distinguishing folate and vitamin b12 deficiency

[iownmle]

Hey all:

Why all the qbanks keep saying to measure methylmalonic acid to distinguish between folate and B12 deficiency? Why don't just measure serum B12? If it's low you got B12 deficiency! lolz

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[dfib slim]

Hey all:

Why all the qbanks keep saying to measure methylmalonic acid to distinguish between folate and B12 deficiency? Why don't just measure serum B12? If it's low you got B12 deficiency! lolz

You measure MMA if the B12 is equivocal.

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[ortnakas]

Folate deficiency has macrocytic anemia, hyperhsegmented neutrophils, glossitis, low folate, high homocysteine and normal MMA.

B12 deficiency has macrocytic anemia, hypersegmented neutrophils, glossitis, low B12, high homocysteine and high MMA.

B12 deficiency also causes neurologic symptoms and folate deficiency does not.

Edited: Apple doesn't believe me that macrocytic is a real word

 

[cyberchicken001]

Hey all:

Why all the qbanks keep saying to measure methylmalonic acid to distinguish between folate and B12 deficiency? Why don't just measure serum B12? If it's low you got B12 deficiency! lolz

You would measure the B12, the methylmalonic acid is a confirmatory test when you get a low B12.

 

[worldbeater]

Other quick points in addition to posters above have described:

B12 - Methylmalonic CoA mutase and Homocysteine methyltransferase are both cofactors, it is a long acting (World Q), water soluble (World Q), vitamin absorbed by the ileum. Presents with neuropathy (World Q where patient is given folate, but patient comes back with neuropathy).

Folate deficiency - seen in alcoholics, 2nd most common vitamin after your classic thiamine (B1) deficiency.