The Schilling test is a four-step medical test used to diagnose pernicious anemia by determining if a patient has a vitamin B12 deficiency. The test involves administering vitamin B12 and radioactive B12, antibiotics, and pancreatic enzymes. Pernicious anemia can cause fatigue, depression, nausea, heartburn, weight loss, low blood pressure, muscle weakness, shortness of breath, nerve pain, and diarrhea. It can be treated with B12 shots or pills.
The Schilling test is a four-step medical test used to determine if a patient has a vitamin B12 deficiency. It is used specifically to diagnose pernicious anemia, a disease in which the number of red blood cells decreases because the body cannot absorb vitamin B12. The Schilling test is named after Robert F. Schilling, a physician known for researching vitamin B12 and using urine to test its absorption.
In the first stage of the Schilling test, the patient is given two doses of vitamin B12. Administrators then collect the patient’s urine and check their vitamin B12 levels. If the first stage is abnormal, the patient will progress to stage 2. In the second stage, the patient is given radioactive B12 with a protein from the stomach lining. The patient’s intestines should absorb vitamin B12; otherwise, the patient will move on to the third stage.
During the third stage, administrators will give the patient antibiotics for two weeks. The patient will return, and subsequent testing will reveal if the patient has abnormal bacterial activity, which can cause low vitamin B12 levels. In the fourth stage, the patient will be given pancreatic enzymes for three days. If this stage of the Schilling test returns a positive result, then the pancreas is the cause of low vitamin B12.
Pernicious anemia causes fatigue, depression, nausea, heartburn and weight loss. Other symptoms include low blood pressure, muscle weakness, shortness of breath, nerve pain and diarrhea. Thomas Addison was the first doctor to contract the disease in 1849. It was called Addison’s anemia at the time. Over the years, Richard Clarke Cabot, physician William Bosworth Castle, George Whipple, George Minot, William Murphy, Edwin Cohn and other chemists have studied the disease to learn its symptoms and how it might be treated.
What they found is that a vitamin B12 deficiency prevents red blood cells from dividing normally. When red blood cells are too large, they cannot carry enough oxygen through the body. Therefore, those suffering from pernicious anemia are often tired and weak.
If this disease continues over time, it can cause heart, brain, and nerve damage. This disease can also cause stomach cancer. Years ago, if pernicious anemia went untreated, it was a fatal disease; it can now be treated easily with B12 shots or pills. There have been some notable people with cases of pernicious anemia, including Alexander Graham Bell, Annie Oakley and Norman Warne.
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