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
Lesho EP, Hyder A. Prevalence of Subtle Cobalamin Deficiency. Arch Intern Med. 1999;159(4):407. doi:
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