Vitamin B12

[TheFlyer]

Hi AllAny advice on this looks quite high

Serum vitamin B12 level 1233 ng/L should be [197.0 - 771.0]

Best wishes

Jules still flying

[Jm954 Administrator]

Hi there, Your B12, whilst high is not very high, have you been taking any supplements, multivitamins, Vegemite? All of these may push your B12 levels up if taken several times a week as the body's need for B12 is not high and B12 is reasonably well conserved in the body.

Liver disease can also cause raised B12 levels so it's probably worth getting your LFTs checked. There is a leukaemia associated with raised B12 levels (CML) but in that case it would likely be in 10,000+

If you have a previous result it may be useful to compare it to that too.

Jackie

[TheFlyer in reply to Jm954]

Hi JackieThese ones.

Serum bilirubin level 8 umol/L [< 21.0]

Serum alanine aminotransferase level 76 iu/L [5.0 - 41.0]; Outside reference range

Jules

[Jm954 Administrator in reply to TheFlyer]

Looks like you've got some sort of irrittion/inflamation going on in your liver. If those are a few weeks old then worth repeating them and the B12 but definitely discuss with your doctor.

Let us know

[TheFlyer in reply to Jm954]

The bloods are from last Tuesday.

[70s-80s-overlander]

As I have noted many times, the standard so-called "vitamin B12 level" has been considered -- for over 20 years -- to be highly inaccurate UNLESS the number is low.

Yes, the most common situation is that extra B12 intake is coming from somewhere. Aged Swiss cheese is high in B12. Clams are high in B12.

High red blood cell breakage can dump B12 into the blood stream.

B12/ cobalamin toxicity is quite rare. Your B12 level is not "sky high," so there probably is not much reason to be concerned.

On the Complete Blood Count/ CBC/ Full Blood Count/ FBC, what is the MCV/ mean corpuscular volume & the what is the red blood cell count/ RBC? If you have any iron panel numbers, please mention those, too. While we are at it, on the Comprehensive Metabolic Profile/CMP/ blood chemistry, what is your TBili/ total bilirubin level?

[TheFlyer in reply to 70s-80s-overlander]

Serum sodium level 144 mmol/L [133.0 - 146.0]Serum potassium level 3.7 mmol/L [3.5 - 5.3]

Serum creatinine level 86 umol/L [59.0 - 104.0]

eGFR using creatinine (CKD-EPI) per 1.73 square metres 83 mL/min

Serum total protein level 61 g/L [60.0 - 80.0]

Serum calcium level 2.47 mmol/L [2.25 - 2.55]

Serum albumin level 45 g/L [35.0 - 50.0]

Serum adjusted calcium concentration 2.41 mmol/L [2.2 - 2.6]

Serum alkaline phosphatase level 116 iu/L [30.0 - 130.0]

Serum bilirubin level 8 umol/L [< 21.0]

Serum alanine aminotransferase level 76 iu/L [5.0 - 41.0]; Outside reference range

Serum cholesterol level 3.9 mmol/L [0.0 - 5.2]

Serum triglyceride levels 1.6 mmol/L [0.0 - 2.3]; Non-fasting samples for lipid evaluation may have

falsely elevated triglyceride levels which will

invalidate LDL Cholesterol estimations. Please fast

patients if triglyceride measurement and/or LDL

Cholesterol estimations are required.

