My active b12 is 390. Range = ( 191-663 ) can anyone comment on whether it needs to be higher for absorbtion of levo?

[nezzykins]

Had thyroid panel and active b12 bloods done at Blue Horizon. I did read that b12 needs to be in the higher range. Can anyone comment please. Thanks. Lynne x

[suki65]

From personal experience of feeling very tired my level was 321 told normal but got my level up to 523 and i feel so good now i take b12 1,000ug one a day a book called Could it be B12?: An Epidemic of Misdiagnoses [Paperback] a great book .also vitamin d3 have you had that checked

[nezzykins in reply to suki65]

Not had it checked, but I do take d3 10 drps daily.

[nezzykins in reply to suki65]

What was the referrence range when you had yours checked suki?

[suki65 in reply to nezzykins]

my vitamin d level was 17 but now 25

[helvella Administrator Thyroid UK]

That appears to be a surprisingly high number for an Active B12 test. So is the reference range rather higher than I remember!

Are you certain it was Active B12?

Rod

[nezzykins in reply to helvella]

It was called a holo transcobolamin active b12 blood test and ive double checked the reult and ref range as posted and it is correct - Blue Horizon labs done at Spire Rod.

[Hidden]

I have to agree with Rod on this one - that range doesn't sound right. I had a Blue Horizon active B12 test done in March, and the reference range was 25.1 to 165.0 pmol/L (was your test result in pmol/L too?). Incidentally, mine came out at 85, so I got to cross b12 deficiency off my list...

[helvella Administrator Thyroid UK in reply to Hidden]

That is the sort of range I would have expected - though I am aware that there have been numerous small adjustments so did not wish to quote inaccurately from memory.

nezzykins,

Am not in any way pointing my finger at you - but am wondering if something got scrambled in the system. If I were you, I would be getting in touch with BH and whoever else to double-check.

Rod

[helvella Administrator Thyroid UK in reply to helvella]

Also, I cannot remember any issues with absorbing thyroid hormone due to insufficient B12.

Low iron tends to make use of the levothyroxine more difficult (rather than absorption).

Low B12 has lots of impacts so maybe it does affect absorption so maybe it does affect absorption. I'd want to see confirmation.

[nezzykins in reply to helvella]

Im not 100% sure about low b12 affecting levo absorption, but I had a feeling that I read it on the forum a while back. Would like to clarify this so will do some reading around it. TY for pointing this out. I will try the P A forum. Maybe get this info there. Lynne

[nezzykins in reply to helvella]

Hi Rod. Thanks for reply. This test was done quoting ng/ L and not pmol/L, as lillymay mentioned in above post. Would this shed any light on it do you think? Best to check this out before contacting B H. Lynne.

[nezzykins in reply to Hidden]

My b12 read ng/L lillymay. Nezzykins.

[Perky]

The b12 I had done at the doctors was 336 range 189-900 I was told that the nhs don't inject until it falls below 189 so I take a sublingual spray.

[helvella Administrator Thyroid UK in reply to Perky]

That is a fairly typical traditional serum B12 test range. The Active B12 test (usually?) has a very different range.

[Perky in reply to helvella]

So the doctor didn't even give me the right test? That just about sums everything up lol! Incidentally at the sane time I requested a Vitamin d test and the lab apparently refused!

[Hidden in reply to Perky]

It's not that your GP gave you the wrong test - it's just the only test currently available on the NHS. The active B12 test is relatively new - if you want to have it done you could contact Guys and St Thomas Hospital pathology lab - I believe they charge about £25.

[deniD in reply to Perky]

I'm near Newcastle upon Tyne and there range us 191- 900 my test was 271!!! Normal!

[Hidden]

Looks like a serum B12 range to me.

[nezzykins in reply to Hidden]

Hi hampster1. Helvella thinks so as well. After requesting active b12 specifically with Blue Horizon, I am now beginning to think so too! As I mentioned above it was measured using ng/L and not pmol/L. I dont know if this has any relevance, but will try and get this clarified as I did pay for a test called ' holo transcobalomin', which they did reassure me, was the active b12 blood test. T Y for your input. Lynne.

[Hidden in reply to nezzykins]

The Active B12 range is usually <25 pmol/l deficient. Very important to remember that St Thomas' recognise a grey area when they do this test of 25 - 70 pmol/l. If you fall in here they will do the MMA test as a back-up. >70 pmol/l is considered replete, but if you've been supplementing at all in the recent past (say previous 4 months) the test can easily come back as replete.

BH do not recognise the grey area, so you could come back as "normal" (>25 pmol/l) and still be deficient. Also the Active B12 test will not pick up transport or methylation cycle defects which happen further down the line, MMA and homocysteine are better tests for this, but no test is perfect (there is no gold standard test). This is why I hate the subject of B12 test results and levels in questions, there is absolutely no right answer as to whether or not someone needs B12.

[nezzykins]

Hampster. My results for b12 were done quoting ' ng/L and not pmol/ L. Do you know what the difference is, as lillymay ( above comment in thread), memtioned that she had an actice b12 done with Blue Horizon IN March and it was measured in pmol/L as mine was ng/L ? Im getting very confused now ( my brain fog lol). Lynne.

[Hidden in reply to nezzykins]

This may well confuse you more! I hope not.

