Archive for the ‘Tips’ Category

What to Drug Test For?

no-drugs-156771_1280Employers who decide to drug test job applicants and/or employees must also decide which drugs they will test for. The basic 6 panel drug test consists of six drugs consistent with the U.S. Department of Transportation requirements. These six substances include THC (tetrahydrocannabinol, the psychoactive ingredient in marijuana), cocaine, opiates, amphetamines, PCP (phencyclidine), and Ecstasy (3,4-methylenedioxy-N-methylamphetamine).

Many employers today go beyond testing for these six drugs, expanding the panel of drugs for which job applicants’ and employees’ are tested. The panel sometimes is expanded to include as many drugs as the employer sees fit, and may include barbiturates, benzodiazepines, methadone, methaqualone, propoxyphene, and methamphetamines. Many employers also test for what is still the most common drug of abuse in America – although a legal one – alcohol.

No business is immune to the problems of workplace drug and alcohol abuse, with workplace drug abuse costing companies millions of dollars every year. It’s your right to protect your company and your responsibility to keep your employees safe in the workplace. With the high number of accidents and workplace injuries that occur as a result of drug and alcohol abuse, it’s a good idea to implement and enforce a strict, 100% substance-abuse free environment.

Creating a Substance-Free Workplace

drugs-1276787_1280Whether an employee or potential employee’s substance abuse occurs at home or at work, employees who abuse alcohol and drugs (including illegal drugs, prescription drugs, and over-the-counter drugs) can create significant issues for both employers and other employees. Employees who abuse drugs have been shown to have higher absenteeism, are less productive, have higher medical costs, and have more accidents and injuries. The cost of drug abuse to employers has been estimated to be as high as $100 billion a year.

In order to address and circumvent these issues, drug testing has become the norm for many companies. Step one in implementing a substance-free workplace is to have a policy against drug and alcohol abuse. Every employer can and should have such a policy. While it’s best to tailor your policy to fit your businesses circumstances, a model policy can serve as an excellent starting point and some common principles and language to use.

Because drug use can affect employees’ health and productivity, it’s important for businesses to periodically review their drug-testing policies. By implementing workplace drug-testing policies, an employer may be able to help prevent drug use before it starts, identify employees who need drug treatment, and reduce work-related accidents due to illegal drug use.

In our next blog post, we’ll discuss the substances most commonly tested using the 6 panel drug test kit, as well as the 8 panel drug test kit. Read on to learn more about those substances and implementing a drug-free policy in your workplace.

What is Type 1 Diabetes?

acarbose-867863_1280Type 1 diabetes, formerly known as juvenile diabetes, is a chronic autoimmune condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy.

The exact cause of type 1 diabetes is unknown. In most people with type 1 diabetes, the body’s own immune system – which normally fights harmful bacteria and viruses – mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics may play a role in this process, and exposure to certain environmental factors, such as viruses, may trigger the disease. Although type 1 diabetes usually appears during childhood or adolescence, it also can begin in adults.

Symptoms
Type 1 diabetes signs and symptoms can come on quickly and may include:
Increased thirst
Frequent urination
Bedwetting in children who previously didn’t wet the bed during the night
Extreme hunger
Unintended weight loss
Irritability and other mood changes
Fatigue and weakness
Blurred vision
In females, a vaginal yeast infection

Type 1 diabetes can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys. Keeping your blood sugar level close to normal most of the time can dramatically reduce the risk of many complications.

If you suspect that you or your child might have type 1 diabetes, get evaluated immediately. Diabetes Assays ELISA kits can let your doctor know if you need further evaluation and treatment.

Despite active research, type 1 diabetes has no cure. But it can be managed. With proper treatment, people with type 1 diabetes can expect to live longer, healthier lives than did people with type 1 diabetes in the past.

Flu Facts: Antiviral Medications

Though it’s not possible to predict the severity of the flu season, it’s a guarantee that it’ll be here before long. Flu seasons are unpredictable in a number of ways. While flu spreads every year, the timing, severity, and length of the season varies from one year to another.

thermometer-833085_1280In order to protect yourself, it’s important to get vaccinated as soon as the flu vaccine becomes available. This ensures that as many people as possible are protected. In addition to the vaccine, everyday preventative steps, such as avoiding sick people and washing your hands to reduce the spread of germs can help you stay healthy.

If you’ve taken those precautions and an influenza testing kit confirms you’ve still come down with the flu, antiviral medications, such as Tamiflu (oseltamivir), zanamivir and peramivir can be used to treat flu illness. Studies show that prompt treatment with antiviral drugs can prevent serious flu complications and can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still be beneficial when given later in the course of illness. Antiviral drugs are effective across all age-and risk groups.

Flu Season Is On The Way

Ready or not, the annual flu season, which generally runs from October through May, is on its way. That also means it’s time for your annul flu vaccine.

vaccine-789890_1280No doubt you recall last year’s vaccine dilemma. So, will this year’s version be more effective? Experts are optimistic.

