VITAMIN B12 (REFL)

Does this test have other names?

Cobalamin test, Pernicious anemia, Vitamin B12 level, MMA, Methylmalonic acid 

What is a Vitamin B12 test?

A vitamin B12 test is a blood or urine test that measures the amount of vitamin B12 in your blood. An MMA (Methylmalonic acid) is used to diagnose the deficiency of vitamin B12. An MMA is a substance that develops in small quantities during metabolism. If you have low B12 levels, your body makes a large amount of MMA. The deficiency of B12 occurs due to high MMA levels in your body. 

Vitamin B12 is essential for your body, including brain health, production of blood cells, and correct functioning of the nerve. Your body does not contain vitamin B12. It is present in food that includes meat, fish, and dairy. Low B12 levels can cause memory loss, temporary infertility, permanent nerve damage, and disorder of brain functions. High levels of B12 indicate liver disease, specific types of leukemia disease, or diabetes. 

Why do I need this test?

Your doctor may also recommend the test if you have a disease of pernicious anemia. It is the condition in which red blood cells decrease in your blood. It mainly occurs when your intestines cannot absorb vitamin B12. Its symptoms include constipation, pale skin, loss of appetite, bleeding from gums, and inflammation of the red tongue. Generally, its symptoms cannot show up in people below 30. The recommended age to diagnose this condition is about 60.

Your healthcare provider may recommend the test if you experience the below symptoms. Symptoms of vitamin B12 deficiency, such as
 

• Weakness
• Irritability
• Walking abnormalities or having difficulty maintaining balance
• Severe Confusion (delirium)
• Hands or feet tingling
• Jaundice (Mostly occurs in people having a liver disease)
• cognitive impairment (a person having difficulty in learning, remembering, concentrating, or decision-making)
• peripheral neuropathy (Malfunctioning of the nerves)

Your provider may suggest the test if you experience specific nervous system symptoms. The deficiency of B12 may also develop due to its lack of absorption, specifically in older adults and people having intestinal disorders. They cannot absorb B12 from food and supplements. This test is generally a part of a series of tests known as newborn screening. It helps to diagnose many health problems in a newborn baby. New mothers can take this test to check their levels of B12. If low levels are present in the breastfeeding mother, her child may have a high chance of neurological damage and development problems.

How to prepare for the test?

You do not have to prepare for the test. If your provider asks for fasting, you may need to keep fasting for 6-8 hours. You need to drink enough water before the test. You have to follow any specific instructions provided to you. Specific medications may alter the test results. If you have a bleeding disorder or blood clotting, you may need to inform about them. You can talk with your provider about any medicine that you are using. 

What happens during the test?

Blood test

Your healthcare provider asks for a blood sample. They insert a needle into the vein of one of your upper arms. Blood collects in the test tube. Your provider applies a bandage to your veins and asks you to press it to prevent blood leakage. You can return to your home for daily activities. This test usually takes at least 5 minutes. You can order the test online at UmbrellaMD to check your B12 levels. 

Urine test

Your provider may also ask for a random or 24-hour urine sample. You may need to collect your urine into a sample container by following the instructions. 

What causes vitamin B12 deficiency?

Several causes of B12 deficiency, such as

• Not getting enough B12 from the diet (It is common in strict vegetarian people)
• Crohn's and celiac diseases may develop malabsorption
• During or after the pregnancy
• Decreased intrinsic factor, a type of protein that supports the intestine absorbing vitamin B12
• Intolerant to high heat, such as hyperthyroidism

You can talk with a child specialist if low levels of B12 are present in your baby. It may lead to severe complications. 

Generally, the excess B12 excretes from the urine. Due to this, a high vitamin B12 in people is not general. Some conditions that can increase B12 levels, such as

• Liver disease include hepatitis or cirrhosis)
• Myeloproliferative disorders include chronic myelogenous leukemia and polycythemia vera

What are the risks involved in the test?

There is a small risk present in a blood test. You may feel some pain where the needle puts in. But its symptoms will go away quickly. For some people, getting a blood sample may be difficult compared to others. The veins and arteries depend from person to person. Some other risks with a blood test include excessive bleeding, fainting, infection, and hematoma (it is the collection of blood under the skin). There is no risk for a urine test. 

What are the normal results of the test?

The recommended or ideal values for vitamin B12 are 160 to 950 picograms per milliliter (pg/mL) or 118 to 701 picomole per liter (pmol/L). These values may slightly depend on the different types of laboratories. They may use different samples of measurements to get the results. You can make an appointment with a doctor to understand your test results. 

What are the abnormal values for the test?

The deficiency of B12 occurs if its value goes below 60 pg/mL (118 pmol/L). It can indicate that you may have symptoms of deficiency. Symptoms may develop in old people if the B12 value lies below 100 pg/mL (74 pmol/L). Methylmalonic acid is a substance in the blood that helps to measure the level of B12. 

Visit Umbrella Health Care Systems to book the order for this lab test if you do not have a prescription. It is an online healthcare that offers services, such as e-consultation, medical imaging, primary care, laboratories test, and pharmacies. You can check and understand your test results while sitting at home. You can register here to learn more about the platform.