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

European Journal of Clinical Nutrition volume 62, pages 1248–1251 (2008)Cite this article

Abstract

Mildly cobalamin-deficient elderly were supplemented with 1000 μg cobalamin (group C, n=34), 1000 μg cobalamin with 400 μg 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.

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Acknowledgements

We are indebted to the participants who took part in this study, and to the directors and staff of the care facility homes for their support. We thank Ove Aarseth, Halvard Bergesen and Randi Mjelde Heimdal at the LOCUS of Homocysteine and Related Vitamins in Bergen for carrying out the HoloTC and tHcy assays, Arno van Rooij at the Homocysteine Unit of Lab Pediatrics and Neurology in Nijmegen for carrying out the MMA assays, and Laura van de Ven and Elham Fallah for their assistance in data collection. This work was sponsored by the Dutch Dairy Association, Zoetermeer, the Netherlands; and the Foundation to Promote Research into Functional Cobalamin Deficiency and the European Union BIOMED Demonstration Project.

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Authors and Affiliations

  1. Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    S J P M Eussen, W A van Staveren & L C P G M de Groot

  2. Section for Pharmacology, Institute of Medicine, LOCUS of Homocysteine and Related Vitamins, University of Bergen, Bergen, Norway

    P M Ueland & J Schneede

  3. The Dutch Dairy Association, Zoetermeer, The Netherlands

    G J Hiddink

  4. Department of Clinical Chemistry, University of Umeå, Umeå, Sweden

    J Schneede

  5. Department of Clinical Chemistry, Metabolic Unit, VU University Medical Center, Amsterdam, The Netherlands

    H J Blom

  6. Department of Geriatrics, University Medical Center, Nijmegen, The Netherlands

    W H L Hoefnagels

Authors
  1. S J P M Eussen
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  2. P M Ueland
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  3. G J Hiddink
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  4. J Schneede
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  5. H J Blom
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  6. W H L Hoefnagels
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  7. W A van Staveren
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  8. L C P G M de Groot
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Corresponding author

Correspondence to S J P M Eussen.

Additional information

Contributors: SJPME, LCPGMdG, GJH and WAvS contributed to the study design; SJPME supervised the data collection; PMU and HJB performed laboratory analysis; SJPME drafted the manuscript, and all other authors contributed to data analysis and critically revised the manuscript. None of the authors had any financial or personal conflict of interest.

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Eussen, S., Ueland, P., Hiddink, G. et al. Changes in markers of cobalamin status after cessation of oral B-vitamin supplements in elderly people with mild cobalamin deficiency. Eur J Clin Nutr 62, 1248–1251 (2008). https://doi.org/10.1038/sj.ejcn.1602834

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