Three kinds of viruses commonly circulate among people today, according to the Centers for Disease Control: two types of influenza A, H1N1 and H3N2, and influenza B viruses. The CDC said all of the 2015-16 vaccines will protect against those three viruses, and so far, health officials say, they appear to be on target.

Experts say the strength of the vaccine all comes down to how well manufacturers – which work months in advance to produce the vaccine – predict the strains of flu virus that will hit us. Flu vaccine predictions start early every year based on what kind of flu strains are hitting people in the Southern Hemisphere during their flu season, which is the opposite of ours. Manufacturers then try to determine if the same flu strains will make their way to us in the Northern Hemisphere.

Whether or not this year’s vaccine is a perfect match is yet to be determined, but public health official’s advice people to get their annual flu shot, especially those most vulnerable to flu, including children under the age of 5 and adults 65 and older. Once flu season is in full swing, if you feel you are coming down with symptoms, see your doctor right away. They can administer an influenza test by using influenza rapid test kit to determine if antiviral medication, like Tamiflu, can help you.

Pregnant women should know about Fertility Elisa kits

If you are planing to have kids you should know about fertility ELISA kits.

Being pregnant is such a special and wonderful time in the life of a woman. Knowing that you carry the life of your child inside of you is life affirming and the greatest gift of all. However, if you are one of the millions of couples who are having a difficult time becoming pregnant, that time in your life can be one of the darkest.

Fertility ELISA kitsSome women are lucky enough to get pregnant easily without even trying, while other women chart their cycles religiously, time their sex scientifically and try for months or years to conceive without any luck. Infertility is a real struggle and effects more couples then many would believe.

Infertility is a sensitive topic; if a man can’t impregnate his lady, he may feel less masculine. And a woman who can’t become pregnant may question her femininity and her body. The answers to why a couple experiences difficulty becoming pregnant can be complicated and requirespecialized testing to delve into the problem and find a solution.

There are often a few common reasons why a woman can’t get pregnant, one of which is endometriosis, which is aconditionthat causes scarring and inflammation. If a woman suffers from Polycystic Ovarian Syndrome (PCOS), the egg never matures and therefore makes it impossible to become pregnant.  For the man’s contribution, sperm morphology (size and shape), motility (movement) and overall count play an important role in conception. These are just a few of the many issues that can cause infertility. Take a look at our selection of fertility ELISA kits available to find the right selection for your needs.

Dengue ELISA test

Dengue ELISA test | Rapidtest.com Blog

Have you gotten sick after traveling abroad to areas like Latin America, Southeast Asia, or the Pacific Islands? If you were stung by a mosquito, there is a possibility that you could have been infected with dengue virusDengue infection can be complicated but early recognition and treatments can lower the risks, such as medical complications or death.  Diagnostic Automation / Cortez Diagnostics, Inc., offers quality dengue ELISA tests for your needs. 

Dengue IgG ELISA Test

Typical dengue symptoms are usually high fever, joint pain, bone pain, and rashes. It’s important to watch for any warning signs and go to the emergency room if you are having severe stomach pains, vomiting, red spots, or difficulty breathing. Typically, there have been very few cases in the US, but there was an outbreak in 2001 in Hawaii. When traveling, it’s important to use bug spray and other pest control methods to avoid being bitten. No one wants to travel with this troublesome disease!

Take a look at our dengue ELISA tests and make your purchase today. Whether you are an individual who suspects a problem or are working for a testing lab and need to run this test, Diagnostic Automation / Cortez Diagnostics, Inc., offers excellent tests for your needs. 

Progesterone ELISA kit blog

Test: Progesterone ELISA kit Cat#: 2077Z

Synonyms: Progesterone EIA kit

Shelf Life: 12-14 months

Total time: ~ 110 minutes

 

Progesterone, a neurosteroid is synthesized from both tissue and circulating cholesterol via pregnenolone through sequential enzymatic actions of desmolase and delta 4-5 isomerase.  Progesterone which regulates a wide range of biological and metabolic functions in the body is the precursor to important steroid hormones such as estrogen, testosterone, and cortisol. It is produced primarily in the corpus luteum of the ovaries in females and testes in males, and in the adrenal glands in both sexes.  Body stores progesterone in adipose tissue.  In blood only 2-10% of the total progesterone circulates as free hormone.   Most of the progesterone in blood is in complex form which is bound to Albumin, Corticosteroid Binding Globulin (CBG), and sex Hormone Binding Globulin (SHBG) [1].

Progesterone’s main function in females is to prepare the endometrium in uterus to accept and sustain the fertilized egg.  It promotes fetal survival and development.  The level of progesterone drops if the egg is not fertilized and menstruation follows. Then progesterone level remains relatively constant throughout the follicular phase of the menstrual cycle. Progesterone concentration increases rapidly following ovulation and remains elevated for 4-6 days and decreases to the initial level 24 hours before the onset of menstruation.  During pregnancy placental progesterone production rises steadily to levels of 10 to 20 times those of the luteal phase peak reaching value as high as 200ng/ml (300-400mg daily) at term [2].

