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How To Test For Vitamin B12 Deficiency

Serum B12 Can Be Used To Monitor Treatment:

Testing for Vitamin B12 Deficiency (Order THESE 4 Lab Tests)

One of the most common problems in the treatment of a vitamin B12 deficiency is that people receive insufficient injections to feel well. Often the serum B12 value is used to ascertain the frequency, or base treatment upon, but there is no correlation between the serum B12 value and the symptoms experienced by patients.During vitamin B12 injections, transcobalamin and haptocorrin are fully saturated with vitamin B12. So, serum and Active B12 values cannot be used to ascertain the effect of treatment levels rise regardless of therapeutic effectiveness.

Some patients can have a bi-monthly maintenance dose straight after the loading dose. However, a large number of patients experience recurring symptoms on bi-monthly injections. Large groups of people need much more vitamin B12 than the recommended maintenance dose to feel well, and prevent recurring symptoms. Symptoms should be used as a guideline, not blood values.Also many physicians are, erroneously, afraid of an overdose.

Cure Vitamin B12 Deficiency In 12 Steps

Vitamin B12 DeficiencyGetting enough B12Pernicious AnaemiaPernicious Anemia Testing for B12 deficiencyToo much B12Vitamin B12 Deficiency CureVitamin B12 deficiency symptomsVita Sci

Many people today suffer from vitamin B12 deficiency that hasnt been diagnosed. To cure vitamin B12 deficiency, its important to understand how you got it and which B12 supplements are the best to relieve symptoms and prevent pernicious anemia.

Can I Take The Test At Home

Several test kits are commercially available that allow you to collect a sample for vitamin B12 testing at home. Some kits test only your vitamin B12 level. Others test B12 in combination with other vitamins.

These kits may be purchased online and include the materials you need to obtain a sample of blood using a finger prick, which you return to the manufacturer for testing. Your test results are available after a few days via a secure online platform.

At-home testing is convenient and allows you to participate in your own health care. However, at-home tests cannot take the place of working with a health care provider. If you have symptoms or are worried that you may have a low level of vitamin B12, be sure to share your concerns with a doctor or nurse.

If an at-home test detects an abnormal vitamin B12 level, your doctor is likely to retest your vitamin B12 and follow up with additional testing if the second vitamin B12 test is also abnormal.

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Vitamin B12 Deficiency: Recognition And Management

ROBERT C. LANGAN, MD, FAAFP, and ANDREW J. GOODBRED, MD, St. Luke’s Family Medicine Residency Program, Bethlehem, Pennsylvania

Am Fam Physician. 2017 Sep 15 96:384-389.

Patient information: A handout on this topic is available at .

Vitamin B12 is a water-soluble vitamin obtained through the ingestion of fish, meat, and dairy products, as well as fortified cereals and supplements.1,2 It is coabsorbed with intrinsic factor, a product of the stomach’s parietal cells, in the terminal ileum after being extracted by gastric acid1,2. Vitamin B12 is crucial for neurologic function, red blood cell production, and DNA synthesis, and is a cofactor for three major reactions: the conversion of methylmalonic acid to succinyl coenzyme A the conversion of homocysteine to methionine and the conversion of 5-methyltetrahydrofolate to tetrahydrofolate.1,2


Patients with risk factors for vitamin B12 deficiency should be screened with a complete blood count and serum vitamin B12 level.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .


Vitamin B12 absorption and transport.

Figure 1

Vitamin B12 absorption and transport.

Are Test Results Accurate

Vitamin B12: Deficiency Symptoms, Sources, Benefits ...

Your health care provider is likely to take a number of factors into consideration when interpreting your test results and determining whether follow-up testing is appropriate.

First, research has shown that there is variation in an individuals vitamin B12 levels over a period of weeks and that some people experience significant fluctuations. Further testing may be needed if your vitamin B12 levels are in the borderline range or if the results of your laboratory testing dont match up with your symptoms or a previous diagnosis.

In addition, certain factors may interfere with the accuracy of your test results.

A false positive means it looks as if a deficiency is present when that is not actually the case.

