Changes in markers of cobalamin status after cessation of oral B-vitamin supplements in elderly people with mild cobalamin deficiency

Eur J Clin Nutr. 2008 Oct;62(10):1248-51. doi: 10.1038/sj.ejcn.1602834. Epub 2007 Jul 4.

Abstract

Mildly cobalamin-deficient elderly were supplemented with 1000 microg cobalamin (group C, n=34), 1000 microg cobalamin with 400 microg folic acid (group CF, n=31) or a placebo (n=30) for 6 months. Participants provided one single blood sample 3, 5 or 7 months after cessation of supplementation to monitor early changes in plasma concentrations of cobalamin, holotranscobalamin (holoTC) and methylmalonic acid (MMA). At the end of supplementation (groups C+CF), one participant met our criteria for mild cobalamin deficiency, as did 13, 14 and 43% of the participants assessed at respectively 3, 5 and 7 months post-supplementation. Cobalamin and holoTC declined on average with 47 and 56% relative to concentrations at the end of supplementation for the group assessed at 7 months post-supplementation. Essentially similar declines were observed for those participants assessed at 3 and 5 months post-supplementation. Mean MMA concentrations increased by 15% (P=0.07) in those participants assessed at 3 and 5 months post-supplementation, and increased by 50% (P=0.002) in those participants assessed at 7 months post-supplementation. Considering MMA as a sensitive tissue marker for cobalamin status, oral supplementation may afford adequate cobalamin status for a period of up to 5 months after cessation in the majority of participants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Biological Availability
  • Biomarkers / blood
  • Dietary Supplements
  • Female
  • Folic Acid / blood*
  • Folic Acid / pharmacology
  • Follow-Up Studies
  • Humans
  • Male
  • Methylmalonic Acid / blood
  • Nutritional Status*
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Treatment Outcome
  • Vitamin B 12 / administration & dosage
  • Vitamin B 12 / blood*
  • Vitamin B 12 / pharmacokinetics
  • Vitamin B 12 Deficiency / blood*
  • Vitamin B 12 Deficiency / drug therapy
  • Vitamin B 12 Deficiency / epidemiology*
  • Vitamin B Complex / administration & dosage
  • Vitamin B Complex / blood*
  • Vitamin B Complex / pharmacokinetics

Substances

  • Biomarkers
  • Vitamin B Complex
  • Methylmalonic Acid
  • Folic Acid
  • Vitamin B 12