 

 

Progesterone Molecular Structure [3]

 

Progesterone measurements are used to determine ovulation as well as to establish luteal phase defects. Thus progesterone level in blood is useful indicator of ovulation and monitoring luteal function.

At Diagnostic Automation the serum Progesterone ELISA kit offers an accurate prediction of ovulation.

http://www.rapidtest.com/index.php?i=Progesterone-ELISA-kit&id=67&cat=14

Fetal adrenal gland uses large amounts of progesterone supplied by the placenta to make cortisol.  Cortisol is an essential hormone for stress response.  Stress reduces progesterone production as body redirects it into cortisol production to manage and decrease stress level in the body [4& 5].

Recent steroid profiling study offers valuable data for the diagnostics of diseases related to steroidogenesis changes in the fetal and maternal compartments and placenta.  Result showed higher production of active progesterone in fetus with the approaching term [6].

 

Moreover, various studies have demonstrated the supportive role of progesterone on normal development of neurons in the brain.   Following traumatic brain injury progesterone is being utilized as a therapeutic mediator to recover neuron loss and improve cognitive dysfunction.  Multiple mechanisms have been proposed for progesterone role as a neuroprotective agent such as reduction of inflammation following brain trauma, and inhibition of calcium signaling [7&8]. A recent study has proposed progesterone as a candidate to be used as a neuroprotective agent for stroke [9].

 

Progesterone concentration can fluctuate considerably not only from person to person, but also its level varies during day, thus serial measurements are highly recommended.

Measuring progesterone level in blood has been an established method for the detection of ovulation.  Progesterone measurements are used clinically to confirm ovulation and normal function of the corpus luteum in non-pregnant women.

At Diagnostic Automation the serum Progesterone ELISA kit offers an accurate prediction of ovulation.

http://www.rapidtest.com/index.php?i=Progesterone-ELISA-kit&id=67&cat=14

 

 

Indications for progesterone elisa testing:

1. Detecting ovulation

2. Monitoring embryo transfer

3. Monitoring fetal health throughout the high risk pregnancies

4. Identifying high risk patients for abortion early on in pregnancy

5. Checking abnormal bleeding in a non-pregnant woman

6. Diagnosis of ectopic & molar pregnancies

7. Monitoring progesterone replacement therapy

8. Checking normal function of luteum in non-pregnant women

9. Diagnosis of Luteinized unruptured follicle syndrome

10. Detecting ovarian tumors

 

 

Intended use of Progesterone ELISA kit Cat#: 2077Z:

The Diagnostic Automation Progesterone EIA test is for the quantitative determination of Progesterone concentration in human serum valid for detection and monitoring of conditions above.

http://www.rapidtest.com/index.php?i=Progesterone-ELISA-kit&id=67&cat=14

 

 

Materials and Components 

Materials provided with Progesterone ELISA Test Kit:

• Goat Anti-Rabbit IgG-coated Microplate 96 wells

• Progesterone ELISA test Reference Standards: 0, 0.5, 3.0, 10, 25, and 50 ng/ml

Liquids, 0.5 ml each, ready to use

• Rabbit Anti-Progesterone Reagent (pink color), 7 ml

• Progesterone elisa-HRP Conjugate Concentrate (11x), 1.3 ml

• Progesterone elisa-HRP Conjugate Diluent, 13 ml

• Progesterone EIA Control 1, Liquid, 0.5 ml, Ready to use

• Progesterone EIA Control 2, Liquid, 0.5 ml, Ready to use

• TMB Reagent (One-Step), 11 ml

• Stop Solution (1N HCl), 11 ml

 

 

Materials required but not provided:

• Precision pipettes: 5~40μl, and 0.05~0.2ml

• Disposable pipette tips

• Distilled or deionized water

• Vortex mixer or equivalent

• Absorbent paper or paper towel

• Graph paper

• ELISA kit Microplate Washer

• ELISA kit Microplate Reader

 

In addition to progesterone ELISA kit, Diagnostic Automation offers two additional tests for assessment of progesterone level in blood:

17-alpha hydroxy Progesterone ELISA kit (Cat # 1292Z)

Diagnostic Automation 17-Hydroxyprogesterone (17-OH progesterone or 17OHP) elisa kit is expedient for the measurements of levels of 17-OHP which are useful in the evaluation of patients suspected with congenital adrenal hyperplasia.  Since defective enzymes, 21-hydroxylase and 11ß-hydroxilase lead to a buildup of 17OHP level.

http://www.rapidtest.com/index.php?i=17-alpha-hydroxy-Progesterone-ELISA-kit&id=72&cat=14

Progesterone CLIA (Chemiluminescence Immuno Assay) kit (Cat # 9025-16)