Factors which increase the risk of a false positive for a vitamin B12 deficiency include:

  • Multiple myeloma, a cancer of certain white blood cells
  • HIV infection
  • Use of oral contraception
  • Use of the anticonvulsant drug phenytoin

Other factors may cause your vitamin B12 levels to appear higher than they are. This can mask a deficiency and cause a false negative, making it appear that no deficiency is present when you actually have one:

  • Blood disorders like chronic myelogenous leukemia or polycythemia vera
  • Alcoholic liver disease, cirrhosis, or hepatitis
  • Kidney disease
  • Use of nitrous oxide, also known as laughing gas or whippets
  • Autoimmune disorders
  • Rare genetic disorders

If the accuracy of your vitamin B12 level is uncertain, you may be asked to take additional tests.

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Who Should Be Checked For Vitamin B12 Deficiency

An older person should probably be checked for Vitamin B12 deficiency if he or she is experiencing any of the health problems that can be caused by low levels of this vitamin.

I especially recommend checking vitamin B12 levels if youre concerned about memory, brain function, neuropathy, walking, or anemia.

To make sure you arent missing a mild vitamin B12 deficiency, you can also proactively check for low vitamin B12 levels if you or your older relative is suffering from any of the common risk factors associated with this condition.

For instance, you can request a vitamin B12 check if youre vegetarian, or if youve suffered from problems related to the stomach, pancreas, or intestine. Its also reasonable to check the level if youve been on medication to reduce stomach acid for a long time.

Best For Vitamin D Deficiency: Everlywell Vitamin D Test

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The EverlyWell Vitamin D Test measures your blood levels of vitamin D and has excellent reviews.

  • One of the least expensive home nutrient tests available

  • Easy sample collection process

  • No other vitamins or minerals included

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EverlyWells Vitamin D Test measures levels of active vitamin D in your blood. Most people in the United States are at least slightly Vitamin D deficient, and this could impact bone and immune health.

EverlyWells Vitamin D Test costs about $49 and shipping is free. However, if you are an EverlyWell subscriber, you can access one test per month for roughly $25 per month. EverlyWell also accepts FSA and HSA funds for payment.

The test kit first needs to be activated before you collect your blood sample using a finger prick test. After packaging it and returning it to the lab, you should receive your results within seven business days. Note that EverlyWell doesnt currently deliver tests to New York state.

Reviewers are satisfied with this test and find the information it provides very helpful, but say that sometimes results can be slower than the website states.

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What Does The Test Result Mean

Normal B12 and folate blood levels may mean that you do not have a deficiency and that your signs and symptoms are likely due to another cause. However, normal levels may reflect the fact that your stored B12 and/or folate have not yet been fully depleted.

When a B12 level is normal or low normal but a deficiency is still suspected, a healthcare practitioner may order a methylmalonic acid test as an early indicator of B12 deficiency.

A low B12 and/or folate level means that you have a deficiency. Additional tests are usually done to investigate the underlying cause of the deficiency. Some causes of low B12 or folate include:

  • Conditions that interfere with their absorption in the small intestine. These may include:
  • Pernicious anemia, the most common cause of B12 deficiency
  • Celiac disease and tropical sprue
  • Inflammatory bowel disease, including Crohns disease and ulcerative colitis
  • Bacterial overgrowth or the presence of parasites, such as tapeworms, in the intestines
  • Reduced stomach acid production from long-term use of antacids or H2 receptor blockers or proton pump inhibitors
  • Surgery that removes part of the stomach, such as gastric bypass, or the intestines may greatly decrease absorption.
  • Pancreatic insufficiency – the pancreas is not able to produce enough digestive enzymes to break down food.
  • Heavy drinking or chronic alcoholism
  • Use of some drugs such as metformin, omeprazole, methotrexate or anti-seizure medications such as phenytoin
  • Smoking
  • Intrinsic Factor Blocking Antibody Test

    Vitamin B12 deficiency symptoms (+ how to test for it and treat it with supplements)

    Sometimes, pernicious anemia from vitamin B12 deficiency occurs because of an autoimmune condition that destroys intrinsic factor, a digestive enzyme crucial for vitamin B12 absorption.

