Pernicious Anaemia Society
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Normal b12

Hi there I've only recently had b12 tested and it came back at 108 and was told it was low but I can't find anyone to tell me what is within the normal range ?

Also have lupus and actually went to doctor with tummy troubles which I've had for 17 years but got worse in last 2 months

Now I've read about b12 it makes sense with so many other issues I have - namely jumpy legs, cold altho always been hot , tired, swollen tongue, hair loss, chronic diarrhoea, short of breath, strange noises in my ear and tingling in my hands

In a way I hope it does come back there's issue with b12 as at least I'd have answers for these things I'd never gone to doctors about as felt silly

10 Replies

Are you in the UK? I've assumed you are.

If you get a paper copy of results it should list the reference ranges next to your results. Your surgery may have online access to results.

It might be possible to find local reference ranges for blood tests by an internet search or search on local NHS website or an FOI (freedom of information) request to local NHS website.

"I've only recently had b12 tested and it came back at 108 and was told it was low"

What treatment are you receiving?

Page 8 BCSH Cobalamin and Folate Guidelines outlines UK B12 treatment.

Page 29 of the same document shows the recommended process doctors should follow with someone they suspect has B12 deficiency.

I found it helpful to read the whole BCSH Cobalamin and Folate Document.

Is the GP trying to find out what has caused your low level?

B12 books

"Could it be b12" by Sally Pacholok and JJ. Stuart

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

UK B12 websites


I am not a medic just a person who has struggled to get a diagnosis.


Hi there not spoken with doctor yet just got results and had second test and awaiting second results

Seeing doctor later in the week


ranges vary from area to area and also from lab to lab depending on the equipment used - whatever your result is low. Ask for a copy of the test results as that would give what is regarded as the normal range - though please bear in mind it is a statistical average and people vary so much in the way they respond to B12 that it isn't a definitive guide - it is symptoms that really count.

Please look through the pinned posts - go through the checklist of symptoms and everything that applies to you and then go through it with your GP.

Generally B12 deficiency is caused by an absorption problem - PA is one. Lack in diet is a possibility if you have no/very little meat/dairy/fish and don't supplement at all eg through fortified breakfast cereals.

If you are in the UK then refer your GP to the BCSH guidelines on treatment - p8 - as there are different protocols for treating when there is neurological involvement.


Hi leeherron79 I'm not medically qualified but I guess it would depend on what ranges the laboratory uses that tested your blood.

Are you in the UK?

My recent Serum B12 test result for example read

VITAMIN B12 (SZ1706)Normal no action469pg/ml187.00 – 883.00 pg/ml

If the same scale was used for your test you are very low at 108 and this would explain your symptoms.

Was your Folate level measured? Folate is essential to process B12

You mention "tummy troubles" Can you see yourself in the list below?

On page 23 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. there is a list showing:-

Who’s at greatest risk for B12 Deficiency?

Anyone at any age, can become B12 deficient. Thus you need to be tested immediately if you develop the symptoms described in this chapter. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

Infants born to and/or breast fed by women who are symptomatic or are at risk for B12 deficiency.


I am amazed that whoever told you the test results didn't advise you of any treatment.

I suggest you go back to your GP with a list of your symptoms and request a course of B12 injections in accordance with the B.N.F. Guidelines.

I wish you well for the future.


Thanks as I say all I've had is blood result over phone and asked for second test which I've done but waiting to see doctor later this week

They don't know half my symptoms as I was in for something else so will go through that in appointment

Only asked on here incase anyone knew the normal range as I didn't know if I'm just a bit low or very low in the scale

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Hi Leeherron79,

Imho, it seems to me that 108 is low no matter what the ranges are! In Japan and Germany, anyone below 500 is treated.

My levels (and I don't have the ranges right in front of me) were 290 & I had lots of Neuro symptoms.

108 definitely needs treating. And I wish you luck in getting loading doses! :-)


Hi just been to doctor they telling me that 108 is "borderline" - hey believe that 110-650 is normal range!!!!??? Not what I've been reading elsewhere

Will give me b12 injections but also want to check thyroid and something to do with iron first (as apparently giving me b12 without iron check could make me anemic

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if the 'normal' range is 110-650 then 108 is not 'borderline' it's low.

Probably a good idea to have folate levels checked as well.

Lack of iron would make you anaemic, regardless of your B12 status. My guess is that they're confused that you don't have macrocytic (large-cell) anaemia because they think that everybody with low B12 has it (they're wrong).

Low iron can cause microcytic (small-cell) anaemia. Having the two together means the average red cell size is normal.

So let them measure iron and treat it if it's low (and it could well be if your low B12 is because of poor absorption). But don't let the size of your blood cells determine your B12 treatment.

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What are they? Brain dead? Really, if the lowest number in the range is 110 then 108 is less than that. Why do they have ranges anyway if they are going to ignore them? Bad science!! :(

The good thing is that you are going to get B12 injections! Good Luck! :)


Sorry should have said second reading was 118 hence why they say I'm "borderline"!! Also told me its one of the most inaccurate tests they do!?? So what's the point.. Also said I'm not anemic but if they didn't test my ferritine then the b12 could make me anemic ?? I'm confused completely


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