Progesterone CLIA detection using Microplate luminometers provides a sensitive, high throughput, and economical alternative to conventional colorimetric methodologies.

http://www.rapidtest.com/index.php?i=Progesterone-CLIA-kit—(Chemiluminescence-Immuno-Assay)&id=535&cat=39

 

 

 

Related kits to progesterone elisa:

 

Beta HCG (Total) ELISA kit (Cat # 4201-16)

Studies have shown that HCG levels can be useful in predicting spontaneous abortions, aiding in the detection of ectopic pregnancy and multiple gestation. Elevated levels of HCG have also been detected in serum from patients with abnormal physiological conditions not related to pregnancy.

http://www.rapidtest.com/index.php?i=Beta-HCG-(Total)-ELISA-kit&id=58&cat=13

 

Luteinizing hormone (LH) ELISA Kit (Cat #4225Z)

This test may be used in conjunction with progesterone elisa kit.  Patients suffering from hypogonadism show increased concentrations of serum LH.  A decrease in steroid hormone production in females is a result of immature ovaries, primary ovarian failure, polycystic ovary disease, or menopause; in these cases, LH secretion is not regulated.

http://www.rapidtest.com/index.php?i=LH-ELISA-kit&id=61&cat=13

 

 

 

 

 

References:

1.Jeremy M Berg, John L Tymoczko, and Lubert Stryer. Biochemistry, 5th edition.2002, New York.  WH. Freeman; ISBN-10: 0-7167-3051-0

2. Hoehn K, Marieb EN. Human Anatomy & Physiology, 2010, San Francisco: Benjamin Cummings; ISBN 0-321-60261-7

3. NCBI

http://pubchem.ncbi.nlm.nih.gov/image/structurefly.cgi?cid=6238

5. Mastorako G, Ilas I. Maternal and fetal hypothalamic-pituitary-adrenal axes during pregnancy and postpartum. Ann N Y Acad Sci. 2003, 997:136-49

6. Hill M, et al. Steroid profiling in pregnancy: A focus on the human fetus, 2013 Apr 10.  J. Steroid Biochem Mol Biol.

7. Pan DS, Liu WG, Yang XF, Cao F (October 2007). Inhibitory effect of progesterone on inflammatory factors after experimental traumatic brain injury. 2007, Biomed. Environ. Sci. 20 (5): 432–8

8. Luoma JI, Stern CM, Mermelstein PG (August 2012). Progesterone inhibition of neuronal calcium signaling underlies aspects of progesterone-mediated neuroprotection. 2012,  J. Steroid Biochem. Mol. Biol. 131 (1-2): 30–6

9. Wong R, Bath PM et al. Progesterone and cerebral ischaemia: the relevance of ageing, 2013 Apr 30. J Neuroendocrinol.

 

 

 

 

Ferritin ELISA Kit blog

Test: Ferritin ELISA Kit

Synonyms: Ferritin EIA

Shelf Life: 12-14 months

Total time: ~ 80 minutes

 

Ferritin elisa kit:

Ferritin is an iron storage protein and a key regulator of iron level in the body with each molecule capable of binding up to 4000 iron atoms. Its main function is storing a soluble and nontoxic form of iron.  Ferritin can store iron and release it in a controlled manner to maintain a balanced level of iron in the body.  Thus ferritin is essential for controlling both iron deficiency and iron overload in the body.

Human gene encoding the major iron storage protein ferritin is FTH1 (heavy polypeptide1).  Defect in ferritin proteins are linked to neurodegenerative diseases [1].

The ideal level of ferritin is 40-60 nanogram/milliliter (ng/ml), below 20ng/ml is deficiency and above 80ng/ml is iron overload.

Ferritin is found in the skeletal muscle (meat), liver, spleen and bone marrow.  A small amount of ferritin is in the blood and that amount of ferritin depicts the iron storage in the body.

Diagnostic Automation offers a rapid and reliable tool as an ELISA kit for measuring the serum concentration of ferritin in blood.

 

 

 

 

Molecular Structure of Human Ferritin [2]

What is Iron deficiency?

Iron deficiency with a complex mechanism is one of the most common nutritional disorders, and at its most extreme it can develop into iron deficiency anemia. Anemia occurs when there is a reduction in the number of red blood cells or red blood cells have a very low level of hemoglobin.  Anemia is common in children and menstruating women typically between ages 14 to 52.  Iron has many functions in human body and one of the most important functions is binding to hemoglobin molecule to serve as an oxygen carrier in every cell of the body [3].

Iron plays fundamental roles in human health, thus maintaining a sufficient supply of iron is crucial.  There are multiple processes through which human body loses iron such as bleeding (especially in menstrual periods in women), sweating, and urination leading to iron deficiency.

Normal function of hemoglobin and multiple enzymes in our body depend on iron.  The absorbance of iron is selective, however our body constantly loses small amount of iron.

