Which test for active b12 - venous or spot test?

[cj-79]

Hi i'm new here, been having symptoms of b12 deficiency for a long time now maybe a year. I have been brestfeeding my 2 daughters and just ignored the numbness and tingling as i thought it was carpal tunnel or something. I also have many of the other symptoms as well. GP did bloods i think it must have been b12 serum which was normal, vit D was on low side and I have been put on 5mg folic acid for 4 months as I am deficient in that. Ive been taking the folic acid and vitamin D for a week already and although I feel less tired my other symptoms have not improved. The numbness and tingling in legs, feet and fingers are really starting to worry me.

I would like to do a private test as I'm worried that I am vit B12 deficient and don't want to wait 4 months to see if the folic acid improves my symptoms. I have been looking at the active B12 test as I understand this is better than the urine test - please correct me if I am wrong. But I am confused as to if I should go for the blood spot test or a venous sample test? are they both accurate tests?

Also any recommendation of companies to get the tests done with? I have been looking at Bluehorizon and medicheck so far.

thanks cj

[Polaris]

GPs generally do not have sufficient knowledge of B12 deficiency and may have considered your B12 test normal but It would be best and you're entitled to ask for a print out of test results, as pregnancy and breast feeding place high demand on and can deplete B12 stores. You probably already know how important it is for you have sufficient B12 if you have been or are still breast feeding?

The numbness, tingling and fatigue you have described could indeed be neurological symptoms of B12 deficiency, especially as you are also low in vitamin D and folate, so may possibly have a problem with absorption.

As you can see from the latest BMJ research summary below, (GP would probably be able to access full document behind a paywall) there is no gold standard test for B12def. and, in view of your history and symptoms, these are more relevant than test results, so your GP should be treating you with injections as per BNF for neuro symptoms - "every other day until no further improvement" - without delay to avoid permanent damage:

bmj.com/content/349/bmj.g5226

Here is another link with more information on the effects of pregnancy and templates for writing to your GP, as all in all, it might be better to concentrate on obtaining early treatment of symptoms rather than wait for more tests. It would also be a good idea to take someone close with you to your next appointment for extra support to ensure your symptoms are treated seriously:

b12deficiency.info/what-to-...

Very best wishes for better treatment Cj-79

PS The Dutch links on the right hand side of the forum have more information in the importance of early and adequate treatment.

[cj-79 in reply to Polaris]

Thank you Polaris for your detailed reply. I managed to get a copy of my results today

Serum Ferritin - 23 - Normal (15-300)

Serum B12 - 416 - Normal (180-700)

Vitamin D - 26.6 - Normal (recommended not below 25)

Serum Folate - 2.6 - (4.60-18.70)

I have been unable to get an appointment booked in to see any of the GP's at my surgery as they have no available appointments. I have been told to ring back tomorrow. So I have ordered a home test kit to test Active B12 but won't get the results till Tuesday or Wednesday next week. To add to things I am also going on holiday next week so I am worried about leaving it yet another week.

It's also concerning that with breastfeeding my 2 children I could have also put them at risk.

thanks again for replying to my post, you have given me lots of info to challenge the GP.