Aa
B12 Question & A Rant
I just got my B12 results back and the level is 288. The lab report says anything under 180 is low and under 145 is deficient.
Normal range = 180-914
Couple questions... I'd like my B12 over 500 or higher. What's the best way to do this? Liquid sublingual? Also, is the number low enough to account for my fatigue?
I wasn't checked for anemia, as it wasn't my regular Dr, she's out of town for 3 more weeks. The Dr that saw me was a complete jerk so I know with a number that's in range he won't order B12 shots and I don't know if a level of 288 warrants shots.
Just so I can't rant a little bit and get it off my chest. I was there for fatigue and a sore joints in my hands, along with nodules that have suddenly appeared on my joints. I'm 37. He thought it was osteoarthritis and said there's no way it's RA. He looked at the clock and said "I have 15 minutes, I don't' know what you're trying to accomplish here". I told him I had a history of Grave's Disease and since it's autoimmune does he think it could be the beginning's of RA and maybe that would explain the fatigue? He just said "Oh, well maybe then". He then zoned in on my thyroid and said that would be where the fatigue was from. I told him my current levels and he just shook his head and said FT3 and FT4 mean nothing and on and on he went about how TSH only is so superior. I knew the appointment was over and I was getting nowhere with him. At the very end I just asked if he would at least look at my B12. There was more but I'll spare you all the rest of the details. I got an email from the office with a synopsis of our appointment and it said "possible depression". I never once said I was sad or anything hinting to depression. Just that my body is extremely weak. Anyhow, I made an appt with a Rheumy for August 10th. I guess I'll know more then.
Normal range = 180-914
Couple questions... I'd like my B12 over 500 or higher. What's the best way to do this? Liquid sublingual? Also, is the number low enough to account for my fatigue?
I wasn't checked for anemia, as it wasn't my regular Dr, she's out of town for 3 more weeks. The Dr that saw me was a complete jerk so I know with a number that's in range he won't order B12 shots and I don't know if a level of 288 warrants shots.
Just so I can't rant a little bit and get it off my chest. I was there for fatigue and a sore joints in my hands, along with nodules that have suddenly appeared on my joints. I'm 37. He thought it was osteoarthritis and said there's no way it's RA. He looked at the clock and said "I have 15 minutes, I don't' know what you're trying to accomplish here". I told him I had a history of Grave's Disease and since it's autoimmune does he think it could be the beginning's of RA and maybe that would explain the fatigue? He just said "Oh, well maybe then". He then zoned in on my thyroid and said that would be where the fatigue was from. I told him my current levels and he just shook his head and said FT3 and FT4 mean nothing and on and on he went about how TSH only is so superior. I knew the appointment was over and I was getting nowhere with him. At the very end I just asked if he would at least look at my B12. There was more but I'll spare you all the rest of the details. I got an email from the office with a synopsis of our appointment and it said "possible depression". I never once said I was sad or anything hinting to depression. Just that my body is extremely weak. Anyhow, I made an appt with a Rheumy for August 10th. I guess I'll know more then.
Read this post after just noticing another joint in my finger hurts...apparently doctors don't test vitamins/minerals much. I have had symptoms of low everything for some time, I didn't even recognize it. I have what is basically a hip replacement and you'd think that every doc I've had would want to keep my bones healthy....no such luck. My B12 (Folate low too, was yours checked?) is right around where yours is and my D is seriously low. Thanks for posting this as i have gotten some good info as well- and thanks to all who posted back. Hope you feel better soon!
I'm not sure about B12 supplements but the Japanese diet is high in nutrients known to be critical for brain function which includes B12.
"Fish (or shellfish) contribute greatly to vitamin B12 intake among Asians, particularly Japanese people, and this trend is spreading throughout the world (35)." - RSM Journal - Vitamin B12 Sources and Bioavailability
"Nutritional intakes in community-dwelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetables and fruits provide sufficient micronutrients." - Pubmed - PMID 15386931.
"It is known that a Western diet is associated with dementia – the risk factors for Alzheimer’s disease are almost identical to those for cardiovascular disease.1 In contrast, higher vegetable and fruit intake is associated with decreased risk of cognitive decline and dementia.2,3
Vitamins are essential for thousands of chemical reactions in the body, and certain vitamins and other phytochemicals have been singled out for their critically important functions in the brain. These include B vitamins, vitamins C, D, and E, and omega-3 DHA." - DHA and micronutrients may prevent brain shrinkage with age by Joel Fuhrman MD.
