Vitamin B12

Serum

Other names: VITAMIN B-12, Vitamin B12 (Cyanocobalamin), Vitamin B12 (Atellica), VITAMIN B12, SERUM, B12 Total

check icon Optimal Result: 232 - 1245 pg/mL, 171.22 - 918.81 pmol/L, or 232 - 1245 ng/L.

Vitamin B12 and folate are separate tests often used in conjunction to detect deficiencies and to help diagnose the cause of certain anemias, such as pernicious anemia, an autoimmune disease that affects the absorption of B12. B12 and folate are two vitamins that cannot be produced by the body and must be supplied by the diet. They are required for normal red blood cell formation, repair of tissues and cells, and synthesis of DNA. B12 is also essential for proper nerve function. B12 and folate levels may be ordered when a complete blood count is done as a part of a routine health checkup. Testing for B12 and folate levels may be appropriate when a person has signs and symptoms of deficiency, such as:

- Diarrhea

- Dizziness

- Fatigue

- Loss of appetite

- Pale skin

- Rapid heart beat

- Shortness of breath

- Sore tongue and mouth

- Tingling or numbness in the extremities

- Confusion

- Paranoia

What does it mean if your Vitamin B12 result is too high?

The most common cause of high B12 in the blood is due to recent ingestion or injection of supplemental vitamin B12. It could also be possibly from your diet if high in animal products such as meat, eggs, and shellfish. 

Limited observational studies have reported associations of increased vitamin B12 levels with other conditions and disease states, including:

- Liver disease due to release of B12 from damaged liver cells into the bloodstream

- Kidney disease due to impaired function of the kidneys to excrete excess B12

- Increased levels of transcobalamin, which is a transporter of B12 in the bloodstream

- Inflammatory conditions: rheumatoid arthritis, lupus

- Hematologic (or blood) cancers: acute leukemia, multiple myeloma

- Hematopoietic disorder: myeloproliferative neoplasm, myelodysplastic syndrome, hypereosinophilic syndrome, transient neutrophilia

Most of the medical conditions often present with other abnormal lab findings such as impaired kidney function, liver function, anemia, low white blood cell count and also other signs and symptoms of problems.

If higher levels of B12 persist, it may be worthwhile seeing a hematologist for a follow up evaluation to receive further review of your history, family history and further laboratory testing if appropriate, especially if the levels continue to be high.

Additional note: Please consult your doctor before making any changes in your diet or supplement regimen. You might want to avoid supplements high in B12 for now, eat a varied healthy diet rich in fruits and vegetables and check to see if B12 is in any supplements you take.

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What does it mean if your Vitamin B12 result is too low?

A low Vitamin B12 level on a test panel can indicate a deficiency, though it doesn't always point to an underlying medical condition. Vitamin B12 is essential for various bodily functions, including nerve health, DNA production, and red blood cell formation. When B12 levels are low, it can lead to symptoms such as fatigue, weakness, neurological issues, and cognitive impairments. Some common causes of low B12 include:

  • Dietary Deficiencies: While uncommon in the general population due to fortified foods, vegans are at higher risk for B12 deficiency, as this vitamin is primarily found in animal products such as meat, eggs, and dairy.

  • Malabsorption Issues: Conditions like Pernicious anemia, Celiac disease, and Inflammatory bowel disease (IBD) can interfere with the body's ability to absorb B12 from the intestines, leading to deficiencies.

  • Chronic Alcoholism: Excessive alcohol consumption can damage the digestive system, impairing the absorption of nutrients, including Vitamin B12.

  • Certain Medications: Some medications, particularly those used to treat acid reflux or gastrointestinal issues, can reduce B12 absorption.

  • Pregnancy: Pregnant women have higher B12 and folate needs to support fetal development. A deficiency during pregnancy can lead to complications, making it crucial to maintain adequate levels.

If you have a low Vitamin B12 level, it's important to address the underlying cause, which can often be managed through dietary changes, supplements, or medical treatment, depending on the cause.

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