Absorption and retention of free and milk protein-bound cyano- and hydroxocobalamins. An experimental study in rats.

INTRODUCTION: Cobalamin/Vitamin B12 (Cbl) is an essential vitamin, supplied mainly as hydroxocobalamin (OHCbl) by animal products, including cows' milk. Cyanocobalamin (CNCbl) is the usual form in vitamin pills. The aim was to explore absorption and tissue accumulation of two Cbl forms, administered alone or bound to milk protein. MATERIALS AND METHODS: We synthesized labeled OH[(57)Co]Cbl from commercially available CN[(57)Co]Cbl. Recombinant bovine transcobalamin (rbTC) was produced in yeast and skimmed milk obtained off the shelf. Male Wistar rats (250-300 g) received labeled Cbl by gastric gavage. First, we administered CN[(57)Co]Cbl, free or rbTC-bound (n = 15 in each group). Rats were sacrificed after two, 24, and 48 h. In the following studies, rats were sacrificed after 24 h. We compared absorption of free or rbTC-bound CN[(57)Co]Cbl added to cows' milk and analogous absorption of OH[(57)Co]Cbl, free or rbTC-bound, to absorption of free CN[(57)Co]Cbl, (n = 10 in each group). Blood, tissues, 24-h urine and feces were collected. Labeled Cbl was measured using a gamma counter. Results are expressed as percentage of administered dose. RESULTS: Absorptions of CNCbl and OHCbl were neither influenced by rbTC-binding nor administration in milk. Absorption increased in the first 24 h with no further tissue accumulation during the subsequent 24 h. Accumulation of free CNCbl and (OHCbl) was 1.4, (4.1) (liver); 20.2, (16.4) (kidney); and 0.05, (0.02) (plasma)% 24 h after administration. Total organ accumulations were 21.6, (20.5)%. While total accumulations of CNCbl and OHCbl were equal, distributions between liver, kidney, and plasma showed significant differences (p < 0.0001; p = 0.01; p < 0.0001). CONCLUSIONS: Cbl added to milk (spiked with rbTC) has high bioavailability matching that of free Cbl. OHCbl and CNCbl are absorbed equally well, but much more OHCbl accumulated in the liver. Benefits of oral supplementation with OHCbl compared to CNCbl should be investigated.

Metformin increases liver accumulation of vitamin B12 - an experimental study in rats.

AIMS/HYPOTHESIS: Patients treated with metformin exhibit low levels of plasma vitamin B12 (B12), and are considered at risk for developing B12 deficiency. In this study, we investigated the effect of metformin treatment on B12 uptake and distribution in rats. METHODS: Sprague Dawley rats (n = 18) were divided into two groups and given daily subcutaneous injections with metformin or saline (control) for three weeks. Following this, the animals received an oral dose of radio-labeled B12 ((57)[Co]-B12), and urine and feces were collected for 24 h. Plasma, bowel content, liver, and kidneys were collected and analyzed for B12, unsaturated B12-binding capacity, and (57)[Co]-B12. RESULTS: Three weeks of metformin treatment reduced plasma B12 by 22% or 289 [47-383] pmol/L (median and [range]) (p = 0.001), while no effect was observed on unsaturated B12-binding capacity. Compared with controls, the amount of B12 in the liver was 36% (p = 0.007) higher in metformin-treated rats, while the B12 content in the kidney was 34% (p = 0.013) lower. No difference in the total amount of absorbed (57)[Co]-B12 present in the tissues and organs studied was found, suggesting that metformin has no decreasing effect on the B12 absorption. CONCLUSIONS/INTERPRETATION: These results show that metformin treatment increases liver accumulation of B12, thereby resulting in decreases in circulating B12 and kidney accumulation of the vitamin. Our data questions whether the low plasma B12 observed in patients treated with metformin reflects impaired B12 status, and rather suggests altered tissue distribution and metabolism of the vitamin.