Serum and active B12 question

Hello!

I had bloods done today so I should get the results in a few days but GP has only requested serum B12 to be done. So this is somewhat of a theoretical question I suppose!

My other tests are old so I know things could well look different now but what would be the best course of action if my serum B12 comes back comfortably in range?

Sept 17: 497 (200-960)

June 19: 250 (300-569)

Nov 19: 413 (200-960)

Active B12

June 19: 51.7 (37.5-188)

June 20: 45 (37.5-188)

I've not been supplementing and my diet is no different yet so I imagine it's about the same.

Will a b-complex supplement be enough to raise the level significantly?

[SeasideSusie Remembering]

geworgie3008

As far as I am aware the NHS only does serum Total B12 at GP level, not Active B12.

It would seem that the Active B12 test can be done when B12 deficiency is suspected - see nice.org.uk/advice/mib40/re...

And you can read what Medichecks has to say about Total B12 and Active B12 here medichecks.com/blogs/news/t...

So,yYou can have a decent level of Total B12 but a low level of Active B12.

As your Active B12 test from June is so low, then I think you should use this result to push your GP for testing for B12 deficiency and Pernicious Anaemia. Check for signs of B12 deficiency - link given in reply to a previous thread of yours, plus you've had lots of information and links from the PA forum. If you have signs, list them to show your GP as evidence that further testing is needed.

Will a b-complex supplement be enough to raise the level significantly?

Not if it's Pernicious Anaemia. You'll need regular B12 injections.

[Hidden in reply to SeasideSusie]

Thank you, Suzie.

Yes, lots of great advice from lots of knowledgeable people on here and PAS community.

My serum B12 has come back as 403 (200-960) but I'm concerned about the low active B12 from my last round of tests. I'm not sure if I have any symptoms because they're quite similar to thyroid symptoms but I will ask GP for further tests to try and rule out PA if I can.

Thanks again Suzie. 🙂

[Marz in reply to Hidden]

Testing anti-bodies to confirm PA can produce many false negatives. You probably know this from reading the PAS Forum.

The Active B12 test indicates the amount of B12 available to be transferred into the cells - where it is needed ...

[Hidden in reply to Marz]

Yes, in my - very limited - understanding PA is hard to diagnose. I don't feel dreadful at the moment which leads me to think I don't have PA but I'd like to increase my active B12.

I guess I just try supplementing and retesting in a couple of months to see if it works. 🤔

[Marz in reply to Hidden]

If you are supplementing then testing is not beneficial as your results will be skewed !

I would supplement B12 lozenges that go under the tongue - Jarrow 5000mcg then go onto 1000mcg pot. Amazon. Also take the B Complex to keep all the B's in balance.

[Hidden in reply to Marz]

Not currently supplementing! I was waiting until after I'd had bloods done (which was yesterday) result of serum B12 came back roughly mid range so GP won't be proactive on that result.

Just checked. It's only 26% through the range.

If I supplement going forward how will I know if I've improved active B12? By stopping the supplements in advance on the tests?

Thank you for the recommendation. Much appreciated. Google is a minefield!!

[Marz in reply to Hidden]

You would have to stop for many weeks to establish a baselevel. If you have lots of B12 symptoms I would think it's not an option.

When you get your results - around 20% of the result is the available amount that can be transferred to the cells. See if that is reflected in your last Active test. Your B12 can fluctuate.

Do you have any gut issues ? Good stomach acid levels are needed.

Due to gut surgery I am without a Terminal Ileum where B12 is metabolised - I self-inject weekly.

[Hidden in reply to Marz]

A year ago I had results of 403 and 45 which is 11%.

In June I had results of 250 and 51.7 which is 20% so I guess it's close enough. I'm just concerned that my overall levels are lowish.

No symptoms that can't be attributed to thyroid, occasional bloating which I think is gluten related it's a job to know what symptoms are from which deficiency! 😂

Overall aim is optimise vitamins for my levo to work properly... But I keep ending up down rabbit holes of information!

[Marz in reply to Hidden]

Try to follow just one or two sources of information - it prevents the rabbit holes. You will soon learn to trust certain sites

b12deficiency.info

[Hidden in reply to Marz]

Thank you for your time and advice. It really is very appreciated!

[Marz in reply to Hidden]

In 2005 I was in your situation - reading and learning ! 15 years later and I'm still at it 🌻

[Hidden in reply to Marz]

The Hashis/hypo diagnosis was overwhelming in and of itself. Trying to tackle low vitamins and gluten free has been a bit overwhelming at times!

Thank goodness for this forum!!

When taking the b complex is that alongside the 5000 (or 1000mcg) of B12 or should it just be the b-complex because it contains B12?

[Marz in reply to Hidden]

Whilst raising levels take the B12 and the B Complex. Then a good B Complex for maintenance.

Click onto my username to read my Bio and edited health history !! Same for many others too !