Vitamin B12 Deficiency among Palestinians: A Critique Study

Khalid Younis

In fact, it takes several years for a person to develop vitamin B12 deficiency as a result ofmalabsorption because the daily requirement of vitamin B12 is low (around 3 mg) and thestorage rate is high (around 5 mg). Also, it is well known that the methods used to determineVit B12 do lack specificity (50%) and sensitivityn(95%). Based on the available data, 25%-50% of the time there were low levels of vitamin B12. As low levels of vitamin B12 withoutvitamin B12 deficiency have been reported, are all the individuals in the study with low levelsof vitamin B12 truly having vitamin B12 deficiency? Conversely, some individuals withnormal levels of Vit B12 do have magaloblastic anemia. As each method of assay has its owndrawbacks (CV is around 11% and they lack sensitivity and specificity), and vitamin B12deficiency may be identified in the absence of the expected clinical and hematologic findingsand visa versa, a careful and intelligent interpretation of results is very essential. To confirmlow or suspected results of vitamin B12, it is recommended to test also for serum and red cellfolate, serum homocystein, and urine MMA.An isolated result of serum B12 should not be the sole criterion on which treatment decisionis based, and a repeat assay and other confirmatory and clinical evaluation are necessary priorto a diagnostic conclusion. Additional secondary testing with metabolite levels andmonitoring of treatment response is recommended.Accordingly, I think that the high incidence of Vit B12 deficiency among Palestinians Is Fakebecause of misinterpretation.