It is important to diagnose the underlying cause of anemia since there are multiple factors contributing to anemia such as:

Nutritional deficiency (e.g. vitamin B12 and/or folate)

Genetic anemia such as sickle cell, thalassemia

Cancer

Acute blood loss

Although diagnosis of anemia is easy, but identifying the correct cause of it is crucial as in some anemia patients such as in thalassemia iron overload is the major problem not the deficiency.

Iron is a potent oxidative stressor which can oxidize susceptible cells or component of a cell.  The oxidizing process generates free radicals which can cause substantial damage to the cells and increase the risk of heart diseases by damaging the inner lining cells of the blood vessels or can cause cancer by damaging the DNA of the cells.

At Diagnostic Automation, we offer the Ferritin elisa kit (Ferritin elisa test), a fast (total time ~ 80 minutes) and reliable test to measure the ferritin level in the serum.

In contrast to iron deficiency, there are also iron overload conditions which can cause serious damage to multiple organs.  This increase in iron generally appears in patients who have regular blood transfusions, or have a genetic predisposition to iron overload disorders such as Hemochromatosis (absorbance of too much of dietary iron), Hemolytic anemia, and Hemosiderosis. Hemochromatosis treatment consists of removing blood from the patient to reduce the amount of iron [4].  Monitoring and guided treatment for iron overloads disorders such as hemochromatosis and hemosiderosis are easily done using Diagnostic Automation Ferritin elisa kit.  In addition to these clinical conditions, processed foods fortified with iron are another source of iron overload.  Moreover, high level of ferritin in blood can be indicative of inflammatory disease, liver problem, rheumatoid arthritis, hyperthyroidism, or cancer.

Finally, iron builds strong red blood cells, and ferritin is one of the body’s primary iron-storage proteins.  Thus, ferritin screening is one of the most important proactive and preventive health tests.  At Diagnostic Automation we offer ferritin elisa test (ferritin EIA) as a serum ferritin elisa kit for a rapid, sensitive, and reliable assessment of ferritin level in blood for diagnosis of both iron deficiency and iron overload.

 

 

Ferritin ELISA kit

 

 

Indications for ferritin testing:

 

Ferritin elisa test is performed for two purposes, diagnosing a disorder or monitoring a clinical condition:

 

A.    Diagnosing a disorder

1. Low hemoglobin level

2. Low hematocrit

3. Hemochromatosis

4. Liver diseases

5. Cancers

 

In combination with a total iron binding capacity and iron test a low ferritin test result using ferritin elisa kit can confirm the iron deficiency anemia.

 

B.     Monitoring iron status

  1. Hemochromatosis and hemosiderosis
  2. Pregnant women
  3. Blood donors
  4. Blood transfusion
  5. Renal dialysis patients
  6. Inflammation
  7. Diabetes type II
  8. Hyperthyroidism
  9. Leukemia
  10. Rheumatoid arthritis

 

Intended use of Ferritin ELISA kit Cat # 1601Z:

The Diagnostic Automation Ferritin EIA test is for the quantitative determination of Ferritin concentration in human serum valid for either diagnosing a disorder or monitoring iron status of conditions mentioned above.

 

http://www.rapidtest.com/index.php?i=Ferritin-ELISA-kit&id=40&cat=159

 

 

 

 

Materials and Components

 

Materials provided with Ferritin ELISA Test Kit:

• Antibody-coated ELISA Microplate 96 wells

• Ferritin EIA test reference standard set, contains 0, 10, 50, 100, 400, &

800 ng/ml, (NIBSC-WHO 80/602, human liver standard), ready for use

• Ferritin EIA enzyme conjugate reagent, 12 ml

• TMB Substrate, 12 ml

• Stop Solution, 12 ml

• Ferritin ELISA test wash Buffer Concentrate (50X), 15ml

Materials required but not provided:

• Precision pipettes: 5~40μl, and 0.05~0.2ml

• Disposable pipette tips

• Distilled water

• Vortex mixer or equivalent

• Absorbent paper or paper towel

• Graph paper

• ELISA kit Microplate Washer

• ELISA kit Microplate Reader

 

In addition to Ferritin ELISA kit, Diagnostic Automation offers two additional tests for assessment of iron level:

1. Ferritin CLIA kit (Cat # 9019-16); a Chemiluminescence Immuno Assay detection using Microplate luminometers. The Ferritin CLIA test utilizes a unique monoclonal antibody directed against a distinct antigenic determinant on the intact ferritin molecule.  Ferritin CLIA kit provides a sensitive, high throughput, and economical alternative to conventional colorimetric methodologies.

http://www.rapidtest.com/index.php?i=Ferritin-CLIA-kits—(Chemiluminescence-Immuno-Assay)&id=570&cat=47

 

2. Soluble Transferrin Receptor (sTfR) ELISA kit (Cat # 3126-15) has been introduced as a promising new diagnostic tool for differentiating between iron deficiency anemia (IDA) and anemia of chronic disease (ACD).  Distinguishing between IDA and ACD is a key step for determining whether iron supplementation would be beneficial.  sTfR ELISA test  is similarly useful for monitoring erythropoiesis in malignancy and chronic renal disease.

