The Schelling test is used to determine whether the body is naturally absorbing vitamin B12 or not, and this test is also called “Vitamin B12 absorption analysis”. Through the “Rest assured yourself” series, we learn how to perform the “Schelling” test to check the body's absorption of vitamin B 12, according to ucsfbenioffchildrens.
How is the Schelling test performed?
This test can be done in four different stages to find out why your vitamin B12 levels are low.
Stage one: you will get two doses of vitamin B12 (cobalamin) you will take a small first dose (a radioactive form of B12) by mouth You will get a second, larger dose after one hour You will need to collect urine over the next 24 hours, and deliver it to the laboratory or office Your doctor will examine your urine to see if you are absorbing vitamin B12 normally.
If the first stage is abnormal, the second stage can be completed after 3-7 days.
The second stage: You are given radioactive B12 along with the intrinsic factor and the intrinsic factor is a protein produced by cells in the stomach lining that the body needs so that the intestine can absorb vitamin B12 efficiently.
The second stage of the test can determine if low vitamin B12 levels are caused by stomach problems that prevent it from producing the intrinsic factor.
If the second stage test is abnormal, the third stage test is performed.
The third stage: This test is performed after taking antibiotics for two weeks. It can find out if the abnormal bacterial growth has caused low levels of vitamin B12.
Stage 4: This test determines if low vitamin B12 levels are caused by problems with the pancreas. With this test, you will take pancreatic enzymes for three days, followed by a radioactive dose of vitamin B12.
How do you prepare for the Schelling test?
Do not eat for 8 hours before the start of the test, then eat normally for the next 24 hours. You can also drink water.
Your health care provider may ask you to stop taking medications that could affect the test.
You cannot have an intramuscular B12 injection within 3 days before the test.
The significance of the Schelling test
The Schelling test is performed to check absorption of vitamin B12 and to evaluate patients for pernicious anemia.
Other diseases under which the test can be performed:
Anemia Caused By Vitamin B12 Deficiency
Blind loop syndrome
Megaloblastic anemia
What do the test results mean?
Urinating 8 - 40% of the radioactive vitamin B12 within 24 hours is normal.
Low levels of vitamin B12 can cause megaloblastic anemia.
If there is a problem with the stomach's ability to form an intrinsic factor, then the first stage of the test will be abnormal and the second stage will be normal.
Both Schelling's stage 1 and stage 2 tests will be abnormal in people who have problems absorbing vitamin B12 and intrinsic factor in the small intestine.
Abnormal results may be due to:
Cholangiocarcinoma
Celiac disease
Crohn's disease
Liver disease
Pancreatic disease
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