Hello.My b12 serum level came back 165 pg/ml that my lab notmal range was(160-899pg/ml).
Im 35 yrs male. I have symptoms like sleeppy, brain fog, feel dizzi or near faint senses. My CBC results also came back normal. But a little bit hgb in high limits. I mean hgb of 17.
Do you think im b12 deficient? Do i need take supplements?
I feel all time fatigue... And very low in energy. I cant drive car for more than 3 hrs. As a taxi driver. I got hungry with little jobs
Yes I believe that you have B12 deficiency, I will reply to you later with my reasons , Just wanted you to have a quick answer as you must be feeling desperate. Just to warn you that doctors are generally ignorant about the condition and many people are suffering needlessly . Up to 80% of B12 results represent inactive B12 which your body cannot make use of ,You are definitely B12 deficient judging by the results and your symptoms . You need to find the reason for your deficiency . Might take me a day to get back to you .
Hello dear wedewood
Thank you for your time and interest about my topic. I too believe that i have some important deficiency. But dont know which one plays main role? B12 or vit d or etc... I will be happy if you share your ideas and thoughts
I’ve had to help arrange a funeral , so I’ve not been able to reply to you .
As I said I believe that you have B12 deficiency because your B12 blood serum reading is so low and you have some B12 deficiency symptoms .
You need to find the reason for the low B12 result . B12 deficiency can be caused by——————-
Having a diet devoid or extremely low in food that provides vitamin B12. i.e. meat , fish , all dairy products and eggs . Vegans and strict vegetarians need to supplement .
Longer term use of PPI medications ( proton pump inhibitors ) e.g. Omeprazole and others. These lower stomach acid which is needed to break down and absorb b12 , which is the most difficult vitamin to absorb . Metformin diabetic medication .etc and other medications ( consult Google )
Bariatric operations that interfere with the parietal cells in the stomach
Fish tape worm in raw fish ( sushi) improperly smoked fish , improperly marinated fish
The most common reason for B12 deficiency is Pernicious Anaemia . Also known as Autoimmune Gastritis . This autoimmune condition produces antibodies that attack and destroy the parietal cells in the stomach . Theses cells produce the Intrinsic Factor and stomach acid , both needed to absorb vitamin B12 . This is an incurable condition which is treated with B12 injections . There is a test calked “intrinsic factor antibody test . IFAB. If positive , you have Pernicious Anaemiane but if negative it does not proove that you don’t have P.A. ! Yes very frustrating. But your doctor should rely on your symptoms . B12 injections are needed FOR LIFE for P.A. and as often as is needed to keep the symptoms at bay .
Be warned ,. Most doctors are very ignorant about B12 deficiency and Pernicious Anaemia . Many of us have to turn to self-help and self -inject . P.A. has a definite genetic connection. 165 is definitely a low reading and needs investigation . Come back to us if you fail to get satisfaction from your GP Some of us have gone through hell before getting a diadnosis and treatment . If treatment of B12 deficiency is delayed too long , irreversible symptoms may remain .
So keep in touch and let us know how you get on .
Best wishes .
Thank you for your time and reply and your good advices. Did you see my cbc results and vit results that is attached here in response of dear nakapan? I personally believe that im deficient in some vitamins. My GP said that your cbc is normal and hgb also is in high limits. So you don't have b12 deficiency. Is it enough to say if i have enough hgb or rbc, so i don't have Anima?
No ! It’s enough to say that for iron deficiency anaemia , but not for B12 deficiency anaemia . You need to find out why your Vitamin B12 is so low .
No, I am male and I had good Hgb but still low b12 symptoms. There are many people who have normal Hgb but have neurological or other symptoms of B12 deficiency. In any case, you have very low B12 and there is no harm in taking weekly injections for a month or so. If you feel better, you can take monthly injections for life, as they do not harm.
Thanks for the reply sir. May i ask what level was your b12 at first time when you diagnosed with b12 deficiency? What was your result and tour lab range
I was first tested regularly and it came at 190 (range 180-1000). Didn't have any symptoms, but doctor asked me to take B12 tablets. Didn't. After a year or so, I had some numbness in my hands and B12 came out to be 140. Doctor prescribed 4 weekly injections. Became OK after a couple of days of first injection itself. However, doctor did not ask me to take regular monthly injections, so things came back. If you are low, it is likely some absorption problem, so will need monthly injections for life (lesser frequency - once every 2-3 months - for hydroxocobalamin may work for some).
Also, doctors don't want to give you injections as it increases their workload, so go for self-injections if needed. Oral tablets don't work for all, so I would not suggest. Also, if going for orals, go for cyanocobalamin and not the methyl one as there are studies, and my personal experience, that methylcobalamin tablets don't work as well.
Have you had folate ,iron, vit D tested? Were results discussed ?
Are you on any medications?
Some stop b12 absorbton
Is your diet rich in b12?
All your blood results need to be looked at together to rule out other things .
The 'in range ' for b12 is set low.
You can still be b12 deficient 'in range '
Was the Intrinsic factor antibody test done
If positive you have Pernicious anaemia but if negative 50% csn still have PA .
