How low is this b12 level?

[Dwg18]

I had a private blood test after long suspecting that I was rather anaemic or deficient in b12, due to constant fatigue. The results came back 156 Pmol/l which I am told is borderline low. After some research it does seem like this result does support that I may be deficient in b12. I am going to approach my GP about this but am worried they will think my result is too high to justify b12 injections.

[fbirder]

Without knowing the range it’s impossible to say any more than - it is borderline low.

Different labs use different methods of analysis and different normal ranges.

But ‘borderline low’ means it’s low enough to cause symptoms.

[Dwg18 in reply to fbirder]

Hi, the specific range for this was 145-600. Sorry I didn’t realise the results can differ that much between labs.

[fbirder in reply to Dwg18]

So, that that is very close to the bottom of the range.

No sensible doctor should rule out a possible B12 deficiency based on that result.

If you were in East Yorkshire the next steps would be to start you on a course of B12 injections and to do a test for Intrinsic Factor antibodies. If your symptoms improve or the IFab test is positive, then you should be given injections for life.

hey.nhs.uk/wp/wp-content/up...

[clivealive Forum Support]

Was your Folate tested at the same time?

[Polaris]

The serum B12 test is flawed for a number of reasons and should not be considered in isolation of history and symptoms as outlined in the latest BMJ research document summary below (GP should be able to access full document - behind a paywall) :

bmj.com/content/349/bmj.g5226

Many experts would also consider your result low :

‘As we age, the stomach shrinks and produces less of the acid needed for B12 absorption to take place,’ says Dr Chandy.

‘Second, those with pernicious anaemia (known as B12 neuropsychiatric syndrome) have an inherited glitch that means their body can’t absorb B12 from the stomach. This can kick in at any age, but is more common as we age.’

Dr Chandy estimates pernicious anaemia could be behind 20  per cent of chronic disease worldwide. The range of symptoms caused by B12 deficiency is diverse with no set pattern — but tiredness and low mood are common.

'In the elderly, it can cause dementia, says David Smith, Professor Emeritus of Pharmacology at Oxford University. ‘B12 deficiency is more common after the age of 60 and, once levels fall below 500 pg/ml (picograms per millilitre — the normal range being 500 to 1,000), the brain starts to deteriorate at twice the usual rate, making memory loss six times more likely,’ he says.

Pernicious anaemia is also linked to tinnitus (affecting seven out of ten sufferers), the skin conditions rosacea, vitiligo and psoriasis — it may even be linked to multiple sclerosis, thyroid disease, rheumatoid arthritis and psychosis, says Dr Chandy. ‘Unfortunately, too few doctors are aware of this or that treatment is cheap, easy and free of side-effects, with robust clinical evidence for its efficacy.’

'Many people are not being diagnosed — and, when they are, they are failing to get the treatment they need, adds Professor Smith.

‘NHS guidelines insist B12 deficiency be identified by one of two possible blood tests — both of which are unreliable.

‘One test looks for macrocytic (enlarged) blood cells, which can be a sign of deficiency. The other measures the total amount of B12 in the blood. But you can be B12 deficient and sail through these tests.

‘GPs need to look for symptoms that suggest B12 deficiency — then see if these improve with B12 treatment.

'The definition of deficiency in the UK is below 200pg/ml — but harm to the brain can begin at anything below 500.’