Vitamin B12 question

[Whatamess2]

Please can someone tell me if you can have pernicious anaemia with a vitamin b12 result of 507 ng/L range 211-946. The reason I am asking is that I feel that I have all the symptoms of pernicious anaemia. My doctor is doing more blood tests to see what is wrong with me.

[Hidden]

Hi Toby,

It is possible, although rare I believe to have high serum B12 levels but actually have PA and need B12 treatment. There can be other problems in the uptake of serum B12 aswell etc.

See:

Spurious Elevations of Vitamin B12 with Pernicious Anemia

nejm.org/doi/full/10.1056/N...

"To the Editor:

Within a 3-week period, two women, 46 and 48 years of age, presented with peripheral neuropathy and associated pancytopenia with macrocytic anemia. Clinical suspicion for pernicious anemia was high, but vitamin B12 levels were 1644 pg per milliliter (1228 pmol per liter) and 1321 pg per milliliter (975 pmol per liter), respectively (reference range, 246 to 1320 pg per milliliter [181 to 974 pmol per liter]). On subsequent bone-marrow evaluation, specimens from both patients showed profound megaloblastic features. Additional findings on laboratory tests included elevated levels of homocysteine and methylmalonic acid combined with detection of intrinsic factor–blocking antibodies and antiparietal-cell antibodies, which further supported the diagnosis of pernicious anemia.

So it is possible, and other tests such as homocystene, MMA, active B12, and antibody tests can be more conclusive in certain cercumstances..

Wishing you good luck with your tests,

Kind regards,

Marre.

[manyarecalled]

Toby ,

(1) the blood serum test does not measure ''active B12'', but ''total B12''

(2) blood in your arm say , is not the same as that in the brain/spinal column

Japanese say that the normal range is 500-1300 in the arm.

(3) folic acid will mask the true reading of blood serum.this is in breakfast cereals etc , even if you don't take a multivitamin.

(4) laboratory results are not standardised , and vary from county to county, even assuming a mistake has not been made.

(5) you are the expert on your body. if you have the symptoms of B12 deficiency, you should be on injections of hydroxycobalamin for 6 months.

as your body returns to life , you will feel awful for some time. the answer is not to discontinue taking B12 , but to persevere until you improve. if you have had the symptoms for years , you may not return to full fitness.

[manyarecalled]

Toby , treatment by injection etc , is for life.

[hopes]

Did you have your RBC Folate checked? If so, what was the reading?

[Whatamess2 in reply to hopes]

Hi, Yes below are the results

RBCs High 5.59 Range 3.90-5.0

Serum folate High >20.0 Range 4.6-18.7

Many thanks

[AndreaM]

Toby, had you been on iron or folate supplements before having these tests done?

[Whatamess2]

Hi AndreaM, Sorry for the delay in replying but have only just got back from holiday.

Yes I am on a Vitamin B complex which contains folic acid and b12.

Would that be of concern with the tests do you think?

Regards.

[AndreaM]

Sorry - only just noticed this again. Yes, supplements will affect the results of blood tests.