Pernicious Anaemia Society

Active B12 test - again

Went for my GP app last night. To be fair she was very nice, listened to me and spent over half hr with me. She is writing a referral note for Active B12 test that I can best obtain at a private hospital, as they will draw the blood too and use their own labs - result with GP in 2 days approx turn around.

My GP is however skeptical that it is B12 causing my nerve damage symproms as although my levels are in the grey area and she recognises are only there because I supplement, She feels my full blood count would show as all in normal range except MCHC which is just below normal range which indicates small red blood cells not the expected large red blood cells. She said a heamatologist would not be impressed with issues as they look at the full blood count.

She had looked at NICE guidelines and only absorbed the issue re pregnant women.

So we agreed to leave it to see what the active B12 test shows. She said she would test for intrinsic factor but didn't see necessary really as obviously absorbing as this is why the B12 increased with supplementation. She said intrinsic factor was only about absorption - is this correct?

She also said that in any serum total B12 test it is expected that at anyone time only 20% of the B12 will be active - this is normal. If the active B12 shows 20% of total when tested therefore then this is normal function

Does anyone have any comments to help - thanks

Oh I suppose I will have to phone the lab to see how soon after supplementing will the test be viable.

Not sure if it is worth it financially and re the stress and not being able to supplement. Maybe considering my full blood count results and GP's comments, I should just vigilantly supplement well with a full B complex containing high B12? (instead of half heartedly as previously) I have also started taking colostrum as good for nerve damage apparently.

After my blood tests which I am relying on in November, I started supplementing with a phytoplankto to provide a full range of minerals. The product states: provides B12 but as far as I am aware plant B12 sources are actually antagonistic to B12 that we need. Maybe taking the phytoplankton without the usual B vit complex (which is what happened) may have reduced my B12 activity hence the symptoms starting? Clutching at straws here.

7 Replies

I am not sure where your doctor is getting this idea:

"MCHC which is just below normal range which indicates small red blood cells "

I consistently have borderline or low MCHC (mean cell hemoglobin concentration). It doesn't mean the cells are small, it means they lack hemoglobin. When my cells were examined under a microscope they were normal sized cells but pale (hypochromic) due to the low MCHC. She may be assuming your cells are small based on a generalization that shouldn't apply to you. But I will also say that my MCHC has stayed borderline low despite sufficient B12 treatment, so it may be an issue that is unrelated to B12.

I believe you're right about the B12 analogue from phytoplankton. If I understand correctly, it is possible to cause a serum B12 test reading to show as inaccurately raised if you're supplementing with a B12 analogue that the body cannot convert into the forms that are needed.

The active B12 test will have a range that will indicate how your result compares to normal. Be sure to ask for a print out of your lab results. If your doctor doesn't routinely order and interpret active B12 test results (and odds are that she doesn't) she could easily misunderstand them and tell you something that isn't accurate. Getting a copy of the results yourself gives you the ability to see if what the doctor says lines up with what the lab says.

1 like

Thanks so much for your information :)


30%+ of people with B12 deficiency present with neurological symptoms before presenting with macrocytosis - BCSH guidelines refer to treating on basis of symptoms as a result.

there are also studies showing that significant numbers of women can actually present with microcytosis when they are B12 deficient.

Basically a myth that macrocytosis has to be present. Its a symptom of the effects of B12 on one particular system in the body - the one that produces red blood cells in your bone marrow. B12 is used by a lot of other systems so symptoms can have a wide range of causes and be present even if anaemia isn't present.

Not come across phytoplankto

1 like

Thanks Gambit, hope this all helps with my GP. Phytoplankton I was taking was Oceans Alive (Web site Crowd Zap) I took (stopped temporarily) to provide full complement of minerals that are absorbable because plant derived


strictly speaking I think plankton actually belongs in the animal kingdom - and B12 can be made by bacterial organisms. I had a brief look and photoplankton was cropping up in relation to the size of algae blooms and their size being limited by the amount of B12 available from micro-organisms ....

Yeast also doesn't sit in the plant kingdom in terms of classifications and it's yeast that is the source of B12 in marmite.

1 like

spoke too soon

phytoplankton plants, zooplankton animals, but I'd still want to dig around a bit more on the biological classification and facts related to an organism that small - just to check out that it isn't actually fitting into the yeast model.

1 like

Hi Gambit, I agree always pays to be cautious. I feel that phytoplankton is the microsopic plant form that obviously uses sunlight and minerals from the oceans to create plant life that is therefore the beginning of the food chain for marine life from which humans subsequently evolved and so have evolved to use minerals and other nutrients available from plant sources. I feel that the most crucial ingredients that enables animal life function are minerals. Vitamins cannot support function without mineral cofactors. We need to obtain minerals from plants that have absorbed and processed minerals from their environment converting them into a viable form for animals. I believe that we can obtain minerals from eating other animals that have eaten the plants and also from the plants themselves. I would not wish to try and fulfil my mineral need other than from a direct source that is from animal and plants. Supplements processed from rock or sediments corals etc are not what we evolved to use. Because of 20/21st century farming methods, often soils that grow our plants are depleted of minerals - so do our health problems stem from our deficiency of minerals. I think we can supplement with as many vitamins that we are apparently deficient in leading to functional pathway issues, that we want but if we are deficient in the necessary minerals nothing much is going to change.

So where do we obtain our full complement of minerals? I found out about Oceans Alive phytoplankton from Functional Nutritional Doctors. Many actually take it as a supplement. To be honest if it is good enough for these cutting edge clinicians then it is good enough for me, who is desperate to find a good nutritional source of minerals incase the organic fruit and veg may still leave me deficient in.

Apart from the depletion of our soil mineral content, modern wheat and grains add to the problem binding to the minerals we actually do obtain from our food, during digestion and so just poop out often.

I had noticed that many who suffer from yeast issues do comment how the phytoplankton has helped or erradicated their issues - just reviews, who can say if honest - I am perhaps niaive cosidering such reviews as valid

I think that I know where your concern stems from - re infective parasites/fungal life, that may use plankton as a food source and so be transferred to us - for good or bad? All too complicated for me, such research. As limited human knowledge of our own microbiome is developing and startling. Thinking of the micro organisms in our environment and in/on our food /water/air and thriving in our own seperate microbiomes for the benefit of our function or sometimes not dependant on proliferation.

We are just not simple organisms and are dependant on micro organisms even yeast as long as it does not proliferate out of balance.

Sorry for long post - just thinking things through on paper so to speak.

If your research brings anything to light, positive or negative re phytoplankton, specfically Oceans Alive which is grown in redgulated tanks with specific bacteria. I would ask you please post about :)


You may also like...