Results May Be Misleading - A case of misdiagnosed B12 deficiency
Pathology testing can help to provide a clear picture of a patient’s nutritional status when the correct tests are completed and correctly interpreted. However results can be misleading if the entire picture is not considered. This case highlights how pathology testing can either aid or hinder the diagnosis of nutritional deficiencies.
Vitamin B12 – A Clinical Overview by Dr Elizabeth Steels
Vitamin B12, also known as cobalamin, is essential for DNA synthesis and energy production. It serves as a cofactor for two vital enzymes in the body: methylmalonyl-CoA mutase and methionine synthase.
Vitamin B12 comes in the form of methyl-, deoxyadenosyl- or hydroxocobalamin and is naturally obtained in the diet from meat, fish, chicken, eggs and milk products. Vitamin B12 however is not acquired from plant-based foods and the synthetic form, cyanocobalamin, is often added to supplements or to fortify foods such as bread and cereals.
Uric Acid: Gout & Complex Co-Morbidities
In Australia gout is a growing health problem. As healthcare practitioners we know that gout is caused from the deposition and accumulation of monosodium urate monohydrate crystals within joints. Increased serum uric acid (SUA) is considered a causal factor in gout patients and treatment considerations in both allopathic and complementary medicine focus on the reduction of uric acid (UA) in the gout patient. However, rising levels of UA also provide clues to early disease onset or warning signs for systemic inflammatory conditions such as obesity, hypertension, abnormal lipid metabolism, impaired glucose tolerance and chronic kidney disease. A bidirectional relationship of SUA, gout and metabolic syndrome exists and is therefore worth understanding.