I can see that you should stop having B12 injections before you have a B12 test because otherwise you are just testing whether the B12 injection is entering the blood stream.
Should one stop oral supplements before a B12 test? I am guessing not because only a small amount of B12 is being absorbed from the tablets each day. so it won't make much difference. My understanding is that only small amounts of B12 are absorbed by the digestive system and unlike many other Vitamins the body store B12 for years, all things being normal.
In December my B12 levels were 201 ng/L. I have been taking 100mcg Solgar B12 tablets since January. Assuming I don't have PA and the B12 is not being guzzled by SIBO, anyone want to hazard a guess as to what they might have climbed to?
I haven't had any of the PA tests (GP says the labs would refuse to do them on a reading of 201 ng/L).
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mickeymouse42
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It is said that the body can’t absorb more than 10 mcg of B12 a day. I came from Vit D deficiency as well. Vit B12 and D deficiency appear to be linked.
J wish the doctors took it as a warning sign and tested b12 !!! I'm annoyed how so many lives have bed wrecked by ignorance an lack if s blood test as not on a form.
Yes, Nackapan - serum B12 test not included in the NHS Free Healthcheck Plus, yet used widely lately, judging from posts and responses here, to curtail long-term effective B12 treatment in patients. Even those who had previously been told they have pernicious anaemia, a lifelong condition with no cure, that can be managed only by regular B12 injections without which they will deteriorate.
Pretty weak stuff - they need to work with health economists at the King's Fund to work out the cost of not testing.
Vit D and B12 deficiency leads to crippling diseases that cost the NHS a fortune to fix. The consequences of the diseases often leads to (social) care costs that are currently not paid for by the state. When a solution to the social care funding is found, maybe someone will join up the dots and work out that doing testing is much cheaper than not testing.
In the meantime, It would be so good if one could purchases tests from the NHS at the prices quoted by NICE without having to negotiate with a GP. The prices of blood tests from the Spire etc are a rip off - the PA test suite is £500 discounted from £800. Medichecks is much better value but GPs often won't recognise home based kits.
Too much money is wasted on b12 levekss once on injections too.
My daughter had so many expensive tests including a lumber puncture brain scan x rays through rheumatology testing for lupus then addisins . before a b12 blood test ???
That is what she needed .
Just needs to be on 'the agenda ' for preventative testing. .
Rhematology departments do not routinely test for Vit B12 - they focus on Vit D and its association with bone health. What they sadly overlook is that some of the worst bone metabolic diseases start with swelling in the bone marrow. This causes internal fractures in the joint and unless treated urgently will lead to what is called AVascular Necrosis (AVN). Orthopaedics is where you usually go because AVN causes enormous pain in the affected joint (typically the hip); if treatment is left too long, joint replacement is the only option.
The early stages of the disease are rarely picked up because B12 is the province of Haemotologists - Orthopaedics would never test for it, Rheumatology departments do not routinely test B12 and nor do GPs.
In theory bone marrow oedema syndrome (as it is called) should result in a referral to Haematology because B12 deficiency is commonly linked with bone marrow problems but the clinical pathways are not there.
Routine B12 testing would be a very cheap alternative to joint replacements.
>In recent years NICE instructed GP’s to not test everyone routinely anymore because most people were low or deficient.
You are right but the word "routinely" is doing a lot of work in this sentence.
NICE's guidelines came from the Royal Osteoporosis Society's guidelines on Vit D testing for people with bone diseases. It's a long document with lots of caveats. Lots of CCGs then cut and paste the documents into their own guidelines - the same has happened with B12. In that process, a lot of the caveats and thinking were lost.
The time scale of "Routinely" need to be defined carefully; "Routinely" is often interpreted as "never". . .
As B12 is retained by the body for many years, testing every 5 years might make sense (particularly in vegans).
The situation with Vit D is much more complicated. Perhaps once every 10 years in someone's life, you should do a 2 stage measurement of someone's Vit D levels once at the beginning of the summer when levels will be at their nadir and once at the end of the summer when levels should be at their zenith. No supplements should be taken in this period. The purpose of the test would be to test whether the Vit D metabolism is working properly. If it's not working effectively, then there's a bunch of other things to consider.
The tests cost very little - a B12 test is estimated by NICE to cost £3.50 (Vit D is a bit more expensive):
Allowing patients to pay and self refer for tests at NICE prices would be the sensible thing to do. The cost of the GP appointment to request the test is the main cost and self referral would save this cost.
Scrapping the CCG committees that pointlessly duplicate guidelines would pay for a lot of B12 tests!
As B12 is retained by the body for many years, testing every 5 years might make sense (particularly in vegans).
But that apparent huge store of B12 depends on a functional entero-hepatic recirculation to keep the B12 losses down at the tiny number of micrograms a day level. The actual stored quantity is much less than it appears due to the very efficient recirculation that many of us have.
In those who have Pernicious Anaemia or any other impairment of entero-hepatic recirculation, B12 stores simply can't and don't last five years.
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Burning Mouth Syndrome?
Blood results all "normal" still feel rubbish
Does taking oral B12 bias a B12 test high for someone with PA?
Hello, I'm new!
Update on blood test - sorry long post
