Odd test results

Hi everyone,

I am writing in for my step sister in Texas. Her doc checked her B12 levels and they cam back at 1000. I find this strange as she's in her 60's. AND..get this- her doctor said that in Texas that 1000 is the number they want their patients to have on their B12 levels!! I couldn't believe it.

Anyway, she takes a multivitamin that I'm sure has some form of B12 in it-most likely cyano, but this seems to me to be very high for someone her age who doesn't supplement with B12. Except for the multi. The doc did not check her folate levels. She also has been having severe panic attacks. And her cholesterol came back high but the doctor ran a test and it is not in her arteries. The doc was wondering where that high number is coming from. As in where is the cholesterol?

I am thinking that her serum level is high but it might not be getting into her cells. I suggested she take a good quality B complex so she would get B6 and folate which we all know helps the b12 to get into the cells.

My question: Does this number seem high for someone in her 60's who does not supplement with B12? She is not vegetarian or vegan.

I am also wondering if there is a correlation between high cholesterol and low cellular B12.

She could get her folate checked before she supplements, do ya'll think this is a good idea?

Thanks so much for any help on this!

21 Replies

  • Thanks, anonymous21, for your reply.

    The reason that the Texas levels surprised me is because I live in another state, Oregon, and the levels here are the same as in the U.K. 200-900. So that doctors in Texas want their patients to have a B12 serum level of 1000 was really surprising to me! That's higher even than Japan or Germany!

    I am prescribed methylcobalamin by my naturopathic doctor. I get the b12 fro a compounding pharmacy here in Portland, Oregon. They mix it up at the pharmacy. I have never tried hydroxo although I would like to give it a go as it might last longer than the methyl which I have to inject 3 times a week and take sublinguals too. I am going to see if that same pharmacy can prepare hydroxo.

    I can't really recommend one form over another as everyone responds to the different forms differently. I did try cyano for a year and did not see any relief in my symptoms, but did with the methyl. However, cyano works very well for some.

    Hydroxo is a very good one as it converts in the body to Methyl and Adeno, as I understand it. Someone will correct me if I am wrong, I hope!

    I am not a medical person, obviously, but if I were to suggest a type of B12 to you I would say to give the Hydroxo a go.

    There is lots of info on this forum as to where to get Hydroxo if you are in the U.K. You could look at fbirder's posts as he has info on where to purchase it from. Or just post a question as to where to buy it. You will get lots of answers!

    Best of luck in your quest to buy B12! :)

  • If she doesn't have absorption problems then the stuff in a multivitamin, combined with a healthy diet, may well be enough to keep the levels high.

  • Thanks fbirder!

    Wow, I guess I never knew what a person's levels are if they don't have PA or absorption problems. I am so used to hearing of numbers well below 300 on this forum. Okay, good to know. I do think she should take a B complex just to make sure she's getting enough of the supporting B's. Can't hurt!

    I love this forum!

    Thanks again, xx

  • I don't believe fbirder or I counseled you to take a multi vitamin. If you read my post again, I was answering your question as to where to purchase b12 & my thoughts on what form of B12 to take.

    Good luck!

  • How many times are you going to post the same request for B12 injections? You've had many answers.

    What possible objection could one have against multivitamins as long as they don't over the top with too high a dose?

  • You keep saying that taking a multi vitamin is dangerous but don't explain why. I am not an analytical chemist so can you explain it to me?

  • If you plan to self-inject B12, please keep a careful eye on your vitamin and mineral status.

    Any deficiency, or levels that bump along the bottom of the reference ranges, are not good for people with B12 deficiency / PA as your body needs really good levels in order to process B12 effectively.

    I note from your previous posts that you have low folate and low iron and hope that these are being addressed, particularly the low folate (B12 will not 'work' in the absence of good folate levels and low ferritin impedes the uptake of B12).

    I note that there are other health reasons why you cannot take multi-vitamins so it might be a careful 'balancing' act to intake what your body requires to process the B12 effectively whilst avoiding the things that may be harmful to you.

    You will see from many of the posts here that forum members really struggle to keep vitamins and minerals high enough to support the uptake of B12. Indeed, some become very ill through deficiency or low levels. And GP's rarely have enough knowledge to help and frequently ignore low levels that should be treated!

    I note that you are already coming across the incompetence of medics! This is particularly so in all things PA / B12 related. You may also meet a level of hostility that will surprise and shock you!

    I hope you have a GP who will support you in this, if only to keep a check on your vitamin and mineral levels!

  • Are you sure that the results are using the same units and ranges?

    Would go with others that it isn't going to be a problem - just good to come across someone who doesn't have an absorption problem

  • Hi Gambit ,

    I think there might be some slight difference in ranges but not a huge one? The ranges at my health clinic are 200-914 pg/ml. I know the ranges in UK are slightly different but in the same ball park. Not sure what they are in Texas but assume it might be pg/ml?

    Regardless, it amazes me to know that that is the level of b12 one can have if there is no a problem. As you say, it's good to come across someone who doesn't have a b12 problem!

    Thanks for your input and I will let my step sister know that some very knowledgeable forum members did not think her high number is a problem.

