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The Syndrome of Food-Cobalamin Malabsorption: A Personal View in a Perspective of Clinical Practice

Emanuel Andres, Khalid Serraj, Mustapha Mecili, Georges Kaltenbach & Thomas Vogel

This article presents recent findings on cobalamin deficiencies due to food-cobalamin malabsorption or nondissociation of vitamin B12 from its carrier proteins syndrome. These findings might be of interest to medical practitioners. This disorder, for which a definitive consensus on the criteria for diagnosis is not yet available, is the leading cause of cobalamin deficiency in the elderly. In practice, food-cobalamin malabsorption is a diagnosis of exclusion, and requires the deductive elimination of all other causes of cobalamin deficiencies, particularly pernicious anaemia. The causes or associated disorders of food-cobalamin malabsorption are multiple and include gastric pathologies, Helicobacter pylori infections and certain drugs (biguanides and proton pump inhibitors). Depending on the disease aetiology, treatment of food-cobalamin malabsorption involves oral supplementation of doses lower than those required for pernicious anaemia.