Vitamin B₁₂Malabsorption in Chronic Pancreatic Insufficiency

Abstract

Abstract 57Co-labeled vitamin B12 urinary excretion tests were performed on 22 patients with pancreatic exocrine insufficiency. Nine excreted less than 8 per cent of the orally administered vitamin in the urine within 24 hours. Known causes of vitamin B12 malabsorption such as intrinsic-factor deficiency, anti-intrinsic-factor antibodies, ileal disease and bacterial overgrowth were not present. The pH and total calcium content of ileal contents were similar in patients with pancreatic insufficiency whether they absorbed vitamin B12 normally or abnormally. No correlation was noted between malabsorption of the vitamin and fat malabsorption. Pancreatic extract (2 to 12 g) given to four of the nine patients with vitamin B12 malabsorption improved the urinary excretion test from a mean of 4.0 ± 0.64 (S.E.) per cent to 18.0 ± 2.63 per cent. Thus, some patients with pancreatic insufficiency show malabsorption of vitamin B12, and the pancreas may have a role in the absorption of this vitamin.