B12 Testing?

[feline01]

Can a doctor order a bloodtest to test B12 levels? Is there a specific test to request?

Thanks

[MzNatural]

You can get your Homocysteine levels and Methylmalonic Acid (MMA) Tests checked. MMA levels can be measured in the urine and the blood. (MMA) builds up in the system when B12 status is poor.

I have had my levels tested and will get tested within a few years. My daughter will be tested within a year. I read a few articles in regards to B12/ and lactation. From the studies I read it would seem that an infant might not receive B12 from nursing. I started using supplementation.

I found a link that talks about the test.

IHTH!

[kriz]

Doctors can order a B-12 test, but many HMOs are reluctant to do so because there are some extra costs involved. I convinced my doctor (HMO) to test my level, and I made him do a protein test too. But he was not a happy camper.

I also go to a doctor who practice conventional and alternative medicin (non-HMO). He's able to do any type of vitamin/mineral screening. Another great thing is that he's very knowlegable about nutrition. I go to him with more complicated issues. I sought his help when I had a terrible yeast problem in my body after eating antibiotics. He charge around $150 per visit, which is not so bad compared to his expertise. Not many MDs can recommend a patient a herbal remedey as well as convetional medication.

[kokopelli]

I requested a B12 test when I was pregnant with my first child in 1985. I had been vegan for a couple of years, without taking any supplements. Also, there were fewer foods with B12 added in those days.

I live in the UK, but my doctor was somewhat reluctant, until I explained that my vegan diet may mean I wasn't getting enough B12. I'm not sure how the test worked, I didn't know about homocysteine or MMA (thanks MzNatural for the interesting link). Anyway, it was a blood test and the result showed that I had a lower than normal level.

At that point, my doctor wanted to give me B12 injections. I think this was because B12 deficiency is usually a sign of pernicious anaemia, which is caused by an inability to absorb B12 normally, via the intestinal tract. I explained that in my case, it was more likely to be due to insufficient B12 in my diet, and I told him I'd rather take supplements for a while and then have another test to check whether my blood level had risen adequately.

I took the lowest dose tablets I could find, which were made from compressed yeast with 10 mcg B12 added per tablet. I couldn't see the point of taking massive doses. After a couple of weeks (I think..it's hard to remember exactly after all this time!) I was re-tested and my level had risen to well within the normal range.

Since then, I've only taken tablets when pregnant or breastfeeding, and I now rely on B12 enriched foods like soya milk, margarine and yeast extract, to ensure my family gets enough B12.

My children are 19, 16 and 12. They are lifelong vegans and have been generally very healthy. They're glad to be vegan and I'm sure your twins will be too, Feline01.

I'd be really interested to know whether anyone who doesn't use enriched foods or supplements has managed to maintain adequate B12 levels, and whether they've checked their B12 status with regular tests.

[feline01]

Thanks Mz and kokopelli for your input. Very interesting stuff. I will definitely see my dr in the new year and request a test. I'm sure I"m fine, I take a supplement plus fortified foods plus I love nutrtional yeast on popcorn.

[Korn]

Hi, there is some more info in this thread, which I just restored from our backups....

[gertvegan]

I gave a blood sample to my doc, and apparently I'm normal . Maybe I should speak to my doc about other B12 tests.

[Flame7]

Im glad this thread is here as Im off to the docs next week to ask for a blood test. Im expecting him to tell me I dont need one but Im gonna try and push it. Ive been vegan for nearly 14 years and if Im honest havent really been looking after myself properly during that time. I started being very careful about nutrition in the beginning but as time went on it all went by the wayside and i just ate whatever i felt like. Well, I havent really been feeling all that great for a while, and Ive decided that enough is enough and I want to sort everything out. Ive been showing all the symptoms of a b12 deficiency for ages, and i had my blood checked about 2 years ago (a simple blood count) but I never told them i was vegan so they just checked for iron etc. Im really not healthy at the moment, I have fatigue, dry skin, palpitations, and have had depression frequently over the past 10 years or so. I suspect that I have an underactive thyroid too (which ive read can be connected to B vit deficiency) as Im overweight, tired all the time and always cold.

Im definately not a good advert for veganism at the moment am I

Anyone else had similar problems? If the doc wont help me out does anyone know where i can find a private nutritionist etc who could help? (I particularly want to check my blood before I start taking supplements so I know Im taking what i need and not wasting my cash)

cheers

xxxFLame7

[eve]

The usual sort of blood test is free here, but I wanted an MMA test, and it cost $50. Anyway it showed that my B12 level was fine. Then I had a 'normal' one done this year, as I've had quite a few expenses lately, and this one also showed a good level.

[Korn]

Ive been showing all the symptoms of a b12 deficiency for ages

Hi, it sounds like you have a B12 deficiency. According to research done at Tufts University, 39% of all people are either deficient or in the low range - and 99% of 'all people' are not vegans. Look around in our B12 forums, and you'll find many possible causes for that B12 deficiency. A blood test doesn't always reveal the truth, so many people prefer to take a MMA and homocysteine test as well.