Serum HDL cholesterol level 0.8 mmol/L

Serum LDL cholesterol level 2.4 mmol/L

Serum cholesterol/HDL ratio 4.9

Serum non high density lipoprotein cholesterol level 3.1 mmol/L

Acute kidney injury warning stage 0; AKI Stage 0

Full blood count

Haemoglobin concentration 158 g/L [130.0 - 170.0]

Total white blood count 11.8 10*9/L [4.0 - 10.0]; Outside reference range

Platelet count - observation 221 10*9/L [150.0 - 400.0]

Haematocrit 44 % [40.0 - 50.0]

Red blood cell count 4.66 10*12/L [5.0 - 6.0]; Outside reference range

Mean cell volume 95 fL [83.0 - 101.0]

Mean cell haemoglobin level 34.0 pg [27.0 - 32.0]; Outside reference range

Neutrophil count 8.51 10*9/L [1.5 - 6.5]; Outside reference range. (Julian’s note Filgastim injection was on the 5th April)

Lymphocyte count 1.62 10*9/L [1.1 - 3.5]

Monocyte count - observation 1.60 10*9/L [0.21 - 0.92]; Outside reference range

Eosinophil count - observation 0.00 10*9/L [0.02 - 0.67]; Outside reference range

Basophil count 0.03 10*9/L [0.0 - 0.13]

Nucleated red blood cell count 0.00 10*9/L; If advice is required regarding the interpretation of

Reticulocyte count - observation 145 10*9/L [10.0 - 100.0]; Outside reference range

Blood haematinic levels

Serum vitamin B12 level 1233 ng/L [197.0 - 771.0]; Outside reference range

Serum folate level 4.7 ug/L [3.0 - 20.0]

Serum ferritin level 219 ug/L [30.0 - 400.0]

Serum total 25-hydroxy vitamin D level 49.8 nmol/L; NB:Reference comments altered to advise treatment.

<25 nmol/L : Vit D deficiency,requiring replacement

25-50 nmol/L : Vit D insufficiency,consider replacement

50-150 nmol/L : Adequate Vitamin D status.

Regards

Julian

[LeoPa in reply to TheFlyer]

Triglycerides too high, HDL too low. Can you do an insulin resistance test and take it from there? Insulin resistance is not good for the liver.

[Jm954 Administrator in reply to LeoPa]

Trigs are normal and HDL is low but LeoPa's reference to insulin resistance and the liver is related to non alcoholic fatty liver disease.

It's been known for a long time that high insulin resistance means that glucose is stored in the liver leading to the most common type of liver disease (non alcoholic fatty liver disease) in the western world. The connection to his B12 is that the fatty liver has inflammation which can increase B12 levels.

A very low carb diet for about a week can help that but returning to a high carb diet will mean that it could return.

 TheFlyer these are general comments but worth thinking about if they could apply to you x

Jackie

[TheFlyer in reply to Jm954]

Hi Jackie yes they do, will take action. Thank you, start Cycle 11 next Tuesday of V&O and its going well. 16th June is my last day.

[Jm954 Administrator in reply to TheFlyer]

I'm very glad it's going well for you. All the best

[TheFlyer in reply to Jm954]

Thank you.

[70s-80s-overlander in reply to TheFlyer]

The results are written in "British"/ "European" rather than in "American," so I had to gauge the probable significance of each number's position within its range.

Mean cell volume seems to be normed for a population in which B12 deficiency is more common -- that is, more likely considered "normal". High monocyte count COULD correlate with inflammation. Probable dehydration. Total bilirubin would not be high (high TENDS to correlate with B12 deficiency). Yes, I was guessing some vitamin D deficiency, & that seems to have been confirmed (especially given the dehydration).

The overall impression I get is that much is in flux -- possibly related to recent red blood cell breakage. ? Diet high on carbs, low on protein? Repeat lab tests once your body has settled down a bit.

[TheFlyer in reply to 70s-80s-overlander]

Diet forthcoming thank you.

[70s-80s-overlander in reply to TheFlyer]

No sweat. It appears to me that you & your body are doing the best that can be done just now. I always am pleasantly amazed when a time of illness is overcome. "The healing power of nature."

[RedBarchetta]

Mine was very high. Due to multi-vitamin. I resolved by interjecting a different multi-vitamin. One on odd days, the other low B12 on even days.

[TheFlyer in reply to RedBarchetta]

Dont do Multi Vitamins

[SERVrider]

Have you been hammering the Marmite?

[TheFlyer]

Once a month if that