 

http://www.rapidtest.com/index.php?i=sTfR-Soluble-Transferrin-Soluble-Receptor-&id=710&cat=159

 

 

 

References:

1. Molecular structure of ferritin:  NCBI

http://www.ncbi.nlm.nih.gov/Structure/mmdb/mmdbsrv.cgi?uid=65592

2. Ferritin gene: http://www.ncbi.nlm.nih.gov/gene/2495

3. Polin V et al. Iron deficiency: From diagnosis to treatment. Dig Liver Dis. 2013

4. Crownover BK, Covey CJ. Hereditary hemochromatosis. Am Fam Physician. 2013, 1;87(3):183-90

5. Muñoz M, García-Erce JA, Remacha ÁF. Disorders of iron metabolism. Part II: iron deficiency and iron overload. J Clin Pathol. 2011 Apr;64(4):287-96.

Vitamin B12 ELISA kit blog

Vitamin B12 ELISA kit

At Los Angeles-based Diagnostic Automation (focusing on ELISA Kits) we offer two vitamin B12 elisa kits:

1) Food Vitamin B12 ELISA kit to determine vitamin B12 quantitatively in vitaminated food in a significantly faster way (2.5 to 4 hours inclusive sample pretreatment) compared to a conventional microbiological assay (24 to 48 hours)

2) Vitamin B12 ELISA kit to measure the serum concentration of vitamin B12

Vitamin B12, also known as cobalamin, has the largest and the most complicated structure in vitamins.  Cobalamin is an organometallic compound and only known essential molecule with a stable metal-carbon bond.  To discover vitamin B12, elucidate its metabolic roles, discover the signs and symptoms of its deficiency, and to find treatment, took over 100 years [1].  In 1850s Thomas Addison an English physician described a lethal (pernicious) anemia.  In 1930s Castel an American physician discovered the intrinsic factor (IF) essential for B12 absorbance and many years later it was found to be a glycoprotein.  In 1934 Whipple, Minot, and Murphy shared the Nobel Prize for their discovery of treating anemia with liver extract.  In 1950s Dorothy Hodgkin a British chemist described the structure of vitamin B12 and received the Nobel Prize for it in 1964[2].  Different biochemical roles of B12 such as its interaction with folate and their linked role in megaloblastic anemia, was identified subsequently.  B12 continues to be the subject of intense interest in research especially the deficiency in infants secondary to maternal origins and its role in their development [3].

 

 

Molecular structure of Vitamin B12 (Cobalamin)

Cobalamin/vitamin B12 is a water-soluble vitamin with a key role in the normal formation of red blood cells and also normal functioning of the nervous system including brain.  Moreover, it is involved in the DNA regulation; synthesis and fatty acid metabolism, thus effecting energy production in the body.  Every cell of human body needs vitamin B12 for its normal function.  Animal, Plants, and fungi are not capable of producing vitamin B12.  Only archaea and bacteria have the necessary enzymes required for the synthesis of B12 in the form of hydroxocobalamin which is then converted to cobalamin in the human body.  B12 is naturally present in animal foods and can also be received through supplements.  However, proper absorption in the body requires a complex pathway [4].

Vitamin B12 has profound effects on human health and is essential for several crucial functions in the body.  The deficiency manifest when serum levels are below the cutoff point.  In USA the limit is 200 picograms per milliliter (pg/ml) [5].  In Europe and Japan the limit for B12 is 500-550 pg/ml, this level of B12 may explain the lower rate of Alzheimer in these countries compared to USA with lower cut off (200pg/ml) [6].  It is essential to identify the B12 deficiency promptly.

Diagnostic Automation offers a rapid and reliable tool as an ELISA kit for measuring the serum concentration of vitamin B12.  Deficiency of vitamin B12 can manifest with hematological disorder, such as severe anemia requiring blood transfusions, and behavioral changes to serious and permanent nerve damage, neurologic, vascular, and gastrointestinal problems.

Vitamin B12 was discovered through investigation of Pernicious anemia.  Pernicious anemia is a member of the large family of megaloblastic anemias that is characterized by production of large immature and dysfunctional red blood cells in the body.  Pernicious anemia is a form of autoimmune disease that destroys cells in the stomach which are responsible for the production of Cubilin, an intrinsic factor (IF) which is a protein essential for the absorption of B12.  IF is located within the epithelium of intestine and kidney. Mutations in CUBN (Cubilin gene) may play a role in autosomal recessive megaloblastic anemia [7].  Real pernicious anemia constitutes only a small fraction of the cases, however, malabsorption due to diminished secretion of gastric acid and enzymes necessary for the cleavage of protein- B12 bond from food is the main concern.  It is very important to note that maintaining an optimal status of vitamin B12 is not only dependent on adequate dietary intake but more critically on its effective absorption which declines with age.

