Cobalamin & Folate

Question 1

In what form is cobalamin when ingested?

Answer 1

Bound to dietary protein

Question 2

How is cobalamin released from its dietary carrier, what implications does this have in its interpretation?

Answer 2

Broken down by HCL and pepsin. Therefore, some anti-acids/PPIs may reduce cobalamin absorption.

Question 3

How does cobalamin make its way from the stomach to the ileum?

Answer 3

Carried to the duodenum by R protein from the stomach then digested by pancreatic proteases. here it binds to intrinsic factor to be carried to the distal ileum.

Question 4

How is cobalamin absorbed from the ileum?

Answer 4

Via specific cobalamin receptors.

Question 5

Given knowledge of the pathway of cobalamin, what does it potentially give information on? Therefore, what should it be interpreted with?

Answer 5

The pancreas
The ileum
Therefore, should be interpreted along with pancreatic enzymes.

Question 6

What are the three benefits of cobalamin supplementation in a disease state?

Answer 6

1. Prevent adverse effects of deficiency i.e. anaemia
2. May stimulate appetite in hyporexic patients
3. May help reverse GI signs