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B12 breath test may ease deficiency diagnosis

By Nathan Gray , 23-Jun-2011
Last updated on 23-Jun-2011 at 17:23 GMT2011-06-23T17:23:39Z

A new breath test for the diagnosis of vitamin B12 deficiency may allow for a cheaper, faster, and more accurate diagnosis, according to new research.

Researchers from the University of Florida and Metabolic Solutions Inc, USA, claim that the newly developed tool could help to avoid potentially fatal deficiencies in vitamin B12.

The study, published in the Journal of Breath Research, the researcher team reported the development of a simple, non-invasive, low-cost breath test which can more accurately measure vitamin B12 status.

“Although this test is inexpensive and readily available, many publications suggest that serum B12 levels do not reflect vitamin deficiency and frequently show false positives and negative results,” said the authors, led by Dr. David Wagner of Metabolic Solutions.

“In light of the shortcomings of these vitamin B12 deficiency screening procedures, we developed a simple, noninvasive, and low-cost diagnostic breath test to detect B12 functional deficiency,” they added.

Deficiency problem

Vitamin B12 plays an important role in the functioning of the brain and nervous system, whilst also being essential for the formation of red blood cells.

Low levels lead to fatigue, clinical depression and memory loss as well as more detrimental and irreversible effects on the brain and nervous system. Several studies have also linked B12 deficiency to pernicious anaemia and Alzheimer’s disease.

Recent research has indicated that B12 deficiency is more widespread than previously believed. A 2007 from Tufts University study in the US found that 39 per cent of 3000 people studied had low values.

Deficiency is also known to be more common among vegetarians and vegans who do not supplement their diet, whilst it is widespread in the developing world and in elderly populations throughout the globe.
As such, the researchers said that vitamin B12 deficiency is “a growing public health problem”, in which the most common tests – using blood serum levels – are limited in accuracy and sensitivity and are non-specific for vitamin B12.

The new study developed a simple B12 breath test to more accurately evaluate vitamin B12 status as an alternative to the most common diagnostic test, serum B12 levels.

Study details

Wagner and colleagues noted that vitamin B12 plays a crucial role in the breakdown of sodium propionate – a common preservative in bakery products – into carbon dioxide.

As such, they reasoned that it may be possible to give propionate to subjects, which would be broken down with the aid of vitamin B12 in the body. The explained that the amount of resulting carbon dioxide exhaled is proportional to vitamin B12 status, noting that individuals with a vitamin B12 deficiency would produce smaller amounts of carbon dioxide.

In order to differentiate this carbon dioxide from the stuff we breathe out normally, the researchers labelled the propionate with a stable isotope of carbon, and then only measured the resulting labelled carbon dioxide.

To test the accuracy of the breath test, the obtained vitamin B12 levels were compared with several blood compounds that are currently used to ascertain vitamin B12 deficiency.

They also measured the incidence of B12 deficiency with the B12 breath test in 119 patients with chronic pancreatitis, Crohn’s disease, small intestinal bacterial overgrowth, and subjects over 65 years of age.

“The BBT results agreed with previous publications showing a higher incidence of B12 deficiency in these patients,” wrote Wagner and co-workers.

The authors concluded that the results from their study indicate that the vitamin B12 breath test is a non-invasive, sensitive, specific, and reproducible diagnostic test to detect vitamin B12 deficiency.

Source: Journal of Breath Research
Published online ahead of print, doi: 10.1088/1752-7155/5/4/046001
“A new 13C breath test to detect vitamin B12 deficiency: a prevalent and poorly diagnosed health problem”
Authors: D.A.Wagner, R. Schatz, R. Coston, C. Curington, D. Bolt, P.P. Toskes

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