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Editor's Correspondence
February 22, 1999

Prevalence of Subtle Cobalamin Deficiency

Arch Intern Med. 1999;159(4):407. doi:

The prevalence of cobalamin deficiency has ranged from 3% to 29%.1-3 Subtle cobalamin deficiency is defined as metabolic evidence of cobalamin deficiency, such as elevated serum or urine methylmalonate levels, or abnormal findings on a deoxyuridine suppression test, or the absence of neurological symptoms or megaloblastic anemia.4 The prevalence of subtle cobalamin deficiency is unknown, but in one elderly population was 39%.1 Concerns have been raised regarding the initiation of widespread folate supplementation because it might obscure the hematologic effects of cobalamin deficiency and facilitate the progression of neuropsychiatric damage.4,5