance
– Adults: 2.4 µg/day

Deficiency:
 megaloblastic macrocytic anemia aka pernicious
anemia (lack of IF, can’t absorb). Large RBC
– May cause neurologic problems
 Vitamin B12

• Toxicity
– None observed
– No UL
• Assessment of nutriture
– Serum concentrations
 Can be maintained at expense of tissues
– Methylmalonic acid
– Doxyuridine suppression test
– Schilling test (not done much due to radioactivity)
 Vitamin B12 Deficiency

Other causes
– Altered gastric pH
– Parietal cell destruction causing insufficient intrinsic
factor
 May result from atrophic gastritis, pernicious anemia, or other
conditions
– Impaired pancreatic exocrine, gastric, or intestinal
function
– Vegan diet