Schilling test

What is a Schilling Test?

A Schilling test is a type of medical diagnostic procedure used to evaluate the absorptive capacity of the intestines. The Schilling test is used to diagnose pernicious anemia (a deficiency in Vitamin B12, leading to megaloblastic anemia), as well as other conditions that may interfere with the absorption of B12.

Preparation for a Schilling Test

Preparing for a Schilling test is relatively simple. In most cases, no advance preparation is necessary. Nonetheless, it is recommended that patients inform their doctor of all prescription medications and herbal supplements they are taking prior to the test.

Procedure of a Schilling Test

The Schilling test consists of two parts. In the first part of the test, a radioactive form of B12 is introduced into the body through three injections. The second part of the test is then performed the following day, and involves consuming a supplement containing a known amount of B12. The amount of B12 absorbed by the body is then evaluated and the results provide an indication as to whether the intestines are able to properly absorb B12. The test lasts about three to four hours and requires the patient to remain in the laboratory or clinic for the duration of the test.

Types of Schilling Tests

There are different types of Schilling tests. The type used will depend on the patient’s individual needs. These include:

  • The flow Schilling test: This is the type of Schilling test most often used. It involves introducing B12 into the body and measuring how much is absorbed.
  • The fractional Schilling test: This is a variant of the flow Schilling test. It assesses the amount of B12 that is taken up and also measures the rate at which it is absorbed.
  • The equilibrium Schilling test: This type of Schilling test uses an equilibrium method to measure B12 absorption. It requires two to three days for the test and results.

Risks of a Schilling Test

The Schilling test is safe, noninvasive, and low risk. However, there are a few minor risks associated with the test. These include the potential for radiation exposure, minor skin irritations or rashes, and nausea or headache. The risks associated with the Schilling test are minimal and can usually be managed with the proper precautions.

Why and When is a Schilling Test Done?

The Schilling test is used to evaluate B12 absorption and diagnose pernicious anemia. It may also be used to evaluate other conditions that may interfere with B12 absorption, such as Crohn’s disease, celiac disease, or intestinal surgery. The test may be ordered if a patient is showing signs or symptoms of a B12 deficiency, such as megaloblastic anemia, fatigue, or neurological symptoms. It may also be ordered if the patient has a risk factor for B12 deficiency, such as poor diet, age, or medication.