[feline01]

I just had my first B-12/MMA/Folate test done. I have to ask the doctor about them because the B12 is showing 394 with a reference range of 200-1100 pq/mL then the Folate is listed as greater than 24.0 with a reference range that varies alot. It then gives me a Cardio CRP (have no idea what this is) of 8.8 mg/L an says that I have a high cardiovascular risk. On the next page, my MMA is listed as 92 with normal range of 90-279 nmol/something and my homocysteine is 5.5 with normal range between 5.4-11.9 MICROmol/something.

I don't know what that Cardio CRP is and my cholesterol/triglycerides/LDL are very high but I'm still lactating which can cause elevated cholesterol levels. Maybe that's the same with that Cardio CRP.

[veganblue]

Cardio C-reactive protein(CRP)

Diabetes and Cariovascular Disease Review - American Diabetes Association / American College of Cardiology - pdf file

Relative Risk Category Average hs-CRP Level1
Low <1.0 mg/L
Average 1.0 mg/L - 3.0 mg/L
High >3.0 mg/L
Source.
Persistent elevations may represent non-cardiovascular inflammation. Therapeutic options include anti-inflammatory drugs (eg, aspirin), statins.

However, C reactive protein levels are elevated by diets inadequate essential vitamins and minerals and lowered by diets containing a balance of lipids including omega-3 fatty acids, hence it is already prudent to recommend that women ensure that they consume balanced diets with adequate intake of vitamins and minerals." Sourced here.

I was unable to find a connection with lactation. CRP, from the above information, is an indicator of cardiovascular inflammation and hence a marker for the possibility of heart-attack or stroke. It also could be due to the fact you are lactating and feeding two babies that will be stripping your reserves and you may not be absorbing as much good nutrition as you require for both yourself, the twins and for dealing with work stresses.

The more medical diagnosis pages recommend a second level being taken two weeks after the first for comparison.

During the past few years, elevated blood levels of homocysteine (a sulfur-containing amino acid) have been linked to increased risk of premature coronary artery disease, stroke, and thromboembolism (venous blood clots), even among people who have normal cholesterol levels. Abnormal homocysteine levels appear to contribute to atherosclerosis in at least three ways: (1) a direct toxic effect that damages the cells lining the inside of the arteries, (2) interference with clotting factors, and (3) oxidation of low-density lipoproteins (LDL).Stephen Barret MD

Not sure how good his information is but it seems aligned with all the other sites on homocysteine.

The fact that your homocysteine is low indicates good B vitamins and folate and notably this is a sign of low cardiovascular risk. If you have a history of CVD, double check with your doctor; it also might be a good time to increase heart health activites and maybe even look at more flax meal and Vitamin E. Rice bran oil is not only a very fine flavourless oil - it has a quite a does of Vit E and other active ingredients

Rice bran oil. Interest in rice bran oil has been growing from the nutritional point of view as well. The unique components, such as oryzanol or tocotrienol, have been drawing people's attention. Numerous studies show rice bran oil reduces the harmful cholesterol (LDL) without reducing good cholesterol (HDL). In those studies, Oryzanol is reported as the key element responsible for that function. Tocotrienol, on the other hand, is highlighted as the most precious and powerful vitamin E existing in nature and is said to have an anti-cancer effect, too. As a Vitamin-E source, rice bran oil is rich not only in alpha Tocopherol but also has the highest amount of Tocotrienol in liquid form vegetable oils. Rice bran oil is a nutritious friendly oil.

Phew! That's my research for the day

[feline01]

Thank you!!

Much better answer than the nurse at my doctor's office which was, "I don't know."

[ConsciousCuisine]

Good job, VeganBlue! Great information

My Sweetie is dealing with elevated homocysteine levels completly naturally (enzymes, probiotics, B vitamins, glutamine, MSM, Vitamin C, turmuric extract, daily sun and exercise and a few other things) and it is decreasing gradually.

[Vegantastic]

Does any one knows about how these checks are done? They take some blood and it is send to a lab, but what then?

I heard that they use animal ingredients in the tests for finding b12?

[Korn]

Does any one knows about how these checks are done? They take some blood and it is send to a lab, but what then?

Then you get the result back.

I heard that they use animal ingredients in the tests for finding b12?

There are many different tests, but I've never heard about this. This sounds like some info planted by someone who wants to give the impression that it's difficult to be a vegan.

[NorVegan]

Many idiotic questions here, but the information regarding b12 is a jungle, and I want to make sure that I have got this correct.

I am wondering if I might have b12 deficiency, maybe some hypochondriac thought, but I am still a bit worried. Have almost all the symptoms in the book, and it would have been nice to find out what is wrong.

I have been taking b12 supplements (Cyanocoblalamid) on and off for some years, but most of it has been swallowing pills, and if I understand things correct, if I have problems whit that the intrinsic factor is low, I am quite likely to have or get b12 deficiency?

So, off to the doctor…

I know that this maybe isn’t the correct forum to ask because of the differences between the countries, but is the “standard test” reliable? And if not, what do I ask for? MMA and Homocysteine levels?

