New Diagnostic Methods for PA

[MoKayD]

I found this online today here, ncbi.nlm.nih.gov/books/NBK5... It describes new methods of diagnosing PA. It looks interesting.

Alternative and new approaches to the diagnosis of PA are under evaluation. One of these is a newer propriety cobalamin absorption test, which has its basis in measuring the change in holoTC following oral ingestion of non-radiolabeled cobalamin. Another approach has been described using accelerator mass spectrometry to quantify 14C in the blood following an orally administered dose of [14C]-cyanocobalamin.[11] One may empirically administer vitamin B12 intramuscularly and assess the response if cobalamin deficiency is suspected. Most patients will feel clinically better within 24 hours. Additionally, marked reticulocytosis will appear within 5 to 7 days.

[fbirder]

Oh good. I've been saying for several years that they could use accelerator mass spectrometry to test for B12 absorption. I used to run a mass spectrometer for 30 years, and we had an AMS in the room next door.

It's the machine they use for really accurate carbon-dating as it can easily measure the tiny amounts of radioactive carbon-14 in a sample.

Using a drug labelled with carbon-14 is great for doing these kinds of studies. You know how much radioactivity they swallowed and you can use radioactivity counters to measure how much goes straight through them. The difference is the amount absorbed. Additionally you can measure the amount of radioactivity in their blood.

But putting radioactivity into humans normally means you have millions of safety checks. And it's expensive.

But AMS is so sensitive that you can use tiny amounts of radioactivity. So small they they don't need all those safety precautions. So the studies are easier and cheaper.

The problem is that an AMS isn't cheap. When we bought ours it was $5 million. And people with the machines charge around $100 a sample!

So I wouldn't expect routine screening any time soon.

[MoKayD in reply to fbirder]

Here in the US we're used to paying for expensive medical tests and treatments. Hopefully insurance would cover part of the cost.