Vitamin B12 deficiency is a condition where the body lacks adequate amounts of vitamin B12, an essential nutrient needed for red blood cell formation, neurological function, and DNA synthesis. It is caused by inadequate dietary intake, malabsorption due to intrinsic factor deficiency or H. pylori infection, or medications that interfere with B12 absorption. The Vitamin B12 and Folates test is the most important test for diagnosis because it directly measures B12 levels in the blood.
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Vitamin B12 deficiency is caused by inadequate dietary intake, malabsorption problems, or certain medical conditions. The most common causes include following a strict vegetarian or vegan diet without supplementation, pernicious anemia (where the body cannot produce intrinsic factor needed for B12 absorption), chronic H. pylori infection that damages the stomach lining, gastrointestinal surgeries that remove parts of the stomach or small intestine, and certain medications like metformin and proton pump inhibitors that interfere with B12 absorption. Age-related decline in stomach acid production also reduces the body's ability to absorb B12 from food, making older adults particularly vulnerable to deficiency.
The Vitamin B12 and Folates test is the most important test for vitamin B12 deficiency because it directly measures the amount of B12 circulating in your blood and also checks folate levels, which can have overlapping symptoms. For a more comprehensive evaluation, the Methylmalonic Acid test is essential as a confirmatory test because methylmalonic acid levels become elevated when B12 is deficient, making it more sensitive for detecting early or borderline deficiencies. The Homocysteine, Cardiovascular test provides additional confirmation since homocysteine rises when B12 is low, and the Intrinsic Factor Blocking Antibody test helps identify if pernicious anemia is the underlying cause of your deficiency by detecting antibodies that prevent B12 absorption.
You should get tested if you experience persistent fatigue and weakness that does not improve with rest, numbness or tingling in your hands and feet, difficulty walking or balance problems, memory issues or brain fog, pale or yellowish skin, or a sore and swollen tongue. Testing is especially important if you follow a vegetarian or vegan diet, are over 60 years old, have digestive conditions like Crohn's disease or celiac disease, take metformin for diabetes or use proton pump inhibitors regularly, or have a family history of pernicious anemia. Early detection and treatment can prevent serious neurological complications.
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What this means
Your vitamin B12 level is slightly below the optimal range. While this is not critically low, it may contribute to fatigue, difficulty concentrating, or feeling run down. Addressing this now can help prevent more serious symptoms from developing.
Recommended actions
Include more B12-rich foods like fish, beef, eggs, and dairy products in your diet
Consider a B12 supplement, especially if you follow a vegetarian or vegan diet
Limit alcohol consumption as it can interfere with B12 absorption
Retest in 2-3 months after making dietary changes or starting supplementation
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