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Malabsorption of protein-bound cobalamin but not unbound cobalamin during cimetidine administration

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Abstract

The suppressive effects of cimetidine on acid, pepsin, and intrinsic factor secretion have been well documented; however, the effect of cimetidine on cobalamin absorption has not been assessed. The absorption of both unbound [57Co] cyanocobalamin and protein-bound [57Co] cyanocobalamin was evaluated in 12 patients with duodenal ulcer disease during and after discontinuation of cimetidine therapy. Cimetidine administration did not lead to malabsorption of unbounds cobalamin but caused malabsorption of protein-bound cobalamin (0.22±0.08%, [mean±1sem] versus 2.3±0.10% in control subjects,P<0.01). This malabsorption was reversible upon discontinuation of cimetidine. Patients on cimetidine therapy malabsorb protein-bound cobalamin and, during long-term treatment, are at risk for developing cobalamin deficiency. This malabsorption of protein-bound cobalamin is not detectable by the usual tests of cobalamin absorption which employ unbound cobalamin.

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During the performance of these investigations Dr. King was the recipient of a Research Associate Award and Dr. Toskes, a Clinical Investigation Award, from the Veteran Administration.

Supported in part by grant RR-82 and training grant AM07209 from the National Institutes of Health.

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Steinberg, W.M., King, C.E. & Toskes, P.P. Malabsorption of protein-bound cobalamin but not unbound cobalamin during cimetidine administration. Digest Dis Sci 25, 188–192 (1980). https://doi.org/10.1007/BF01308137

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  • DOI: https://doi.org/10.1007/BF01308137

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