Vitamin B12 is absorbed through saliva at the ingestion stage, and then during digestion.  The vitamin B12 from food proteins is released with the help of acids in the stomach.  Absorption of B12 depends on intrinsic factor (IF) which is present in the gastric juice.  IF combines with vitamin B12 and facilitates its absorption in the lower part of the small intestine. Vitamin B12 and Folate deficiencies have similar symptoms, so it is important to have accurate tests that can detect the differences.  Fortunately, Vitamin B12 deficiency can easily be treated and prevented [8].  It is very important to be aware of it since there is a high prevalence of mild, subclinical B12 deficiency in asymptomatic individuals, especially with individuals at high risk such as vegan/vegetarian [9].

Delay in the diagnosis and treatment of vitamin B12 deficiencies can lead to development of severe and irreversible neurologic damage.  Although vitamin B12 deficiencies was estimated to occur at a frequency of 1 in every 31 adults 51 years of age or older in USA population, but the incidence of vitamin B12 deficiency is far more common than previously assessed [10; 11].  The rise in gastric bypass surgeries in obese women and growing incidence of gastrointestinal issues such as coeliac disease, Crohn’s, and ulcerative colitis, plus the increasing number of vegan/vegetarian mother are the growing concern [12].  These conditions substantially decrease the absorption of vitamin B12 which adversely affects the development of children born of these women. The association between vitamin B12 and cognitive development in children has been observed in infant born to vegan and vegetarian mothers.

A recent study in infants with B12 deficiency has reported diverse clinical abnormities including hypotonic muscle, apathy, cerebral atrophy, and nerve cell demyelination.  Some of these symptoms were reversible since, a rapid improvement in neurological symptoms was reported after vitamin B12 therapy.  However, in long term follow up many of these infants showed serious delay in cognitive and language development.  Babies born to vegetarian mothers may show deficiency of vitamin B12.  Delayed detection and treatment in infants with vitamin B12 deficiencies, can lead to severe and permanent damage to their nervous system.

At Diagnostic Automation (focusing on “ELISA Kits”) we offer vitamin B12 elisa kit which informs mothers before their pregnancy and upon the detection of low level of B12 using vitamin B12 elisa kit, supplement intake can prevent the complications due to deficiency if that is the primary cause of the deficiency.  Although our vitamin B12 serum elis kit is very fast and accurate, Homcysteine and methylmalonic acid can also be used to confirm a vitamin B12 deficiency for cases with ambiguous initial results because metabolic changes often precede low cobalamin levels [13].

Homocysteine levels in blood are influenced by blood levels of B-complex vitamins: cyanocobalamin (B12), folic acid (B9) and pyridoxine (B6).  Studies have shown that high plasma total homocysteine levels are associated with an increased risk of atherosclerotic diseases. Elevated level of homocysteine which is an amino acid with biological functions in methionine metabolism is a risk factor for cardiovascular events.  Cardiovascular disease, including coronary artery disease, stroke and congestive heart failure, is the number one cause of death worldwide.  Thus, it has been suggested that B vitamin supplementation might reduce the risk of myocardial infarction and stroke.

Preventive strategies might include healthy people with low or high risk for developing cardiovascular disease and people with an established cardiovascular disease to take these supplements.  A study including 12 randomized clinical trials involving 47,429 participants show no evidence that homocysteine lowering interventions such as supplementations of vitamins B12, B9 or B6, prevent myocardial infarction and stroke.  However, multiple studies have shown a significant improvement.

Heart Outcomes Prevention Evaluation 2 (HOPE 2) trial reanalysis, showed a reduced incidence of nonfatal stroke with long term (over 3 years) treatment with B vitamins [14-16].  Patients with homocystinuria are prone to thromboembolic events even with minor surgeries.  Levels of homocysteine should be reduced to a near normal level before any surgery.   Increased levels of methylmalonyl CoA and homocysteine in sever form can affect the vascular system and increase the diseases such as Parkinson, atherosclerosis, heart diseases, and stroke. It is postulated that the effect might be through increased level of stress at the cellular level, eventually leading to apoptosis (programed cell death).

Vitamin B12 has high level of importance in public health, not only because of its deficiency leading to megaloblastic anemia and irreversible nerve damage, but also because there are emerging evidence that links vitamin B12 deficiencies to an increased risk of a number of age related diseases, such as cardiovascular disease, cognitive dysfunction, and dementia.  Moreover, there are concerns relating the imbalance of B12 and folate, especially the potential adverse effects for older adults with low vitamin B12 status and over exposure to folate especially in countries with mandatory fortification of food with folate. Thus, inter relationship between vitamin B12 and folate is an important emerging issue in aging population.

