THE LINK BELOW STATES PEDIATRICS BUT CONTENTS APPLY TO ADULT PATIENTS:
Your doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include the following:
Complete blood count (CBC)—a count of the number of red and white blood cells in a blood sample
Vitamin B12 level—a test that measures the amount of vitamin B12 in the blood
Methylmalonic acid (MMA) level—a measurement of the amount of methylmalonic acid in the blood; this test determines whether a vitamin B12 deficiency exists.
Homocysteine level—a test that measures the amount of homocysteine in the blood (homocysteine is a building block of protein). The homocysteine level will be elevated if there is a shortage of vitamin B12, folate, or vitamin B-6.
Schilling test—a test in which a harmless amount of radiation is used to assess whether a vitamin B12 deficiency exists (rarely used)
Red blood cell folate level—a measurement of the amount of a B vitamin called folate
Gastrin level—a test that may help determine the cause of a vitamin B12 deficiency
Intrinsic factor assay—a measurement of the amount of a protein called intrinsic factor normally produced in the stomach; this test helps to rule out pernicious anemia as the cause of symptoms.
Bone marrow staining—a test that shows whether an iron deficiency exists
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Oral Vitamin B12 Supplement
This treatment consists of high doses of an oral vitamin B12 supplement.
Vitamin B12 Injections
The doctor may advise the patient to receive injections of vitamin B12 into a muscle. Injections of vitamin B12 may be given 2-4 days per week. When blood tests show improvement, the doctor may give injections on a monthly basis.
Treatment With Antibiotics: This type of medication may be needed in cases where bacterial overgrowth in the intestines exists. The bacteria compete with the body to absorb the vitamin B12 in the intestines.
Intranasal Vitamin B12: The doctor gives the patient a supplement of vitamin B12 that is placed in the nose.
Oral Iron Therapy: The physician will recommend this treatment when an iron deficiency exists. In this case, the doctor will tell the patient to take iron supplements before treating with vitamin B12.
Prevention: To help reduce your chances of developing a deficiency of vitamin B12, take the following steps:
Avoid long-term over-consumption of alcohol.
As directed by your doctor, take a daily supplement containing vitamin B12.
As directed by your doctor, give vitamin B12 to your breastfed baby if you are a vegan or vegetarian.
Avoid overuse of nitrous oxide.
Seek diagnosis and treatment of any suspected tapeworm infestation.
Have your doctor check you for iron deficiency.
Undergo testing if your doctor suspects you are infected with the bacterium Helicobacter pylori .
Have your doctor monitor your health closely if you are taking the following drugs:
Biguanides, Aminosalicylic acid, Calcium-chelating drugs taken by mouth, Colchicine, Neomycin, Cimetidine, and Cholestyramine
Last reviewed October 2012 by Daus Mahnke, MD