"Fish (or shellfish) contribute greatly to vitamin B12 intake among Asians, particularly Japanese people, and this trend is spreading throughout the world (35)." - RSM Journal - Vitamin B12 Sources and Bioavailability
"Nutritional intakes in community-dwelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetables and fruits provide sufficient micronutrients." - Pubmed - PMID 15386931.
"It is known that a Western diet is associated with dementia – the risk factors for Alzheimer’s disease are almost identical to those for cardiovascular disease.1 In contrast, higher vegetable and fruit intake is associated with decreased risk of cognitive decline and dementia.2,3
Vitamins are essential for thousands of chemical reactions in the body, and certain vitamins and other phytochemicals have been singled out for their critically important functions in the brain. These include B vitamins, vitamins C, D, and E, and omega-3 DHA." - DHA and micronutrients may prevent brain shrinkage with age by Joel Fuhrman MD.
That is amazing info!
I particularly like the connection between Japan and USA Alzheimer's and dementia rates compared to the lower reference ranges.
I'd further be interested to find out the rate of supplementation in Japan. That is do the people in Japan simply get more B-12 from their diet and they don't need much oral supplements. Or do they have high rates of supplementation in their society.
I particularly like the connection between Japan and USA Alzheimer's and dementia rates compared to the lower reference ranges.
I'd further be interested to find out the rate of supplementation in Japan. That is do the people in Japan simply get more B-12 from their diet and they don't need much oral supplements. Or do they have high rates of supplementation in their society.
A book on vitamin B12 deficiency: "Could It Be B12? An Epidemic of Misdiagnoses, Second Edition" by Sally M. Pacholok, R.N., B.S.N., and Jeffrey J. Stuart, D.O.
"At least six neurological and psychiatric papers, in top medical journals, have shown that the normal range should be regarded as at least 500-1,300 pg/ml (rather than 200-1,100), since the cerebrospinal fluid level can be deficient when the serum level drops below 500, and neuropsychiatric symptoms often occur at serum levels between 200 and 500 pg/ml (VanTiggelen et al, Lindenbaum et al, Mitsuyama/Kogoh, Nijst et al, Ikeda et al, Regland). excerpt from B12 - Signs, symptoms and optimal treatment.
"Why is B12 deficiency so under-diagnosed?
B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.
Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).
In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country." - "B12 deficiency: a silent epidemic with serious consequences" by Chris Kresser
"At least six neurological and psychiatric papers, in top medical journals, have shown that the normal range should be regarded as at least 500-1,300 pg/ml (rather than 200-1,100), since the cerebrospinal fluid level can be deficient when the serum level drops below 500, and neuropsychiatric symptoms often occur at serum levels between 200 and 500 pg/ml (VanTiggelen et al, Lindenbaum et al, Mitsuyama/Kogoh, Nijst et al, Ikeda et al, Regland). excerpt from B12 - Signs, symptoms and optimal treatment.
"Why is B12 deficiency so under-diagnosed?
B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.
Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).
In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country." - "B12 deficiency: a silent epidemic with serious consequences" by Chris Kresser
Correction....he knew about my thyroid because I mentioned that I had Grave's Disease just because I wanted him to know about the possibility of RA. That's when he looked in my medical history about my dose having 10 mcg's of T3 and my TSH level being suppressed. Regardless, I wasn't there to waste his 15 mins on my thyroid.
Yeah, I pity the poor people that have to see Dr's like that. I didn't even want to discuss my thyroid but he saw that I take thyroid medication in my medical history.
I will buy some sublingual B12 today. Do you know how much I should take? I'd like to get some big doses in to jump start this. I know it's water-soluble but I don't want to ridiculously over do it. Do you know what a good hefty dose would be to start with?
I will buy some sublingual B12 today. Do you know how much I should take? I'd like to get some big doses in to jump start this. I know it's water-soluble but I don't want to ridiculously over do it. Do you know what a good hefty dose would be to start with?
COMMUNITY LEADER
When your regular doctor gets back, you need to talk to her about the B12 level. I was dx'd Pernicious Anemia with a level of 248 (range 200-1100). I don't function well with levels < 900 or so. I take weekly shots to keep the level up.
In order to bring yours up, you can try supplementing with a sublingual, which is better than just regular pills, because it's absorbed directly into the blood vessels under your tongue.
Totally agree that the doctor was a total jerk and advise that you not waste anymore time with him, especially, if you are happy with your regular doctor.
In order to bring yours up, you can try supplementing with a sublingual, which is better than just regular pills, because it's absorbed directly into the blood vessels under your tongue.
Totally agree that the doctor was a total jerk and advise that you not waste anymore time with him, especially, if you are happy with your regular doctor.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
