can anyone tell me what 34.3 pmol/L means.
This is my B12 reading from a recent test but everything online is in pg/ml so I’m not sure how low this is. I’m advised to check my full blood count an intrinsic factor antibodies.
Any advise would be very much appreciated
I guess that the test you had is an Active B12 test?
(The standard serum test can have results in pg/ml or pmol/L but the very low number strongly suggests it is Active B12.)
In any case, you need the reference interval from the lab which did the test.
Yes it’s active thanks
My last Active B12 test had a range 37.5 to 150. But they do vary a bit.
You definitely need to look further asap.
Had a doctor care appointment and have been advised to re test in a few months along with FBC intrinsic factor and Gastric Parietal Cell Antibodies
I’m fit and healthy 46 female, run 4 times a week, CrossFit 3x per week , eat meat fruit etc etc take vitamin supplements including b12 and have for years.
Will another few months make a difference do you have think
If your B12 really is that low, I don't consider it good practice to leave you in that state for a few days, let alone months.
Low B12 can, and does, result in things like nerve damage. And, to a worrying extent, once your never are damaged, they do not recover. (Not meaning to be too negative - some improvement might be possible. But full recovery becomes progressively less likely.)
Just why leave you at that level?
If you are down there despite taking B12, even a low dose, there is a problem. I'd like to see you getting an Intrinsic Factor antibodies test. And methylmalonic acid. And homocysteine. Gastric Parietal Cell antibodies might help make your case. But if they have already mentioned these, they should be doing them. Not leaving you months.
So far as I can see, there is no possible benefit to you in waiting. None.
I really appreciate your response, after discussing with my husband who had exactly the same opinion I have ordered those tests. I don’t really have any symptoms that I’ve been aware of but like a lot of people I do tend to put things down to getting older, or just over done it this week etc. I did mention to the doctor that I’ve suffered with bloating and stomach pains, but always just thought IBS, numbness in my toes - sometimes my skin too. Frequent dizziness when I stand
He didn’t seem too concerned.
Thankyou again. Think I just really needed to hear that !
Hi, I have an MPN which is a rare(ish) blood cancer, I have just had HoloTC test which is for Active B12, The NHS range for having low B12 is between 25 -70 so you are definitely in that category. Active B12 regulates MMA which is an acid it keeps the MMA level low. They should send your sample off for a confirmatory MMA test if the results come back high you should defiantly seek treatment. As the other posts have said it can cause long term/permanent neurological issues if left untreated.
Side effects include bone and joint pain, tingling , fatigue, muscle pain, headaches, memory issues etc.
The issue is why do you have the deficiency, there are lots of causes e.g. Is it an absorption issue which if you have stomach issues it can be. If you have to little stomach acid HCL this can cause a deficiency in B12 as the HCL breaks down the food and allows the absorption of the B12. Other things that can influence B12 deficiency can be underlying health issues like MPN or Leukemia, as the cell proliferation can create the deficiency, or if you are taking any medication some of which affect the absorption of B12. Its good to work out why as well as get treated, so that you can try to sort the underlying cause if possible rather than just treating the symptom.
I’ve had a blood test with Medichecks , and they quote my B12 in pml/L .for an active B12 reading . If yours is also active B12 , then it seems to be below range . Active B12 range is 37.5 lml/L — 187.5 pml/L. Get a doctors appointment , if yours haven’t already got one . Needs investigation .
Surley medi checks should explain the results. Also giving the reference range thd lab uses ?
Symptoms are important too
Yes they did sorry - that was my poor explanation as it’s my first ever test and was just googling around trying to find out how significant the low result was. I wasn’t tested for any specific symptoms just a general health check
Arrh okay .We all operate at different levels.
Don't be too alarmed as you seem to be able to do alot of exercise.
Don't push your body too hard .
Good you have had it checked ✔
Also you ard having more tests.
If your diet is plentiful and mixed .
You eat diary ,meat ect its pointing towards an absorbtiin issue.
I thought I was unfit as had many symptoms gradually appearing.
My b12 was not tested when I went to the G.p suffering from strange fatigue and falls though.
I pushed more with exercise and had a very bad fall after swimming.
In Hindsight the worst thing to be doing wax more exercise !
As after another fall, vertigo and a collapse.
I wasnt unfit I was B12 deficient.
My diet hadn't changed.
The only change was the menopause .
My trigger..
So do monitor and get a referral to gastro if needed .
Also see your G.p .
NHS labs are robust.
You know what to ask for which is a good start .
Hi, Thankyou for sharing this. I read your bio and I am so sorry you have gone through all of that.
