16 year old low range b13

[Jessiepup]

My 16 year old son had B12 of 286. Is there a possibility this is temporarily low due to a period of hight growth? He has been tired and suffering from some exam stress. Gp has noted all bloods as normal. His alk phosphatase is high which can be related to growth spurts.

[fbirder]

What were the units and range for the B12? 286 doesn't sound especially low, particularly if it's in pmol/L

[Jessiepup in reply to fbirder]

286ng/l no range just a note saying deficiency excluded over 160

[Gambit62 Administrator]

RDA for children is often different from that for adults for most vitamins and minerals because more is needed for growth.

According to this article - from NIH in the US - the amount needed actually increases up to 14 years and then is the same as for adults

ods.od.nih.gov/factsheets/V...

Sort of implies that it wouldn't be temporarily low due to growth spurt.

The body normally stores significant amounts of B12 in the liver so small variations in daily intake unlikely to be a problem. The caveat to this is that things change if there is a B!2 absorption problem.

B12 is only found in animal products - so if your son isn't eating meat/dairy/egg to get enough B12 then levels will become depleted. Many breakfast cereals are also fortified with B12.

Have you looked at how much B12 is in your son's diet?

Is there a history of B12 absorption problems in the family? or some other factor that leads you to believe that there is an absorption problem? If there is an absorption problem then there should be a detectable decline in B12 levels overtime (assuming no very high-dose supplementation).

Another possibility is folate - which is much more directly tied to dietary in-take because it isn't stored - so may be worth looking at whether there is adequate folate in diet - most of the good sources tend to be quite unpopular with teenagers - eg green vegetables like broccoli.

Folate (B9) is needed to process B12.

as fbirder says, the level quoted doesn't seem particularly low - though the serum test is a difficult one to interpret and symptoms need to be looked at as well -

pernicious-anaemia-society....

However, should be noted that there is a huge overlap with other conditions.

[Jessiepup in reply to Gambit62]

Thanks, I have also had low in-range b12 with no help from anyone. Unfortunately my son is in his last year at school so a crucial time.

[Gambit62 Administrator in reply to Jessiepup]

I presume that means that you have tried talking to your GP about the fact that the serum B12 test isn't a good test and the results need to be evaluated on the basis of symptoms. If you have got as far as you can with GP then suggest that, if not already a member of the PAS, you join and contact them to try and get proper treatment for yourself and your son.

Sorry I don't have a wand that I can wave.

pernicious-anaemia-society....

martynhooper.com/2016/09/23...

[Jessiepup]

I gave up with gp's ages ago sadly

[SarahFerguson in reply to Jessiepup]

Hi Jessiepup, I've just read you post about your son. I am going through something very similar with my 18 year old son at the moment. He was diagnosed with Gastritis just before Christmas 2016 after Endoscopy. His recent bloods came back showing B12 Serrum of 174 (Reference range at 130-800, as you can see, very low... he's at Uni in Southampton at the moment and very symptomatic. I myself was diagnosed with PA 3 years ago.... Did you ever go back to your GP and get a result for you son?

[Jessiepup in reply to SarahFerguson]

Hi, didn't get anywhere with treatment though he has been on desicatted liver tablets (perfect brand) since December and he feels miles better. Plus I am putting mineral drops In his squash which seem to be helping. We are in Southampton so good luck with referral, in my experience they don't budge from the guidelines.

[SarahFerguson in reply to Jessiepup]

Ok, sorry to hear that you didn't get anywhere. I have just purchased Martyn Hoopers book about pernicious Anaemia - I've highlighted all the areas relevant regarding MCV in bloods and GPC / Instrinsic Factor bloods combined with strong family histofy of PA - Gp backed down a little after I sent letter to practice manager laying out everything in black and white and that I thought the surgery was putting my son at risk of neurological problems... got a phone call from GP saying she would refer him to heamatology , just waiting for appt. we are in Southampton aswell (Warsash). I will let you know how we get on! I would suggest that as its been sometime now get your sons bloods retested!

[Jessiepup in reply to SarahFerguson]

Great news, let me know how you get know and if positive can you let me know the consultant name. My son seems really ok again at he moment so they won't test, of he slips at all I will be straight back there. Good luck for your son.