Recent articles1,2 on the association of vitamin B12 deficiency and multiple sclerosis (MS) have revived interest in vitamin B12 metabolism in MS. In both disorders, demyelination is a noteworthy feature; however, MS is clearly different from vitamin B12 deficiency. Vitamin B12 deficiency is usually a disorder of the middle or late stage of life and rarely occurs in the age range typical for the presence of MS.3 Mild but significant macrocytosis has been found in patients with MS compared with an age- and sex-matched neurological control group.4 Significant lowering of the serum vitamin B12 concentration has also been reported in patients with MS.5 This association, however, remains unclear because convincing evidence of clinical abnormalities attributable to vitamin B12 deficiency in patients with MS was not documented by the authors. Although the serum vitamin B12 assay is an extremely sensitive
Río J, Montalban J, Tintoré M, Codina A, Malinow MR. Serum Homocysteine Levels in Multiple Sclerosis. Arch Neurol. 1994;51(12):1181. doi:10.1001/archneur.1994.00540240025007
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