Diagnosis of Vitamin B12 Deficiency
Vitamin B12 Deficiency Diagnosis: Book Excerpts
Diagnostic Tests for Vitamin B12 Deficiency: Online Medical Books
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Vitamin B deficiencies:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
The following values confirm vitamin B deficiency:
❑ Thiamine deficiency: commonly measured as micrograms per deciliter in a 24-hour urine collection. Deficiency levels are age-related: 1 to 3 years, less than 120; 4 to 6 years, less than 85; 7 to 9 years, less than 70; 10 to12 years, less than 60; 13 to 15 years, less than 50; adults, less than 27; pregnant women, less than 23 (second trimester), less than 21 (third trimester).
❑ Riboflavin deficiency: measured as micrograms per gram of creatinine in a 24-hour urine collection. Deficiency levels are age-related: 1 to 3 years, less than 150; 4 to 6 years, less than 100; 7 to 9 years, less than 85; 10 to 15 years, less than 70; adults, less than 27; pregnant women, less than 39 (second trimester); less than 30 (third trimester).
❑ Niacin deficiency: measured by N-methyl nicotinamide in a 24-hour urine collection as micrograms per gram of creatinine. Deficiency levels are: adults, less than 0.5; first trimester of pregnancy, less than 0.5; second trimester, less than 0.6; third trimester, less than 0.8.
❑ Pyridoxine deficiency: xanthurenic acid more than 50 mg/day in 24-hour urine collection after administration of 10 g of L-tryptophan; decreased levels of serum and red blood cell transaminases; reduced excretion of pyridoxic acid in urine.
❑ Cobalamin deficiency: cobalamin serum levels less than 150 pg/ml. Tests to discover the deficiency’s cause include gastric analysis and hemoglobin studies. In addition, the Schilling test measures absorption of radioactive cobalamin with and without intrinsic factor.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin C deficiency:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Confirming diagnosis Serum ascorbic acid levels less than 0.2 mg/dl and white blood cell ascorbic acid levels less than 30 mg/dl help confirm the diagnosis.
Dietary history revealing an inadequate intake of ascorbic acid suggests vitamin C deficiency. A capillary fragility test may be performed on the patient’s forearm with a blood pressure cuff; it’s positive if more than 10 petechiae form after 5 minutes of pressure.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin D deficiency:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Physical examination, dietary history, and laboratory tests establish the diagnosis. Test results that suggest vitamin D deficiency include plasma calcium serum levels less than 7.5 mg/dl, serum inorganic phosphorus levels less than 3 mg/dl, serum citrate levels less than 2.5 mg/dl, and alkaline phosphatase levels less than 4 Bodansky units/dl.
Confirming diagnosis X-rays confirm the diagnosis by showing characteristic bone deformities and abnormalities such as Looser’s zones (pseudofractures).
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin E deficiency:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Confirming diagnosis Dietary and medical histories suggest vitamin E deficiency. Serum alpha-tocopherol levels below 0.5 mg/dl in adults and below 0.2 mg/dl in infants confirm it. Creatinuria, increased creatine kinase levels, hemolytic anemia, and an elevated platelet count generally support the diagnosis.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin K deficiency:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Confirming diagnosis A PT that’s 25% longer than the normal range of 10 to 20 seconds, measured by the Quick method, confirms the diagnosis of vitamin K deficiency after other causes of prolonged PT (such as anticoagulant therapy or hepatic disease) have been ruled out. The International Normalized Ratio (normal value, 0.8 to 1.2) is the more common method of assessing PT adequacy.
Repetition of testing in 24 hours (and regularly during treatment) monitors the therapy’s effectiveness.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin A deficiency:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Dietary history and typical ocular lesions suggest vitamin A deficiency. Carotene levels less than 40 mcg/dl also suggest vitamin A deficiency, but they vary with seasonal ingestion of fruits and vegetables.
Confirming diagnosis A serum level of vitamin A that falls below 10 mcg/dl confirms the diagnosis. Levels between 10 and 19 mcg/dl are also considered low but the patient isn’t likely to have developed significant symptoms.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
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