‘Hypercobalaminuria’ – Is urinary cobalamin loss a potential determinant of parenteral cobalamin (B12) efficacy in Pernicious Anaemia?

McCaddon, Andrew, Nexo, Ebba, Green, Ralph, Ahmadi, Kourosh R., Hanniba, Luciana, Thain, Alfie and Miller, Joshua W. (2025) ‘Hypercobalaminuria’ – Is urinary cobalamin loss a potential determinant of parenteral cobalamin (B12) efficacy in Pernicious Anaemia? Medical Hypotheses, 199 (111664). ISSN 1532-2777

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Abstract

It is unknown why many patients with pernicious anaemia are satisfactorily treated with injections of hydroxocobalamin or cyanocobalamin every 1–3 months whereas others require far more frequent replacement regimens, sometimes even weekly. A substantial but inconstant fraction of an injected dose of cobalamin is excreted in the urine within 72 h of injection, with subsequent loss of variable smaller amounts. We hypothesize the existence of ‘hypercobalaminuria’, whereby increased urinary cobalamin losses constitute a currently unrecognized factor influencing treatment refractoriness in some individuals. The hypothesis is testable by comparing cobalamin urinary losses in patients needing frequent as opposed to 1–3-monthly injections of cobalamin to remain symptom free. It implies that ‘less-responsive’ patients are likely to have significant hypercobalaminuria.

Item Type:	Article
Keywords:	Vitamin B12CobalaminHydroxocobalaminCyanocobalaminTreatment efficacy
Divisions:	Social and Life Sciences
Depositing User:	Hayley Dennis
Date Deposited:	09 Sep 2025 11:12
Last Modified:	09 Sep 2025 11:12
URI:	https://wrexham.repository.guildhe.ac.uk/id/eprint/18331

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