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Upcoming SlideShare. Like this presentation? Why not share! Embed Size px. Start on. Show related SlideShares at end. WordPress Shortcode. Full Name Comment goes here. Are you sure you want to Yes No. No Downloads. Views Total views. Actions Shares. Embeds 0 No embeds. No notes for slide. Rh1 1. Thymidilate 8. Histidine 9. Methionine Gastrectomy Tabel 6. B12 is available singly or in combination with other supplements.

B12 supplements are available in forms including cyanocobalamin, hydroxocobalamin, methylcobalamin, and adenosylcobalamin sometimes called "cobamamide" or "dibencozide".

Body stores in the liver are refilled with half a dozen injections in the first couple of weeks and then maintenance with monthly to quarterly injections throughout the life of the patient.

However, oral replacement is now an accepted route, as it has become increasingly appreciated that sufficient quantities of B12 are absorbed when large doses are given. This absorption does not rely on the presence of intrinsic factor or an intact ileum. This is thought to be due to decreased production and a compensatory prolonged lifespan for circulating neutrophils, which increase numbers of nuclear segments with age.

The isozyme is LDH-2 which is typical of the serum and hematopoetic cells. As vitamins go, B12 is large. One part of its structure is known as the corrin nucleus, which holds an atom of cobalt. The corrin resembles the heme of hemoglobin which holds an atom of iron. Any molecule that contains a corrin nucleus is considered a corrinoid. There are many different cobalamins and they are named after their attachments.

For example, methylcobalamin is cobalamin with a methyl group one carbon and three hydrogens attached. Many corrinoids, and possibly even some cobalamins, are not useable by human B12 enzymes. These are considered inactive B12 analogues. Beta globulin Contains more sialic acid than transcobalamin III Alpha globulin NOT a glycoprotein Encourages absorption in a number of tissues Degenerates once B12 is released B12 then recirculates Excreted in bile However, it is sensitive without being specific.

For this reason, MMA is not routinely recommended in the elderly. Moreover, preliminary evidence suggests that high serum folate levels might not only mask vitamin B12 deficiency, but could also exacerbate the anemia and worsen the cognitive symptoms associated with vitamin B12 deficiency [6,11].

Permanent nerve damage can occur if vitamin B12 deficiency is not treated. For these reasons, folic acid intake from fortified food and supplements should not exceed 1, mcg daily in healthy individuals [5]. Jalur metabolik asam folat dan vitamin B Lethargy Weight loss Weakness Dementia Leucopenia Thrombocytopenia Axonal degeneration Demyelination Urethral Sphincter problems Depression Increased liver weight Homocysteine MMA Bilirubin excretion LDH Liver glycogen Mitochondrial cristae in liver Hepatic citrate synthase Propionic acid Succinate dehydrogenase Cytochrome c activity Propionyl CoA Amino Acids Cell metabolism Protein synthesis Fatty acid synthesis enzymes ATP citrate lyase Decrease Transcobalamin II The COBASORB test contains three separate tests first, second and third test than can be performed separately, sequentially or in random order and number.

The first test use non-radioactive cobalamin for ingestion, the second test uses non-radioactive cobalamin and recombinant intrinsic factor for ingestion and the third test uses recombinant haptocorrin saturated with cobalamin for ingestion. All three tests involve analysis of changes in the concentration of cobalamin saturated transcobalamin holo-TC and cobalamin saturated haptocorrin holo-HC in the blood. Also disclosed are fits suitable for use in these methods.

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Mechanisms in pernicious anaemia.

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Vitamin B12 deficiency anemia

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B


Diagnosis and Management of Pernicious Anemia

Vitamin B 12 deficiency anemia , of which pernicious anemia PA is a type, [8] is a disease in which not enough red blood cells are produced due to a deficiency of vitamin B Pernicious anemia refers to anemia that results from lack of intrinsic factor. Because pernicious anemia is due to a lack of intrinsic factor, it is not preventable. Pernicious anemia due to autoimmune problems occurs in about one per people. The symptoms of pernicious anemia come on slowly. Untreated, it can lead to neurological complications, and in serious cases, death. Many of the signs and symptoms are due to anemia itself, when anemia is present.

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