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2003 article suggests B12 serum test may miss up to 1/2 of deficient patients

_tracy_ profile image
3 Replies

I found this 2003 article which makes a couple of interesting points:

1. The use of low serum B12 (< 200 pg/mL) as a sole means of diagnosis may miss up to half of the patients who have actual tissue B12 deficiency (they were looking at elderly patients)

2. If B12 is between 100 - 400 pg/mL, then MMA and homocysteine should be checked and a B12 deficiency is indicated if either of these are high (this logic is in the flowchart graphic, Figure 3)

They back these up with statistics from studies.

Article is here:

aafp.org/afp/2003/0301/p979...

Title: Vitamin B12 Deficiency

Authors: ROBERT C. OH, CPT, MC, USA, U.S., Army Health Clinic, Darmstadt, Germany

DAVID L. BROWN, MAJ, MC, USA, Madigan Army Medical Center, Fort Lewis, Washington

Publication: Am Fam Physician. 2003 Mar 1;67(5):979-986.

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_tracy_
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Chancery profile image
Chancery

Interesting, Tracy. That's 12 years old now, but I suspect lots of doctors would still argue with both points! And for reference on point 2, I asked my doc to have Homocysteine and MMA measured when my B12 was 384 and he said the NHS didn't do the tests. There's not a day goes by that I don't regret not insisting on having them done. Exceptionally valuable information to have - I wish I had it.

_tracy_ profile image
_tracy_ in reply to Chancery

Yes I thought it was interesting particularly because it is an old article. Even back then there are those who realized there was a significant problem. And very sad that this has not changed even though it was recognized there is a problem with many people getting missed.

The medical community is very set in its ways, even if those ways are harming people. Darn near impossible to change things...

Chancery profile image
Chancery in reply to _tracy_

I know. It's a slow old dinosaur. More's the pity. Especially when you consider their ridiculously moribund ways literally kill people.

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