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Your doctor may recommend you have one for a few different reasons, such as:
What is the purpose of a vitamin B-12 level test?
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A vitamin B-12 level test checks the amount of vitamin B-12 in the blood or urine to gauge the body’s overall vitamin B-12 stores. Levels will usually be between 200 and 900 picograms per milliliter, but the way of measuring will depend on the laboratory.
Vitamin B-12 is necessary for several bodily processes, including nerve function and the production of DNA and red blood cells.
A person whose vitamin B-12 levels are outside of the normal range will require treatment. Low levels of the vitamin can cause neurological symptoms, as well as fatigue, constipation, and weight loss. High B-12 levels may indicate liver disease, diabetes, or another condition.
Read on to learn more about testing B-12 levels and what the test results mean.
The vitamin B-12 level test checks how much vitamin B-12 is in the body. The results can help doctors to determine if abnormal vitamin B-12 levels are causing symptoms.
A doctor may order a vitamin B-12 level test if a person has any of the following:
Suspected vitamin B-12 deficiency
Researchers believe that up to 15 percent of people in the United States have vitamin B-12 deficiency. Signs and symptoms of deficiency include:
- confusion
- dementia
- depression
- difficulty maintaining balance
- fast heartbeat
- numbness and tingling in the hands and feet
- poor memory
- a sore mouth or tongue
Infants with vitamin B-12 deficiency may fail to thrive. They may experience movement problems in addition to delayed development.
Pernicious anemia
People with symptoms of pernicious anemia may also need a vitamin B-12 level test. Pernicious anemia, which causes low levels of red blood cells, results from an inability to absorb vitamin B-12.
It often affects older adults or those who are lacking intrinsic factor. Intrinsic factor is a substance in the stomach that binds to vitamin B-12 so that the body can absorb it.
Symptoms of pernicious anemia include:
- constipation
- fatigue
- loss of appetite
- pale skin
- weakness
- weight loss
High serum folate levels
Serum folate is the level of folic acid in the blood. High serum folate levels can mask the symptoms of vitamin B-12 deficiency and make its neurological symptoms worse.
They can also increase the likelihood of anemia.
Symptoms of other conditions
An abnormally high vitamin B-12 status can be an early sign of liver disease, diabetes, or certain types of leukemia. A doctor may use the results of a vitamin B-12 test to help form their diagnosis.
Share on Pinterest Children and older adults are more likely to experience low vitamin B-12 levels.
Certain people are more at risk of vitamin B-12 deficiency than others, especially those who have low stomach acid or other digestive issues. Stomach acid separates vitamin B-12 from food so that the body can absorb it more efficiently.
The following groups of people are more likely than others to experience low vitamin B-12 levels:
- older adults
- children
- vegans and vegetarians
- people with diabetes
- people with conditions that reduce vitamin B-12 absorption, including celiac disease and Crohn’s disease
- people who have had gastric bypass surgery
- those who are breast-feeding
- people who are taking medicines such as chloramphenicol, proton pump inhibitors, or H2 blockers
Doctors usually use a blood test to check vitamin B-12 status, but home urine tests are also available. A doctor can check vitamin B-12 as part of a standard blood test.
Although it is not necessary to fast before a B-12 test, a person may need to if the doctor is also using the test to look at other components in the blood.
It is important that individuals tell their doctor about any medications and supplements they are taking, as some can affect the results.
What’s a Vitamin B12 Test?
Vitamin B12 is vital for good health. Your body needs steady levels of this nutrient to make enough red blood cells and keep your nervous system working.
For most people who eat a balanced diet, low B12 levels are rare. But there are reasons why they may dip below normal. A simple blood test can show whether your levels are healthy, low or somewhere in between.
Do I Need the Test?
Your doctor may recommend you have one for a few different reasons, such as:
- You’ve been diagnosed with anemia.
- They suspect you have a medical condition that affects how well your body absorbs B12.
- You’re taking medications that may interfere with B12 absorption.
- You have symptoms linked to low B12 levels.
- You follow a vegan or strict vegetarian diet.
The main health problem associated with poor B12 absorption is a condition doctors call “pernicious anemia.” It develops if you lack intrinsic factor, a type of protein made in the stomach. Without it, you can’t absorb enough vitamin B12 from food.
Crohn’s disease and celiac disease may also cause your B12 levels to go down.
Several types of medications might affect your vitamin B12 levels. Among the most common are drugs to help treat gastroesophageal reflux disease (GERD). Medications called proton-pump inhibitors reduce the amount of acid in the stomach, which is needed for food to release B12.
If you’re not taking any of these medications or haven’t been diagnosed with pernicious anemia or other health problems that might cause lower B12 levels, your doctor may order the test based on your symptoms and dietary or health history.
Common symptoms of low vitamin B12 include:
- Fatigue
- Fuzzy thinking
- Numbness or tingling in your hands and feet
- Headaches
- Moodiness
These could be signs of many conditions. A blood test that checks your B12 levels can rule out or confirm that your low B12 levels may be the issue.
What Does the Test Involve?
It’s a simple blood test. You can get it anytime, and you don’t need to go without food (fasting) before you do. Your doctor can add it to the order for your blood test that checks your levels of cholesterol, glucose, and other markers of health.
You should tell your doctor about all of the medications and supplements you take before the test. Some of them may affect the results.
Understanding the Results
The normal range for vitamin B12 can vary slightly depending on the lab. But a normal level of vitamin B12 in your bloodstream is generally between 190 and 950 picograms per milliliter (pg/mL). Between 200 to 300 pg/mL is considered borderline and your doctor may do more testing. Below 200 pg/mL is low and more testing is needed.
In some cases, your doctor may also test for your folate level because low folate can cause signs and symptoms similar to low B12.
Moving Forward
If your vitamin B12 test shows that your levels are healthy, you don’t need to do anything but continue eating a balanced diet. Sources of vitamin B12 include fish, meat, dairy, and other foods fortified with B12, like cereal and milk.
If you’re still concerned about your levels, talk with your doctor about whether B12 supplements or dietary changes make sense.
But if you have low vitamin B12 levels, you’ll likely need to supplement your B12 with injections or oral supplements depending on your stomach’s ability to absorb the vitamin.
Vitamin B12 deficiency can lead to problems with brain function, your nervous system, and other aspects of your health. It’s important to check your levels if there are any signs that they are low.
Older adults are at increased risk for low levels of vitamin B12. Talk to your doctor about whether your diet provides enough B12, or if taking a supplement would help.