Test not robust enough.
There are many other absorbton problem that results in same symptoms and need b12 injections for life.
It's poorly understood
Oral supplements work well if cause is dietary .
Hope you find a good doctor to ask all these questions to .
No point in taking bloods if results not explained .
This happens alot .
It's a matted of elimination too.
Hope it goes well.
Hello dear NACKAPAN .First of all i want to thank you for your very detailed reply and explanations.
Yes i had done some of your mentioned test but not all of them. I did CBC and vitD too. But i didn't do intrinsic factor antibidy test yet. If needed i will do it for sure. I also didnt do tests for folate and ferritin. I can remember that 2 years ago i done vitb12 and folic acid and i attach the results here (hand written results are done 2 years ago). As you can see in the oldest test of b12 test we see that the result came back in lower limits too. 194pg/ml (187-883 lab range). Folic acid test was 5.9 ng/ml (3.1-20 lab range).
Today I went GP and she looked at b12 of 165pg/ml and said that is in normal range😏🤔😑😲.
I should add that i did TSH and free T4 hormones test. Came back normal. I personally think all the time the blood can't reach in my brain and feel something like near faint or dizzy or near syncope (but not happen).
Im always sleeppy and can say for sure that i have the most bad quality sleep in world😔😅. The confusing thing is that here s doctors says your vitb12 is normal but when i looke in web, many countries looks below 350 pg/ml as deficiency.
I will be happy to here your advise and comments 💐💐
As you've had a few b12 levels done so on record. And seemingly no action taken on results or other reason found for youf symptoms .
Surely there's no harm at this stage to try an oral b12 supplement .
It will raise levels in your blood snd maybe your body is able to utilise it .
My husbands serum b12 was borderline and he takes a daily low dose of b12 to top up his food intake.
It worked.
His level went ftom 180(200-900)
To 360(200-900)
H4 only had vague symptoms that couldvd been anything but must get some benefit as takes it daily.
For him .....unusual .
Of I frightened him bh mh symptoms!-
My sisters deficiency wax dietary and needed a boost.
Shd hax 500mcg ×2 a day.
Avoided injections as absorbtion slowed with age menopause we think
My mum needs b12 injections as does my daughter .
A multivit not bad idea either.
B12 should be taken before folic acid .
Its up to you .
In my non medical view worth a try.
Did you not get any advice?
We are often on our own to work things out.
Introduce one thing at a time and keep a log .
B12 can be bought in many doses.
I wouid start quite high to see if it helps you.
Tablets ,sublingual. Loads to try as a trial.
If not dietary ,or not meds. No heavy alcohol intake.
Ect .
You may need injections if an absorption problem.
Just forgot to add that im on medication as below(bupropion 150mg) - half piece of pill after breakfast.
(paroxetine 20mg)_ half piece of pill every night.
I always was in antidepressants meds for about 10 years. I couldn't be alive without antidepressants meds. But i personally believe that my problem is not related to mental issue but i think i have an important deficiency in some things like b12 or vit d or etc.. Doctors usually can't satisfy me that the say its just a depression. I remember 5 month ago that i was not even able to stand in my feet or do regular jobs. No energy att all and get exterem thirst. And extremely urinate. (FBS and A1cHGB was normal). My eyes gets dark when stand and felt i should sit down rapidly. I felt like passing out. But after taking meds of bupropion it helped me alot and i can go and do my job now normally or at least not that way like 5 month ago
Hi Emiroskui,
In the UK where I live, some guidelines suggest that people who have the symptoms of B12 deficiency should be treated even if their serum (total) B12 results are within normal range.
Many of us on this forum have met doctors and other health professionals with a poor understanding of B12 deficiency.
Do you have the symptoms?
Symptoms of B12 Deficiency (folate deficiency also mentioned)
pernicious-anaemia-society....
b12deficiency.info/signs-an...
b12-institute.nl/en/symptom... (from B12 Institute Netherlands)
Do you mind me asking which country you are in?
The reason I'm asking is that treatment for B12 deficiency can vary between countries.
Knowing which country you are in may help people to post relevant information.
A few B12 links that may be useful
PAS (Pernicious Anaemia Society)
Based in Wales, UK. Has some overseas members.
pernicious-anaemia-society....
There is a helpline number that PAS members can ring and an online contact form.
PAS membership is separate to membership of this forum.
Testing for PA
pernicious-anaemia-society....
B12 Info.com (also called B12 deficiency Info) website
B12 Awareness (US website)
Stichting B12 Tekort (Dutch website with English articles)
stichtingb12tekort.nl/weten...
Two useful B12 books
"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper
Martyn Hooper is the former chair of PAS (Pernicious Anaemia Society).
"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)
Very comprehensive with lots of case studies.
I'm not medically trained, just someone who struggled for years with undiagnosed and untreated B12 deficiency.
Lots of secondhand copies available -t hough postage might add a bit.
Just plug in the title here (for one of many sites):
B12 level of 800 but still i have symptoms?
B12 of *208 pmol/L 25.1 - 165 . 0 Please Help
Is serum folate levels the level of b12? 
