Vitamin B12-I am new here :)

[syl123]

I have been told that I have a folate deficiency but that my B12 levels are "within the normal range" , I have read that the blood tests for B12 are inaccurate in relation to counts of both active and inactive B12. I score 76+ on the pas b12 deficiency list.I have suffered from most of these symptoms for years with increasing fatigue and feel like i am grinding to a halt. Is there a Vitamin B12 tablet that I can get over the counter that will help or do I need to get injections ( im in the UK)

[Gambit62 Administrator]

It would help to get hold of the actual results.

There is a huge overlap between the symptoms of B12 deficiency and folate deficiency so just looking at symptoms isn't going to give a clear picture and it would really help to have a lot more information so pertinent facts can be identified and raised with your GP.

The fact that the symptoms seem to have developed over time, if I am reading your post correctly, would tend to point to B12 rather than folate underlying at least some of the symptoms as symptoms of folate deficiency tend to develop much quicker.

Serum B12 isn't a gold standard test - it will miss about 25% of people who are B12 deficient if used as a single marker but it will also pick up % of people who aren't B12 deficient.

Another common marker is macrocytosis (larger rounder red blood cells) though that is going to be inconclusive if you also have a folate deficiency as its also a symptom of folate deficiency. On the other hand, absence of macrocytosis doesn't rule out B12 deficiency as 30% of people with a B12 deficiency initially present without macrocytosis.

You could try an ordinary B12 supplement from a suppermarket - usually somewhere around 2.5mcg to 12mcg ... or even anything up to 50mcg - these will be effective at correcting a deficiency that isn't due to an absorption problem but won't have an appreciable impact on results if you don't have an absorption problem.

A much higher dose - 1000mcg is going to be needed if you do have an absorption problem - and although this can help people manage an absorption problem its not very effective at raising levels if you are already deficient as the amount that is absorbed is somewhere around 1%. However, using high dose supplements isn't recommended if you are looking for a diagnosis and it would be better to exhaust all possibility of getting a diagnosis before supplementing. Generally you need to lay off most supplements for 3-6 months to get a clear result for most of the tests associated with B12 absorption problems (more info in the pinned posts).

[syl123 in reply to Gambit62]

Thank you Gambit62, I have waited 2 days to get hold of my results and picked the envelope up today but its not the results I asked for, I wanted the last 3 blood test results and they sent 2x A4 sheets with details of serum c reactive protein and Erythrocyte sedimentation rate , nothing to do with the b12,folate and vit d results I asked for, very frustrating but I will try again tomorrow.I will wait until I see the results before taking any supplements like you suggested. many thanks.

[syl123 in reply to syl123]

Hi all, i got the results today showing:

Serum B12 as 278ng (198-771)

Serum ferritin 21ng (13-150)

Serum folate 3ng (3.9-26.8)- flagged

RBC 4.81 (3.8-4.8)-flagged

WBC 5.4 (4-11)

Platelet 272 (135-450)

Mean cell volume 85fl (80-100)

Haematocrit 0.41 (0.35-0.45)

MCHL27.9pg (27-34)

RB cell distribution width 13.7% (10-15)

I am being treated for the folate but nothing else has been mentioned, im not sure if anybody can help with assessing whether I have a b12 deficiency?