Abstract
After successful vagotomy, patients usually have normal absorption of 57Co B 12 but serum levels of vitamin B 12 are often low or in the low range of normal. To determine if low gastric acid levels might reduce the patients' ability to free vitamin B 12 from food binders, the absorption of 57Co B 12 bound to chicken serum was studied in twenty patients more than five years after they had undergone vagotomy and a drainage procedure. All of the twelve patients with successful vagotomy showed malabsorption of the bound 57Co B 12. Seven of the eight patients with unsuccessful vagotomy showed normal absorption. The amount of bound 57Co B 12 absorbed was roughly proportional to gastric acidity. Furthermore, acid was shown to release bound 57Co B 12 in vitro. The test of absorption of bound 57Co B 12 may be a convenient substitute for the Hollander insulin test.
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