B12 level

[naveed123]

I have no pernicious anaemia problem and my B12 level is 345.Is this level is ok?

[clivealive Forum Support]

Hi naveed123 your having thyroid problems may put you at risk of developing a Vitamin B12 deficiency but your level is probably well above the bottom of the range. Do you know what the range <From -- To> is?

We source B12 from eating animal products such as meat, fish, seafood, eggs, poultry and dairy produce so as long as you have these in your diet then, as long as you don't have an absorption problem with your digestion, you should be fine.

Together with the above foods, for Folate you need to eat plenty of leafy green vegetables, sprouts, broccoli, asparagus, spinach, peas, beans etc. Was your Folate level tested along with the B12?

I am not a medically trained person.

[fbirder]

Yes, that level is just about bang on the middle of what's average for normal people. If you have no symptoms then you have no B12 problems.

[Polaris]

If you're still supplementing B12, naveed123, then this would not indicate high levels. Looking back at your history, it seems you tested positive for intrinsic factor, which would mean you cannot absorb B12 and should have regular B12 injections for life.....

As clivealive has already replied, Hashimoto's thyroid disease can contribute to lack of absorption of B12 and other essential nutrients, as many sufferers also have gastric atrophy (often silent) which will lead to PA/B12def.

[Polaris in reply to Polaris]

PS. The serum B12 test only measures B12 in your blood, but not whether it's being absorbed, and is flawed for many reasons (Martyn Hooper's latest book, 'What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency') has more detail.

The Dutch links on the r/h side of the HU PAS forum also explain about testing, B12 misconceptions and the importance of early and adequate treatment:

stichtingb12tekort.nl/weten...

Another helpful link re. Hashimoto's/PA connection:

frontiersin.org/articles/10...

"Chronic Autoimmune/Hashimoto’s Thyroiditis and CAG

Chronic lymphocytic thyroiditis is the most frequent autoimmune disorder and represents the prototype of organ-specific autoimmunity (19). Its prevalence, despite some difference of sex, age, race, and iodine intake, reaches about 5% in the general population (20). Much less frequent is the chronic autoimmune atrophic gastritis (type A gastritis or body/fundus gastritis), which represents only some 5% of the whole spectrum of chronic gastritis and must be differentiated from the one associated with chronic Helicobacter pylori (Hp) infection (type B gastritis or antral gastritis) (21, 22). HT is characterized by diffuse inflammatory changes with lymphocytic infiltration of the thyroid gland, leading to the destruction of the thyroid epithelial cells with subsequent fibrosis (23). Similarly, autoimmune gastritis is a chronic inflammatory disease involving gastric body and fundus, with the progressive reduction and/or disappearance of the native gastric glands that are sometimes replaced by intestinal or pyloric epithelium (metaplasia) (3). The natural history of HT is the progressive reduction of thyroid function till overt hypothyroidism (24) with a rate of progression of 2–4% per year (23), while that of gastric atrophy features the progressive reduction, till disappearance, of parietal cells, leading to reduced or absent acid production (3, 22). These alterations interfere with absorption of essential nutrients leading, at first, to iron-deficient anemia, followed by PA if the self-injurious process involves the IFA (13)"

[deniseinmilden in reply to Polaris]

Excellent answers, thank you Polaris. Any sort of supplementing should push levels much higher than below midway on most ranges and in fact suggests a problem to me too.

Midway on a range of 200 to 900 is 550.

Either way, symptoms should be taken into account.

I hope I don't add thyroid problems to my absorption issues but at least I know I'm in safe, caring and knowledge hands here if I do: thank you.

[Gambit62 Administrator]

as fbirder says your level is well into the normal range.

However, the normal range is very broad and it is based on averages. The fact that it is based on averages means that there is a logical problem with picking any point in the range and assuming that an individual is okay at that point. Different people are okay at different points in the range and a small number of people are also okay outside the range.

if you have previous tests that showed levels much higher and a downward trend in levels then that would indicate an absorption problem.

If you have significant symptoms and have done for a time then that could mean that it isn't the right level for you but as symptoms overlap with a large number of other conditions it is quite difficult to be certain that B12 is the specific problem.

Looking back over your previous posts you mention a level of 321 a year ago - so roughly the same level (certainly within the limitations of serum B12 tests) so that would imply that you haven't got an absorption problem, though I also notice that previous posts mention supplementing with 500mcg tablets.

I know there is a lot of talk on the TUK forum about needing B12 levels over a certain point but this seems to be based on reports of average levels needed by people who have had injections for B12 absorption problems - having an injection introduces another factor that significantly changes the range where people are able to function - however, this still doesn't mean that everyone needs high levels after injections - just that there is a pretty significant minority who respond to injections in a way that means B12 levels need to be exceptionally high and that then skews the resulting average towards the very high end.

[deniseinmilden in reply to Gambit62]

Thank you Gambit62 for a clear and sensible explanation.

[mountainice]

I spoke to Dr Chandy over the weekend and he said he treats anyone with a level of 300 to 350. I was in touch with him by email owing to ongoing symptons, but when i sent him test results, including thyroid, from 2014 and this year he said i need 100% to be treated for hypothyroidism. Doctor not treated me so far, even though she mentioned my thyroid, but didn't deem TSH high enough to treat.

4.9 miu/L in 2014 and 4.6 this year - range 0.3 to 5.0

Free T3 15pmol range 9 to 24