The Schilling Test is a medical examination that tests whether a patient can take vitamin B12. Vitamin B12 is needed as the building block of the cell, especially of red blood cells. A deficiency of this can lead to, for example, anemia. Background
In order to absorb this vitamin, it binds to the r-factor (a protein produced by the salivary glands). Pancreatic enzymes then break the r-factor compound, and bind vitamin B12 with intrinsic factor. Intrinsic factor is required for the resorption of vitamin B12 by specific receptors in the final part of the small intestine. Approximately one percent can be taken passively, without intrinsic factor or intestinal receptors. Performance
The research is usually conducted by a nuclear medicine department. In the Schilling test, the patient is given oral radioactive vitamin B12. In addition, a large amount of non-radioactive vitamin B12 is injected intramuscularly. Due to the actual vitamin B12 overdose, the patient will expel much of this substance. Therefore, in normal ingestion, radiolabelled vitamin B12 will be detectable in the urine. If vitamin B12 is not resorbed, it is excreted with the faeces, and therefore will not be detectable in the urine. Variant
If reduced vitamin B12 uptake has been demonstrated, the test can be repeated while giving vitamin B12 also intrinsic factor. If the uptake of B12 is impaired by the absence of intrinsic factor (eg in pernicious anemia), this test variant will have a normal outcome. In a small intestine resorption disorder, the results of both tests are different.
wiki