    Thanks so much for your reply! xx :-)

  • Hi Ndodge. Interesting to note that in her book 'Could it Be B12 An Epedemic of Misdiagnoses', Sally Pocholok advises that people aged 60 and above should aim to have a B12 level between 1000 and 1500 to maintain good health.

    I'm so impressed that her Doctor wants his patients to have those kind of levels 😀.

    Heartily agree with fbirder's comments on why her levels are so.

    Long may her current levels reign!


    P.s. If you're worried about her vitamin and folate levels, she could always get them tested to see if she is deficient or at the lower end of the reference ranges.

    Afterthought - is she having any symptoms that are causing you to worry?

  • Thanks, foggyme for your reply.

    Yes, isn't that amazing that her doctor said that 1000 is the correct b12 serum level? Will wonders never cease and in Texas to boot! Couldn't resist that little pun. That one's for you Clivealive! :-)

    Getting serious again, She's having horrible panic attacks. That and the fact that her b12 was so high made me think she might have a high serum level but does not have enough folate to get it into get cells.

    She eats a very healthy diet and has no stomach issues. Yours is a good suggestion to get tested. My thought is that the simplest thing is if she just takes a good quality b complex. I think that should do it.

    I was just so shocked to see such a high number. One sees so many low numbers on this forum!

    And as you said, "Long may her current levels reign!

    Thanks a bunch for your input, dear foggyme. xx

  • Grief Ndodge...panic attacks are truly awful!

    Is she having any treatment (CBT etc). I find that yoga is really beneficial for a general sense of well-being - especially the breathing and meditation elements (though luckily, I've never had panic attacks - yet!).

    There's also this new thing called mindfulness. Seem to recall reading that some found this beneficial.

    Hope she manages to find something that works for her.

    I send her a big hug 😀

  • How kind of you, foggyme! I'll tell her about your sent hug. That will make her feel better. She's having a tough time with really severe panic but her doctor has prescribed klonopin which is helping. She's suffered for years. I'm praying that this medication will help her. She's going to start therapy but yoga and breathing and mindfulness are great ideas. Thank you! :-)

  • Hi Annonymous21 i hope your headache has improved.

    You say "The dr will act depending and relying on their clinical judgment and assessment of the patient" when prescribing - and this surely would apply to all medications.

    However when I was diagnosed with Type 2 diabetes last year it was my pharmacist that raised his eyebrows - not a the range of multivitamins I take (I had two thirds of my stomach removed 57 years ago) but at the Metformin and PIPs I'd been prescribed, both of which are known to suppress the absorption of B12.

  • Thank you for your reply, annonymous21. My step sister does not have b12d symptoms and is being advised by her doctor of 13 years as to her vitamin supplementation.

    Be well.

  • Hi Nancyndodgeoverthere,

    On page 11 in the book "Could it be B12? – an epidemic of misdiagnoses” by Sally M. Pacholok R.N., B.S.N. & Jeffrey J. Stuart, D.O. under the heading "Types of tests for B12 Deficiency" talking about the Serum Vitamin B12 Test it says:-

    However, it appears that these markers demonstrate B12 deficiency primarily in patients whose serum B12 is in the "gray zone" (a serum B12 result between 200 pg/ml and 450 pg/ml). We believe that the "normal" B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebral spinal fluid (CSF) below 550 pg/ml

    At this time, we believe normal serum B12 levels should be greater than 550 pg/ml. For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1,000 pg/ml.

    I hope all is well with you and yours.

  • Thank you, Clivealive, you know, I read her book but I need to read it again because I've forgotten so much.

    I just couldn't believe that a person could have that high a level without a lot of supplementation. But I guess if one doesn't have PA or absorption problems, then you would find high levels like that. Amazing! To think that a person's levels can be that healthy and they don't even have to supplement except for a multi vitamin. Not in my world!

    Hope you are well, way on the other side of the world, and that the extra B12 shots are making a positive difference for you! Take care :-)

  • I just couldn't believe that a person could have that high a level without a lot of supplementation.

    I guess it's because the body is just so good at recycling B12 (when it's working properly).

    The recommended daily amount is that required to keep the average person just ticking over. So, if you consume more than the average amount in your diet, add extra as a supplement and maybe have a very efficient kidney (so that not much is eliminated in the urine) then a lot of the B12 that you ingest is going to stay inside the body.

    1000 pg/ml (1 ug/L) means there's a total of about 30 ug of B12 in the body (assuming a Volume of Distribution of 30 L). That's about the amount one would consume over 10 days at the recommended daily amount - or about a week eating a healthy diet and taking a multivitamin.

  • Thanks fbirder, that really puts it into perspective! Amazing what the body can do when it's not broken! :-)

  • Hi Nancyndodge. Just had a thought about your step sister's high cholesterol, and her panic attacks that you mentioned to Foggyme.

    Hypothyroidism can cause serum cholesterol to rise. Has she had her fT4 and fT3 and thyroid antibodies checked recently?

    Disturbances in thyroid function, both hypo-T and hyper-T, can manifest as mental health issues, including panic attacks.

    Best wishes xx

  • Thank you so much, Hillwoman, for this great information!

    I will certainly run this by her so she can get tested if she hasn't been. What would I do without you wonderful forum mates?!! Much appreciation. :-) xx

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