Vitamin B12 deficiency can easily be treated and prevented.  There are inexpensive treatment options available as B12 supplement to treat a vitamin B12 deficiency. The treatment is safe, effective, with no known toxicity. To prevent B12 deficiency, all patients 51 years of age and older should be recommended to take B12 supplement daily however, the dosage recommendation may vary.  Recent studies show that in people with malabsorption problems of B12, high dose of oral or nasal intake may be as effective as injection.  However, in severe cases of deficiency such as pernicious anemia and neurological symptoms injection is still the preferred method of administrating vitamin B12.  In USA cyanocobalamin is the most frequent form of B12 supplementation, however recent research prefers hydroxycobalamins which is more common in Europe and it has shown to be superior to cyanocobalamin.

Finally, to identify B12 deficiency the first step is to take an accurate test to determine the level of B12 in the serum.  At CORTEZ DIAGNOSTICS we offer a rapid and reliable vitamin B12 deficiency elisa test kit proved to be both accurate and fast in determining B12 concentration in blood.  The next step is identifying the mechanism and problem leading to B12 deficiency.  This is a challenging step and requires professional help, after that the suitable form of B12 in a form of injection, oral, nasal, and sublingual and the dose and length of treatment will be determined easily.  All patients with unexplained hematologic or neurologic signs and symptoms should be evaluated for B12 deficiency since it is easy to miss the B12 deficiency.

 

Indications for B12 testing:

Megaloblastic or Pernicious anemia: a condition in which there is a lack of an intrinsic factor (IF)

Hyperhomocysteinaemia: an inherited disorder of the metabolism the amino acid methionine and Homocystinuria: also known as cystathionine beta synthase deficiency, both are associated with atherosclerosis, venous and arterial thrombosis.  Acquired forms can be treated with vitamins B12 and B6 and folate

Peripheral neuropathy: damage to the nerve of the peripheral nervous system, may be caused by diseases or trauma to the nerve or as a side effect of a systemic illness

Patients with GI problems: patients with gastritis (long term use of acid-reducing drugs), gastric surgery (e.g., gastric bypass, gastrectomy), gluten intolerance or intestinal resorption disorders, atrophic gastritis (a thinning of the stomach lining that affects up to 30% of people aged 50 and older)

Conditions affecting the small intestine: such as Crohn’s disease, Celiac diseases, parasite (B12 utilizing fish tapeworm such as the Diphyllobothrium latum) or bacterial overgrowth in the small intestine and viral infection (e.g. HIV)

Alcoholism: decrease vitamin B12 absorption

Autoimmune disorders: such as Grave’s disease or systemic lupus erythematous

Pancreatic insufficiency

Patients with thrombosis

Chronic liver and kidney disease

Vitamin B12 deficiency from diet: vegan and vegetarians; pregnancy and lactation

 

 

References:

1. Scott J.M. Molloy A.M. The Discovery of Vitamin B12. Ann Nutr Metab 2012;61:239–245

2. Dorothy Crowfoot, et al. Structure of Vitamin B12: The Crystal Structure of the Hexacarboxylic Acid derived from B12 and the Molecular Structure of the Vitamin. Nature 176, 325 – 328 (20 August 1955)

3. Pepper MR, Black MM . B12 in fetal development. Semin Cell Dev Biol. 2011, 22(6):619-23

4. Jeremy M Berg, John L Tymoczko, and Lubert Stryer.  Biochemistry, 5th edition W H Freeman; 2002. ISBN-10: 0-7167-3051-0

5. Goodman M, Chen XH, Darwish D. Are US lower normal B 12 limits too low? 1996. J Am Geriatr Soc 44 (10): 1274–5

6. Mitsuyama Y, Kogoh H. Serum and cerebrospinal fluid vitamin B12 levels in demented patients with CH3-B12 treatment–preliminary study. 1988. Jpn. J. Psychiatry Neurol.42 (1): 65–71

7. Stabler SP, Allen RH. Megoblastic anemias. In: Goldman L, Ausiello D, editors. Cecil Textbook of Medicine. 22nd ed. Philadelphia: W. B. Saunders Company; 2004. p. 1050-7

8. Medline plus, B12 deficiency: https://www.nlm.nih.gov/medlineplus/ency/article/000574.htm

9. de Benoist B.  Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008; 29(2 Suppl):S238-44

10. den Elzen WP, Gussekloo J. Anaemia in older persons. Front Hum Neurosci. 2013; 7: 97

11. Hughes CF, Ward M, Hoey L, McNulty H. Vitamin B12 and ageing: current issues and interaction with folate.  2013 April 16; Ann Clin Biochem.

12. Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008; 66(5):250-5.

13. Sally P. Stabler. Vitamin B12 Deficiency. N Engl J Med. 2013; 368:149-160

14. Toole JF. et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA. 2004;291(5):565-75

15. Spence JD. Homocysteine-lowering therapy: a role in stroke prevention? Lancet Neurol. 2007;6(9):830-8

16. Saposnik G. et al. Homocysteine-lowering therapy and stroke risk, severity, and disability: additional findings from the HOPE 2 trial. Stroke. Apr 2009;40(4):1365-72