A patient is referred to you for a Shilling test. Yesterday, an injection of nonradiolabeled B12 and an oral dose of radiolabeled B12 was administered. A 24-hour urine collection reveals abnormally low excretion of vitamin B12 today.What do you do next?
A. Call the referring physician and suggest that this patient likely has a decreased dietary intake of B12 as the cause for his anemia.
B. Call the referring physician and suggest that this patient likely has autoantibodies to his gastric cells as the cause for his anemia.
C. Repeat the test and give radiolabeled B12 by injection and nonlabeled B12 orally.
D. Repeat the test and give oral IF with the radiolabeled B12.
E. Treat the patient with both B12 and folate.
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