Schilling test
Measures absorption and urinary excretion of radioactive vitamin B12
The Schilling test is a diagnostic test used to determine the cause of vitamin B12 malabsorption. It involves two steps and is typically conducted over a period of two days.
Step 1: Ingestion of radioactive vitamin B12
In the first step, the patient is given a small amount of radioactive vitamin B12, either by injection or orally. This vitamin is labeled with radioactive cobalt-57 or cobalt-58, which allows it to be tracked inside the body.
Step 2: Ingestion of non-radioactive vitamin B12 with intrinsic factor
In the second step, the patient is given a larger amount of non-radioactive vitamin B12, along with intrinsic factor, a protein that helps the body absorb vitamin B12. The level of non-radioactive vitamin B12 in the patient’s urine is measured over the next 24 hours.
If the patient’s body absorbs a sufficient amount of the non-radioactive vitamin B12, it means the intrinsic factor is functioning properly. Conversely, if the patient’s body fails to absorb the non-radioactive vitamin B12, it indicates that the intrinsic factor is not functioning effectively.
If the second step of the Schilling test fails to identify a cause for the vitamin B12 malabsorption, additional tests may be necessary to identify other underlying factors contributing to the condition.
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