Really pleased you are finally making some improvements.
The reason I got a test was because my husband decided to do a Numan test - he’s 54. His vitamin D level was way over and the reason is that we take a supplement at 4000 iu (poorly recommended by a PT a few years ago) so I thought I’d best check mine.
Vitamin D came back fine for me but the B12 low so I did find out purely by accident.
But I do have spells of dizziness regularly- especially when doing heavy lifts at the gym but usually when I just get up off the sofa
Also noticed going a bit light headed when I’m running which is new.
Bang into door frames, regularly, tables - sideboards, anything that’s sticking out in the room. Often bang my head on the wall when putting washing on radiators. And I’m getting progressively more sensitive to light
Always just laughed about how clumsy I am getting but maybe there’s another reason for it.
Also get nerve pain down my legs into my feet but again just put that down to a heavy gym session or the runs I do
Hopefully will get to the bottom of it soon.
I wish you the very best in your recovery
Your symptoms sound consistent with possible b12 deficiency. It does creep up on you over many months or even years.
Best wishes
Your symptoms are the same as mine were for a long time. I kept going, thinking they were down to other health problems that I had, they gradually progressed and by the time I was eventually diagnosed I was at a very late stage of PA.
There is no point in waiting a few months to find out, with your symptoms and low b12 level, you need to book a GP appointment and get further testing asap.
Some of your problems sounds B12 related. It is important to not supplement before your other tests. But after it would be good to get every other day injections (loading doses). I am a but suspicious about your dizziness and bumping into things. It would not hurt to get a full physical to see if anything else is a problem.
Please bare in mind that if your Intrinsic Factor comes back negative it does not mean that you don't have PA but if its positive you definitely do. The intrinsic factor tests only picks up 50% of PA.
Hi Lola246,
Some useful links about PA and B12 deficiency...
It's possible that some links may have details that could be upsetting to read.
Maybe read them over a week or two so it's not so overwhelming.
Just wondered if you'd considered joining and talking to PAS (Pernicious Anaemia Society).
pernicious-anaemia-society....
You do not need a PA diagnosis to join them.
PAS have lots of useful leaflets eg
Helpsheet for Patient-GP Discussion
pernicious-anaemia-society....
PAS have a helpline that PAS members can use.
pernicious-anaemia-society....
They also have online webinars aimed at health professionals and the public.
pernicious-anaemia-society....
There are PAS support groups in UK and other countries.
Most meet online.
pernicious-anaemia-society....
Thread about tests for PA/B12 deficiency
healthunlocked.com/pasoc/po...
Other UK B12 websites
B12info.com
Run by a UK campaigner on B12 deficiency issues.
Lots of useful info and interesting blog posts.
B12d.org
Organises online talks about B12 deficiency.
Has monthly coffee mornings (near Durham).
The B12 Society
Useful lists of causes and symptoms.
UK B12 documents
If you have the time and energy, I recommend searching for these.
NICE stands for National Institute of Health and Care Excellence.
1) "NICE guideline B12 deficiency" - published 2024
I have some reservations about this document ...I feel there is too much emphasis on treating patients with oral B12 as an alternative to injections but there are some good bits.
2) NICE CKS Anaemia B12 and Folate deficiency" - updated 2024
CKS stands for Clinical Knowledge Summary.
3) Try to track down the local B12 deficiency guidelines used by your ICB (Integrated Care Board) in England ( Health Boards in Wales/ Scotland).
If you can't find them online, best bet is probably to submit a FOI (Freedom of Information) request to ICB/Health Board asking which B12 deficiency guidelines they use and for a link to or copy of them.
Sometimes these local guidelines can differ from NICE guidance.
I left some very detailed replies in the links below eg symptoms lists, links to help those struggling to get adequate treatment in UK, help for GPs etc
Help Needed! Have I got Pernicious Anaemia?
healthunlocked.com/pasoc/po...
Patient Safety
healthunlocked.com/pasoc/po...
Is this the tip of the iceberg?
healthunlocked.com/pasoc/po....
I'm not medically trained.
Thankyou for this - I’ll take a look over the next few weeks and try to digest as much as possible
I'd definitely ask if the GP could retest everything especially folate and B12
It is also worth checking your average blood glucose levels with an HbA1C blood test as the symptoms of type 2 diabetes are similar.
34,3 pmol/L vitamine B12 ( normal is 150-700 pmol/l)= 46,5 ng/L (nanogram per liter) = 46500 pg/L=46,5pg/ml. Is MMA methyl malon acid known?
Medichecks PA test
Blood Results. 
Blood results 
Endoscopy results
Intrinsic factor blood test results...
