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High B12

I have had a high B12 level persisting in my blood tests for over a year >1476 pmol/ .  I am not taking any supplements and have never had B12 injections.  All my other blood tests are normal and I feel well.  I have been referred to a haematologist and will be seeing her tomorrow.  I also work for doctors and they also tell me they have not seen this without supplementation.  I have also had an a normal abdominal ultrasound, a normal colonoscopy, normal blood tests.  It has raised my anxiety levels.  Has anyone had this experience?  I am anxious to know if others have had a similar situation.
4 Responses
Tbd
External User
Likewise. I would like to follow this. I had gastric bypass 2 years ago. I was placed on supplemental vitamin b12. Ever since taking it my levels have been sky high which is unusual because gastric bypass patients tend to be low hence the need for supplements. I was told to back off on the amount I take which I have and my levels are still remarkably high. The MD states it is because I still make it. I'm not convinced
1 Comments
Hi Mbull77.
Your MD's comment is likely wrong,since B12 is water-soluble and any excess  under NORMAL circumstances is usually excreted
through urination.
I would like to hear his/her explanation!

In cases where there's a deficiency
of Methylocobalamin B12, as I mentioned previously, it is common
to have Cobalamin levels within high normal reference range or above range as the body tends to retain the B12 stores and not excrete them.
In your case the part of the stomach
which produces intrinsic factor (necessary for B12 absorption) has been bypassed, therefore you may need to take supplemental Methylocobalamin B12 sublingually
for fast delivery to the blood stream.
Do a trial of this for a few weeks and then have both your Cobalamin and Methylocobalamin levels tested (see earlier post for proper MB12 testing).
Best wishes,
Niko

1530171 tn?1448129593
The problem might be with the type of test.
Please consider asking for a urinary MMA (methylmelonic acid) to rule out a conversion issue to the active type of B12
Methylocobalamin. If your MMA test shows low Methylocobalamin, your body is likely holding on the stores of inactive B12. Blood tests are not helpful in such cases.
Should my suggestion not help clear this up, please post again, as there are other less common possibilities, albeit much more complex.
Oh, consider also a Homocysteine test (tests also for Methylocobalamin, Methyl-folate and B6), specially if your MMA comes back positive for low Methylocobalamin.
High Homosysteine is an independent heart disease  risk factor (among many other diseases)!
common in patients with low Methylation.
Methylation is involved in numerous biochemical processes, including detoxification, converting homocysteine into methionine and much more and for this you need the methylated forms of the aforementioned vitamins B12, folate and B6.
Some genetic mutations, specially in the MTHFR gene
may be the main factor in low methylation.
Do not let the haematologist convince you  that this is nothing! Please insist that anything serious, as I mentioned here, is totally ruled-out!
I hope this helps,
Niko
Avatar universal
Thank you for your thoughts on this.  I did ask the Haemotologist about an MMA urine test, but she said she doesn't normally do this.  She has given me a referral for a lot of other blood tests.  She said she has seen this before and has had people go as far as a Bone marrow test with nothing showing up.  I have had a normal abdominal ultrasound, a normal recent colonoscopy, among other tests.  All other blood tests were normal.  I told her it is causing me some anxiety and she told me not to be anxious because I am well.  She doesn't want to see me for another 5 or so weeks.  So I guess that's a good sign.
1 Comments
Hmm, why am not surprised?


Here's the conclusion of an excellent article on this subject which appeared in the Oxford Journal of Medicine titled:
"The pathophysiology of elevated vitamin B12 in clinical practice"

-High serum cobalamin is a frequent and underestimated anomaly. Clinically, it can sometimes be paradoxically accompanied by signs of deficiency resulting in a functional deficit linked to qualitative anomalies, which are related to defects in tissue uptake and action of vitamin B12. The aetiological profile of high serum cobalamin mostly encompasses severe disease entities for which early diagnosis is crucial to prognosis. These entities are essentially comprised of solid neoplasms, haematologic malignancies and liver diseases. This reflects the potential importance of a vitamin B12 assay as a possible early marker in the working diagnosis of these diseases. A codified approach is needed to determine the potential indications of the search for high serum cobalamin and the approach to adopt upon discovery of elevated cobalamin levels. As in many fields of medicine, further studies are needed more than ever to better understand the clinical data related to high serum cobalamin.-

Best wishes,
Niko
Avatar universal
I have had a huge amount of blood tests for many serious conditions.  They have all come back essentially normal except the B12 which is still over the highest normal range.  They said that some people are just good absorbers of B12. I still have to go back to the Haematologist, (although I've got the results from GP as they were also copied to her).  I am a Christian and I went forward for prayer and the anointing with oil.  I give thanks to God for my good results.  He is faithful, and His mercy is new every morning.
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