{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:10:55Z","timestamp":1771269055628,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2002,11,5]],"date-time":"2002-11-05T00:00:00Z","timestamp":1036454400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:p>\n                    <jats:bold>OBJECTIVES:<\/jats:bold>\n                    Because the effects of lower\u2010dose oral cobalamin (Cbl) supplements on older people with cobalamin deficiency are not known, we determined whether oral Cbl supplements at three different dose levels would normalize elevated serum methylmalonic acid (MMA) and total homocysteine (tHcy) concentrations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DESIGN:<\/jats:bold>\n                    Sequential nonrandomized intervention study of three dose levels.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>SETTINGS:<\/jats:bold>\n                    Two university\u2010based senior care clinics.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>PARTICIPANTS:<\/jats:bold>\n                    Twenty\u2010three older adults (aged \u226565) with serum Cbl levels of 221 pmol\/L (300 pg\/mL) or lower and serum MMA greater than 271 nmol\/L who had been enrolled in a previous screening study for Cbl deficiency (mean age 79 \u00b1 9; 17 male, 6 female; 17 white, 6 other).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>INTERVENTION:<\/jats:bold>\n                    Sequential daily treatment with 25 \u03bcg oral cobalamin, followed by 100 \u03bcg and 1,000 \u03bcg cobalamin each for a 6\u2010week period.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>MEASUREMENTS:<\/jats:bold>\n                    Serum MMA, tHcy, and other metabolites at baseline and after each 6\u2010week dosing interval.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Treatment with 25 \u03bcg and 100 \u03bcg lowered but did not normalize MMA levels in most subjects. A dose of 1,000 \u03bcg\/day proved to be the most effective in lowering MMA levels to within normal limits. Serum tHcy was normalized in six of 11 subjects who had elevated tHcy pretreatment with oral Cbl alone and in one subject in combination with a multivitamin.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSIONS:<\/jats:bold>\n                    Most Cbl\u2010deficient older people require more than 100 \u03bcg of oral Cbl to normalize serum MMA, which is a larger dose than is available in most standard multivitamins and Cbl supplements.\n                  <\/jats:p>","DOI":"10.1046\/j.1532-5415.2002.50506.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T00:36:47Z","timestamp":1047429407000},"page":"1789-1795","source":"Crossref","is-referenced-by-count":76,"title":["Response of Elevated Methylmalonic Acid to Three Dose Levels of Oral Cobalamin in Older Adults"],"prefix":"10.1111","volume":"50","author":[{"given":"Suparna","family":"Rajan","sequence":"first","affiliation":[]},{"given":"Jeffrey 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