The active B12 test is measured in pmol/l. Very generally speaking active B12 (holotranscobalamin) constitutes about 20% of total serum B12 (obviously varying from person to person). The rest constitutes inactive B12 which is called haptocorrin, this is not bioavailable.

The serum B12 test is sometimes measured in ng/l or pg/ml (these are the same), or pmol/l.

The bottom of your range is 191 ng/l, which you can multiply by 0.738 to convert to pmol/l, so it's 141 pmol/L.

If you work out 20% of this you get 28 pmol/L, which as you can see correlates nicely with the bottom of the Active B12 range (25 pmol/L). Which makes sense if on average 20% of serum B12 is active.

So I would definitely say that the test you've had is serum B12.

[Hidden in reply to Hidden]

Yes, me too. I looked for a conversion calculator for pmol/l to ng/l on Google. 390ng/l is 876pmol/l. So it can't just be a different range - they've done the serum b12 test methinks.

[Hidden in reply to Hidden]

I don't think your conversion tool was right LilyMay, 390ng/l using a conversion factor of 0.738 is 288 pmol/l. You can use this tool (ng/l is the same as pg/ml):

endmemo.com/medical/unitcon...

[Hidden in reply to Hidden]

Oh, I wouldn't be at all surprised if I'd got it wrong, thanks Hampster1.

Wish they'd just stick to one unit of measurement!

[Hidden in reply to Hidden]

My BH Active B12 test Ref HOM2131240 - range (25.1-165 pmol/L) 75

My GP (local lab) Serum B12 test - range (190-900 ng/L) 521

[nezzykins]

Im more than convinced tbat they have got it wrong!! I specifically asked for the Active B12. The guy even told me the name of the test which was holo tanscobalomin!! Ive just sent an email to them and as I am going to spire for folow up bloods, I will get the RIGHT one done. Grrrrrr. Feeling really let down by this. Thank God for this forum! Many thanks to you all for pointing this out to me. Lynne x

[Hidden in reply to nezzykins]

I did the Active home-test through the TUK - Blue Horizon link (& discount) it was £57 (I think) - there's other providers of course - GPs usually only do the ordinary serum one (as you probably know already)

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

(by the way - they offered to do other tests on the sample - if big enough & within a week) J

[nezzykins]

All the info on b12 has scrambled my brain lol. So... going back to my result of 390 for a bog standard b12 level blood test, does anyone agree or disagree that I could do with taking some b12 supplements or is 390 adequate? Any comments please? Lynne x

[Hidden in reply to nezzykins]

Sorry, I can't personally recommend B12 supplements, they did nothing for me, injections are better. And my serum B12 was 310, but I had elevated MMA and positive parietal cell antibodies. I am almost back to normal (apart from some lingering exercise intolerance) on B12 injections once or twice a week, and my Graves is in remission. So the only advice I'm happy with is that if you are symptomatic of B12 deficiency make sure you've had all possible tests before you supplement, because once you start on those sublinguals you'll never get a diagnosis and they might not relieve your symptoms.

[Hidden]

If that *is* your serum B12 then yes, it could do with being higher. I found this on a Chris Kessler page chriskresser.com/b12-defici...

(NB - as Hampster1 has pointed out, pg/ml = ng/l)

...it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.

[nezzykins in reply to Hidden]

T Y lillymay. will start supplements. lynne

[Hidden in reply to nezzykins]

Nezzykins just a thought...

I was keen to sort B12 (since Vit D worked well for me) & took some supplements with B complex before my B12 tests (Active then serum) and although I did stop for a week or so I'm sure it affected my results - so now I'm wondering how low I was really,

as Hampster said my Active test was a bit low and a London hospital would have followed up with MMA etc. so I'm stuck with supplements and no diagnosis.

It is so hard trying to sort this when you can't think straight - which is why we go to the GP!

Perhaps you can have the Active B12 done first, or take your result to the GP and ask for further tests (that's what I did - didn't get far 'tho - I hope you have a more persuasive technique!) J

[nezzykins in reply to Hidden]

Thanks spareribs. My Health AUthority don't do active b12 anymore either. Thats why I went and had it done through BH at Spire Hospital in Cardiff. ( or at least, thats what I asked for, and was led to believe that holo trancobalomin was being done. I double checked with the guy that this would be the Active b12, and was reassured of this. I am going back on Tuesday to Spire for repeat thyroid panel so will ask them to do the Active B12 again. When my results came through from the 3rd of April, the form with my results on, quoted vit b12 - 390. There was No holo transcobalomin mentioned on it. I should have guessed then that they had NOT done the holo trancobalomin test as the Active B12 test was not quoted on the form! There has obviously been a total mix up somewhere along the line, and so I have emailed them about this situation and hopefully get what I payed for next Tuesday! I have very little faith in Doctors anymore anyway, so hopefully this mistrust will not extend to Spire! Due to my general health, I have become very anxious and this experience has made it worse! Cant even go privately anymore without cock ups! Lynne x

[nezzykins in reply to nezzykins]

Hi spareribs. I forgot to mention that iv'e not been replacing with b12. Will get this holo transcobalomin test sorted out first and see what the result is first. TY. Lynne x

[suki65]

b12awareness.org/could-it-b...