    A positive IFAB test result means that you have antibodies to intrinsic factor, resulting in the inability to digest vitamin B12 naturally from foods such as meat, fish, poultry, dairy, and egg products.

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    Warning Symptoms Of Vitamin B12 Deficiency And How To Fix It

    Jenny Hills, Nutritionist and Medical Writer Food & Nutrition

    Vitamin B12 is a water-soluble vitamin which plays an important role in the production of red blood cells and is required to keep nerve cells healthy.

    Vitamin B12 deficiency, also called cobalamin deficiency, is a medical condition of low B12 levels in the blood. According to studies, one in every five adults in the United States suffers from vitamin B12 deficiency.

    Vitamin B12 is dubbed the energy vitamin and its shortage can result in an array of health problems, including some potentially very serious conditions.

    The average adult should get 2.4 micrograms of vitamin B12 daily. Your body cannot produce vitamin B12 and you must get it from food or supplements. Good food sources of vitamin B12 include dairy products, eggs, fish, meat, and poultry.

    Despite being a water-soluble, vitamin B12 gets stored in your liver, kidneys and other body tissues, so vitamin B12 deficiency can go unnoticed for a long time. That is where the danger lies. By the time the condition gets detected, there might be some irreversible damage done already.

    Some of the symptoms of vitamin B12 deficiency are fatigue, cognitive problems, and tingling in hands and feet.

    In this article, you will find out about the role of vitamin B12 in the body, causes and symptoms of vitamin B12 deficiency, how to treat this vitamin deficiency and how long it takes to fix B12 deficiency.

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    Readily available in animal products, such as eggs, people should be able to obtain all they need from their diet or supplementation if vegan. Disappointingly, with age, a condition called pernicious anaemia may develop. This is where the immune system begins to attack stomach cells so that vitamin B12 can not be stored in the body.

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    Ruling Out Folate Deficiency

    A deficiency of folate, the nutrient also known as folic acid or vitamin B9, good sources of which include foods like broccoli, asparagus, peas and brown rice, can cause some of the same symptoms as vitamin B12 deficiency. For this reason, a doctor will typically examine the levels of folate in blood tests when checking for vitamin B12 deficiency.

    Taking a lot of folic acid can mask the symptoms of a vitamin B12 deficiency, so in cases where folate deficiency is suspected, a doctor will usually test for vitamin B12 deficiency before prescribing medication.

    Why The Test Is Performed

    Vitamin B12 Deficiency: The Under

    This test is most often done when other blood tests suggest a condition called megaloblastic anemia. Pernicious anemia is a form of megaloblastic anemia caused by poor vitamin B12 absorption. This can occur when the stomach makes less of the substance the body needs to properly absorb vitamin B12.

    Your provider may also recommend a vitamin B12 test if you have certain nervous system symptoms. A low level of B12 can cause numbness or tingling in the arms and legs, weakness, and loss of balance.

    Other conditions for which the test may be done include:

    • Sudden severe confusion
    • Nerve abnormalities, such as peripheral neuropathy

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    How Can I Find Out If I Have It

    Anemia can make you feel tired and short of breath. Here are some other signs:

    • Your skin looks pale or yellow.
    • You feel dizzy.
    • You often have mood changes.
    • You’re confused or forgetful.

    Because these can also be symptoms of other conditions, see your doctor for a diagnosis. Your doctor will do a physical exam and might order one or more of these tests:

    • Complete blood count. This test checks the size and number of your red blood cells. If you’re low in vitamin B12, your red blood cells won’t look normal. They’ll be much bigger and shaped differently than healthy ones.
    • Vitamin B12 level. This test checks to see if you have enough of it in your blood.
    • Intrinsic factor antibodies. These proteins tell your immune system to attack intrinsic factor. If you have pernicious anemia, you’ll have them in your blood.
    • Schilling test. This test uses a radioactive form of B12 to see if your body has enough intrinsic factor.
    • Methylmalonic acid level . This test measures the amount of MMA in your blood. When your vitamin B12 level is low, your level of MMA rises.

    Causes Of Folate Deficiency

    Folate dissolves in water, which means your body is unable to store it for long periods of time. Your body’s store of folate is usually enough to last four months. This means you need folate in your daily diet to ensure your body has sufficient stores of the vitamin.

