Serum Vitamin and Metabolite Concentrations Before and After 4 Months of Therapy in Patients Randomized to Oral Cyanocobalamin
| Patient No. . | Therapy . | Serum Cobalamin (pg/mL)* . | Serum Folate (ng/mL)* . | Serum Methylmalonic Acid (nmol/L)* . | Serum Total Homocysteine (μmol/L) . | ||||
|---|---|---|---|---|---|---|---|---|---|
| Pre† . | 4 mo† . | Pre . | 4 mo . | Pre . | 4 mo . | Pre . | 4 mo . | ||
| 1 | Oral | 30 | 1,635 | 8.7 | 6.6 | 25,400 | 136 | 113.4 | 8.2 |
| 2 | Oral | 10 | 330 | 3.9 | 7.4‡ | 14,700 | 195 | 175.0 | 13.3‡ |
| 3 | Oral | 35 | 510 | 13.8 | 10.6 | 13,600 | 160 | 96.0 | 8.0 |
| 4 | Oral | 70 | 520 | 6.0 | 8.3 | 5,350 | 447 | 27.3 | 12.2 |
| 5 | Oral | 100 | 315 | 6.4 | 5.1 | 1,450 | 287 | 41.7 | 16.5 |
| 6 | Oral | 65 | 1,885 | 6.1 | 8.7 | 1,180 | 151 | 14.2 | 7.8 |
| 7 | Oral | 150 | 1,470 | 6.4 | 4.1 | 1,060 | 95 | 10.5 | 6.3 |
| 8 | Oral | 125 | 1,030 | 4.6 | 5.4 | 877 | 153 | 9.0 | 6.9 |
| 9 | Oral | 65 | 555 | 4.3 | 3.2 | 811 | 94 | 22.5 | 6.7 |
| 10 | Oral | 160 | 1,650 | 4.3 | 4.1 | 789 | 158 | 16.8 | 7.6 |
| 11 | Oral | 95 | 845 | 8.5 | 11.4 | 732 | 125 | 23.2 | 21.7 |
| 12 | Oral | 110 | 2,100 | 6.5 | 8.4 | 636 | 101 | 22.8 | 11.2 |
| 13 | Oral | 95 | 520 | 1.9 | 1.8 | 600 | 111 | 19.5 | 10.7 |
| 14 | Oral | 60 | 660 | 5.9 | 5.7 | 525 | 174 | 12.3 | 8.0 |
| 15 | Oral | 120 | 625 | 7.2 | 8.3 | 458 | 115 | 17.9 | 8.7 |
| 16 | Oral | 155 | 1,900 | 3.6 | 3.0 | 407 | 294 | 13.1 | 11.7 |
| 17 | Oral | 65 | 745 | 1.5 | 1.3 | 389 | 118 | 24.6 | 18.3 |
| 18 | Oral | 155 | 650 | 10.3 | 65.0 | 386 | 127 | 10.5 | 6.6 |
| Mean | Oral | 93 ± 46 | 1,005 ± 595 | 6.1 ± 3.0 | 9.4 ± 14.2 | 3,850 ± 6,930 | 169 ± 90 | 37.2 ± 44.9 | 10.6 ± 4.4 |
| Patient No. . | Therapy . | Serum Cobalamin (pg/mL)* . | Serum Folate (ng/mL)* . | Serum Methylmalonic Acid (nmol/L)* . | Serum Total Homocysteine (μmol/L) . | ||||
|---|---|---|---|---|---|---|---|---|---|
| Pre† . | 4 mo† . | Pre . | 4 mo . | Pre . | 4 mo . | Pre . | 4 mo . | ||
| 1 | Oral | 30 | 1,635 | 8.7 | 6.6 | 25,400 | 136 | 113.4 | 8.2 |
| 2 | Oral | 10 | 330 | 3.9 | 7.4‡ | 14,700 | 195 | 175.0 | 13.3‡ |
| 3 | Oral | 35 | 510 | 13.8 | 10.6 | 13,600 | 160 | 96.0 | 8.0 |
| 4 | Oral | 70 | 520 | 6.0 | 8.3 | 5,350 | 447 | 27.3 | 12.2 |
| 5 | Oral | 100 | 315 | 6.4 | 5.1 | 1,450 | 287 | 41.7 | 16.5 |
| 6 | Oral | 65 | 1,885 | 6.1 | 8.7 | 1,180 | 151 | 14.2 | 7.8 |
| 7 | Oral | 150 | 1,470 | 6.4 | 4.1 | 1,060 | 95 | 10.5 | 6.3 |
| 8 | Oral | 125 | 1,030 | 4.6 | 5.4 | 877 | 153 | 9.0 | 6.9 |
| 9 | Oral | 65 | 555 | 4.3 | 3.2 | 811 | 94 | 22.5 | 6.7 |
| 10 | Oral | 160 | 1,650 | 4.3 | 4.1 | 789 | 158 | 16.8 | 7.6 |
| 11 | Oral | 95 | 845 | 8.5 | 11.4 | 732 | 125 | 23.2 | 21.7 |
| 12 | Oral | 110 | 2,100 | 6.5 | 8.4 | 636 | 101 | 22.8 | 11.2 |
| 13 | Oral | 95 | 520 | 1.9 | 1.8 | 600 | 111 | 19.5 | 10.7 |
| 14 | Oral | 60 | 660 | 5.9 | 5.7 | 525 | 174 | 12.3 | 8.0 |
| 15 | Oral | 120 | 625 | 7.2 | 8.3 | 458 | 115 | 17.9 | 8.7 |
| 16 | Oral | 155 | 1,900 | 3.6 | 3.0 | 407 | 294 | 13.1 | 11.7 |
| 17 | Oral | 65 | 745 | 1.5 | 1.3 | 389 | 118 | 24.6 | 18.3 |
| 18 | Oral | 155 | 650 | 10.3 | 65.0 | 386 | 127 | 10.5 | 6.6 |
| Mean | Oral | 93 ± 46 | 1,005 ± 595 | 6.1 ± 3.0 | 9.4 ± 14.2 | 3,850 ± 6,930 | 169 ± 90 | 37.2 ± 44.9 | 10.6 ± 4.4 |
*Normal range for serum cobalamin, 200 to 900 pg/mL. Normal range for serum folate, 2.6 to 13.0 ng/mL. Normal range for serum methylmalonic acid, based on mean ± 3 SD after log normalization to correct for skewness of data toward higher values, 53 to 376 nmol/L, and based on mean ± 2 SD, 73 to 271 nmol/L; for serum total homocysteine, based on mean ± 3 SD, 4.0 to 17.9 μmol/L, and based on mean ± 2 SD, 5.1 to 13.9 μmol/L.
Pre and 4 mo as in footnote to Table 1.
After 2 months of cobalamin treatment, the hematocrit was 41%, MCV was 90 fL, serum value for cobalamin was 315 pg/mL, for folate was 4.8 nmol/L (2.1 ng/mL), for methylmalonic acid was 231 nmol/L, and for homocysteine was 49.4 μmol/L. Folic acid at 400 μg daily by mouth was administered during the last 6 weeks before the 4-month specimen was obtained.