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Table 9 Causes of vitamin B12 deficiency, and short-term effect on HoloTC production

From: Holotranscobalamin (HoloTC, Active-B12) and Herbert’s model for the development of vitamin B12 deficiency: a review and alternative hypothesis

Cause of vitamin B12 deficiency

Classification

Short-term effect on HoloTC production?

Inadequate dietary intake

Inadequacy

No

Defective gastrointestinal absorption (other than food-cobalamin absorption)

Inadequacy

Yes?

Defective gastrointestinal absorption (food-cobalamin malabsorption)

Inadequacy

No

Inadequate cellular utilization (deficiency of a cobalamin coenzyme)

Inadequacy

No

Increased requirement (pregnancy or hyperthyroidism)

Excess

No

Increased excretion (alcoholism)

Excess

No

Increased destruction (nutrient or drug interactions)

Excess

No, unless intrinsic factor destroyed

  1. From Herbert (1987, 1994), Carmel (1995) and Andrès et al. (2004)