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Cobaltous cation (Co2+) is the divalent form of the element cobalt and acts as a monoatomic dication. It is used in medicine primarily as a component of radioactive diagnostic agents such as Cobalt 57 (as in Rubratope-57), which was indicated for the diagnosis of pernicious anemia and to assess defects in intestinal vitamin B12 absorption. The mechanism involves its use as a tracer; it is incorporated into cyanocobalamin (vitamin B12) analogs that are tracked during absorption studies. Cobalt ions can act as enzyme cofactors but also exhibit toxicity through oxidative stress mechanisms, interference with calcium channels, chelation of lipoic acids affecting metabolism, inhibition of DNA repair proteins, and immunologic sensitization. Rubratope-57 was withdrawn from the market in July 2017[1][2][5].
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