Pernicious Anaemia Society
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What tests to get done

My son who is 23 returned for a few days from university as feeling depressed and is always tired I expect he is deficient in B12. He is going to see doctor when he returns to university at Norwich and ask for Blood tests, which ones should he ask for? I have bought him the Better you B12 spray but he will not use it before he gets tested

He also turned Vegan 2 months ago although is eating well that may have a connection, however he has been feeling tired for past few years.


3 Replies

What ever you do make sure he does not supplement in any form before the Dr does the test, he is very wise to say he isn't going to bit please make sure he doesn't change his mind.


B12 deficiency cause by malabsorption can take years to manifest itself as B12 is stored in large quantities in the liver - so unlikely the change to veganism in past 2 months is a causal factor though he could be in a bit of a catch 22 position as it could make any deficiency worse (malabsorption doesn't necessarily mean zerio absorption) but he DEFINITELY doesn't want to supplement until he has had the blood test done.

There isn't a definitive test for B12 deficiency - people can be symptomatic without this showing up in the test results - hence current guidance in UK is to treat on basis of symptoms not test results ... however as most GPs don't have a clue what the symptoms are ...

Tests to ask for are B12 (active would be better than serum but he's unlikely to be offered that option), folate (needed to metabolise B12), MMA and homocysteine - last two measure waste products that build up if B12 and B9 are low - so would give high results. There is a large grey area on the B12 test results that labs report as normal and GPs take at face value so important he asks for the results and probably posts them here.

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The serum blood test for B12 is notoriously inaccurate , but that's the only one that the NHS do. Much better is the active B12 Holotranscobalamin (HoloTC) test,available at St Thomas Hospital London and 30 Spire Hospitals (cost £140) Also youwill need to test for the Intrinsic Factor(in case of Pernicious Amaemia) The NHS do this one

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