Korn, I guess you know a bit about the Norwegian health system? Is it extremely difficult to have these tests done? And I am prepared to have to pay for them myself, but do you have any idea how much I have to be prepared to spend? Maybe it is easier, and cheaper to just ask for a Cyanocoblalamid or Hydroxocobalamin shot whit out testing? As I have been able to find out, it is no danger of taking one b12 shots, and see if that works, even if the levels are ok? It is the HIGH doses over long time that is dangerous? Just thinking that that the doctor might be maybe be more willingly to give me a b12 shot just to shut me up instead of to take expensive tests

This is going to be a interesting trip to a complete strange doctor…

[Korn]

if I have problems whit that the intrinsic factor is low, I am quite likely to have or get b12 deficiency?

Yes.

I know that this maybe isn’t the correct forum to ask because of the differences between the countries, but is the “standard test” reliable?

Good question. I wrote something yesterday, here, related to that topic.

And if not, what do I ask for? MMA and Homocysteine levels?

Yes, at least that's the 'normal' answer, without making it more complicated. If you want a more complicated version of this answer, you could look at this thread....

Korn, I guess you know a bit about the Norwegian health system?

I've been lucky enough not to need to be in touch with the Norwegian health system much, but I'll write something in the Norway-thread....

Is it extremely difficult to have these tests done?

Not at all... just a blood test, MMA can be a urine test as well.

Maybe it is easier, and cheaper to just ask for a Cyanocoblalamid or Hydroxocobalamin shot whit out testing?

I guess it would be more expensive, and less interesting, because you wouldn't know what your levels actually were. To take B12 as injections is something that is normally done only as medical treatment - if you just need food supplements, I can't see why you should take an injection - but as you said, you may have an intrinsic factor problem (which is not realted to being a vegan), and then the situation may be different.*

As I have been able to find out, it is no danger of taking one b12 shots, and see if that works, even if the levels are ok? It is the HIGH doses over long time that is dangerous?

Maybe you want to have a look at this thread, where the possible risk of taking too much B12 (including some possible side effects of tahing the strong B12 shots) are being discussed...

Just thinking that that the doctor might be maybe be more willingly to give me a b12 shot just to shut me up instead of to take expensive tests

My humble advice would be to ignore what he would be willing to, and find out what you want him to do, and make sure he does it. Remember, doctors are here to serve us, we are not here to please them...

This is going to be a interesting trip to a complete strange doctor…

You could make it even more interesting by not mentioning anything about being vegan, because I've heard that doctors aren't actually humans, but robots, and if they hear the word vegan (especially in areas with few relatively vegans around), they start to make conclusions based on pre-programmed assumptions - before having tested the patient. According to reliable sources, these robots are run on old software, based on code that contains many bugs... .


*
Look at this:
From http://www.aafp.org/afp/20030301/979.html

Contrary to prevailing medical practice, studies show that supplementation with oral vitamin B12 is a safe and effective treatment for the B12 deficiency state. Even when intrinsic factor is not present to aid in the absorption of vitamin B12 (pernicious anemia) or in other diseases that affect the usual absorption sites in the terminal ileum, oral therapy remains effective. (Am Fam Physician 2003;67:979-86,993-4. Copyright&#169; 2003 American Academy of Family Physicians.)

[NorVegan]

Threads read, but I think I first will try the easiest way out if I am still in doubt, I guess I have to go more through trough this

Yes, I know that it is a easy test strictly technically specking, the main concern is to get trough to the doctor, that can be a real challenge sometimes.

The reason for that I was thinking of shots instead of going trough tests and so on, is only because that I want to have a way out if the doctor refuses to test me. As the situation is now I don’t have the opportunity to go to 5-6 doctors before I find one that listen.

Hehe, I know, and trust me, I will NOT even consider mention my diet before I get the “feel” of him, and I suspect that I will do what I can to keep veganism off topic

Just hope I have enough courage to demand this tests (and some others) done, and not let the ingrown “respect” for doctors get in the way for my own health.

Than you once again for your answer, and support

[Korn]

The reason for that I was thinking of shots instead of going trough tests and so on, is only because that I want to have a way out if the doctor refuses to test me.

If you say that you have some symptoms that sounds like B12 deficiency symptoms, he would probably not only NOT refuse to take a B12 test, but recommend it. If not, you should definitely find another doctor! The one I have been using is very friendly; the only thing she did was to excuse herself for not knowing much about b12 and nutrition....

[NorVegan]

If you say that you have some symptoms that sounds like B12 deficiency symptoms, he would probably not only NOT refuse to take a B12 test, but recommend it. If not, you should definitely find another doctor! The one I have been using is very friendly; the only thing she did was to excuse herself for not knowing much about b12 and nutrition....

Can I borrow your doctor?

I hope you have right, and I have only been extremely unlucky before.

[Korn]

Sure, you can borrow her...

Re. your mentioned/possible intrinsic factor issue, maybe this is interesting for you:

http://www.veganforum.com/forums/sho...1&postcount=37