    Like vitamin B12 deficiency anaemia, folate deficiency anaemia can develop for a number of reasons. Some are described below.

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    Symptoms Of Other Conditions

    An abnormally high vitamin B-12 status can be an early sign of liver disease, diabetes, or certain types of leukemia. A doctor may use the results of a vitamin B-12 test to help form their diagnosis.

    Certain people are more at risk of vitamin B-12 deficiency than others, especially those who have low stomach acid or other digestive issues. Stomach acid separates vitamin B-12 from food so that the body can absorb it more efficiently.

    The following groups of people are more likely than others to experience low vitamin B-12 levels:

    • older adults

    What To Eat To Prevent Vitamin B

    Schilling’s test for Vitamin B12 deficiency

    Many cases of B-12 deficiency are rooted in underlying health problems, but its possible to take preventative measures. Preventative measures include paying close attention to your diet, especially if youre vegetarian or vegan.

    One serving of fortified breakfast cereal may fulfill 25 to 100 percent of your daily intake value, depending on the brand. Three ounces of cooked salmon has about 80 percent of your daily intake value.

    You can also find B-12 in:

    • seafood

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    What Does The Test Involve

    Itâs a simple blood test. You can get it anytime, and you donât need to go without food before you do. Your doctor can add it to the order for your blood test that checks your levels of cholesterol, glucose, and other markers of health.

    You should tell your doctor about all of the medications and supplements you take before the test. Some of them may affect the results.

    What Is Vitamin B12 Deficiency

    Vitamin B12 deficiency occurs when there are inadequate levels of the vitamin B12 in the body. This important vitamin is necessary for the production of red blood cells and the healthy functioning of the nervous system.

    A lack of vitamin B12 can cause anemia and other health problems.Anemia is a condition where the body either cannot make enough healthy red blood cells or cannot produce enough of the substance hemoglobin that allows red blood cells to transport oxygen around the body.

    There are several different types of anemia, each with their own causes and symptoms. For example, vitamin B12 deficiency can cause megaloblastic anemia, a condition where the red blood cells are larger than normal and cannot function properly.

    For many people, a balanced and varied diet provides all the vitamin B12 they need. Good sources of vitamin B12 include meat, fish, eggs and dairy products.

    Despite the availability of vitamin B12 in a balanced diet, deficiency is not all that uncommon, particularly among people over 50 years of age, premenopausal women and people who follow strict vegan diets.

    Symptoms of vitamin B12 deficiency usually develop gradually and can be wide-ranging. These may include general symptoms of , such as fatigue and lethargy, as well as the symptoms specific to the deficiency, such as yellow tinge to the skin and a sore tongue.

    Worried you may have vitamin B12 deficiency? Check your symptoms using the free Ada app

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    How To Detect A Lack Of Vitamin B12

    Detecting a lack of a particular vitamin in the organism is not easy. However, when a person has a prolonged deficiency, in this case of vitamin B12, he or she tends to develop different symptoms. Lets say that somehow the organism alerts us that something is wrong.

    Some of the most common symptoms of vitamin B12 deficiency are memory loss, tingling in arms and legs, weakness, blurred vision or a feeling of tiredness. All these indications appear because damage is occurring in the nervous system of the human body.

    In addition, a prolonged lack of this micronutrient in the organism can lead to heart failure or the development of megaloblastic anemia. In short, through the following symptoms we could detect an efficiency of vitamin B12:

    • Feeling constantly tired, weak, dizzy and confused.
    • Having a yellow skin color or pallor.
    • Feeling disoriented.
    • Loss of memory or difficulty in language.
    • If you have started a vegan diet, monitor your vitamin B12 levels through a medical test.

    Lack of vitamin B12 can lead to cognitive impairment. However, it can be treated in time and in these cases the most common course of action is a vitamin B12 injection. This is a quicker method than the use of supplements to quickly alleviate the dangerous deficiency of this micronutrient.

    Finally, it should be noted that people with Helicobacter Pylori, a bacterium that affects the stomach causing gastritis, are also more prone to develop vitamin B12 deficiencies.


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