Best Tests for and Sources of Vitamin B12
Vitamin B12 Tests
So how can you know for sure you are deficient and need a B12 supplement? Any of the following methods work well:
- B12 Blood Test: This is a simple, inexpensive blood test that checks serum levels of B12. It is accurate and insurance almost always pays for it. If you need to have blood work done anyway, ask your doctor to add this test and to repeat it on a yearly basis. If you have any digestive disorder, are taking prescription medications, drink alcohol more than three times per week, or have a thyroid disorder, I recommend having this test a minimum of every six months.The B12 blood test will be the most accurate if done while fasting at least 10-12 hours. Note that drinking alcohol or taking Vitamin C prior to the test can affect the results. Most labs list “Normal” levels as anything between 200-800 pg/ml. However, most people are symptomatic of a B12 deficiency when their levels fall below 400. I like to see levels of at least 500 and tend to recommend a supplement if levels are any lower.
- Anti-parietal Antibodies: The parietal cells in the digestive tract produce a chemical called Intrinsic Factor that is necessary for the absorption of Vitamin B12. If someone has an autoimmune condition that causes an inability to absorb B12 (Pernicious Anemia), then the person’s body will typically produce antibodies that attack and kill the parietal cells. The Antiparietal Antibody blood test is a very accurate indicator that a person may not be able to absorb B12 due to an autoimmune condition. If you have consistently low B12 levels, I recommend asking your doctor to order this test.
- Folic Acid test: Many people who have low B12 levels also have low Folic Acid levels. Folic Acid is another B vitamin that may produce symptoms similar to a B12 deficiency if levels are low. It is another blood test that is very inexpensive and which insurance typically pays for without question.
- Homocysteine and Methylmalonic Acid: Homocysteine and Methylmalonic Acid are chemicals that may become elevated in the presence of a B12 deficiency. Neither is a definitive indicator of a B12 deficiency, but it may be helpful to have these blood tests run on a yearly basis if you’ve had low B12 levels in the past.
- Complete Blood Count (CBC): A CBC can be helpful to identify anemia caused by a B12 deficiency and as a general check of blood health. A B12 deficiency can cause a deficiency in red blood cells and may create red blood cells that are overly large (megaloblastic anemia). A CBC is not an indicator of a B12 deficiency, but may be helpful in recognizing a B12 deficiency and may help identify other issues. If you’re having blood work done anyway, this is another test I recommend having run.
- Electro-Dermal Scanning: This is an assessment technique that uses a system consisting of testing stylus connected to a measuring unit that measures nerve flow through specific energy centers and acupuncture points on the body. It is a very accurate, highly reliable test method that provides valuable insight into nutritional deficiencies and systemic weaknesses. This test method is used by many mainstream MDs and is recognized as valid by the FDA.
- Kinesiology and Muscle Response Testing: This is another form of assessment that measures nerve flow through specific points to assess nutritional deficiencies and systemic weaknesses. The B12 point is very valuable and very accurate.
Most of these tests can be ordered through online services without a doctor’s prescription. Please use caution when ordering your own blood work. Interpreting abnormal results is best done by a professional, but knowing your blood level of certain vitamins can be helpful.
Vitamin B12 is available in the following forms. One thing to be aware of is that B12 can be difficult to absorb through the digestive tract unless it is in the natural form found in foods. If you have a B12 deficiency, I recommend taking B12 in a sublingual (under the tongue) form or asking your doctor to prescribe B12 injections. Note that B12 is typically listed in microgram doses (mcg), but that higher dosages may be listed in milligrams (mg). There are 1000 micrograms in a milligram, so a 5 mg dose is the same as a 5000 mcg dose. The most typical forms of supplemental B12 include:
- Methylcobalamin B12: This is the form I recommend taking. This form is known to be the most absorbable and has a variety of benefits over other forms. It is best taken sublingually in a tiny lozenge that is placed under the tongue and allowed to melt. This form of B12 is more easily absorbed because your body does not have to convert it and can much more easily metabolize it to absorb it. The Methylcobalamin form of B12 also provides methyl groups (one carbon combined with three hydrogen) which are essential for the detoxification of certain hormones and toxins in the body. A B12 deficiency typically causes a decrease in methylation in the body, which can cause a wide variety of other issues. Taking Vitamin B12 in the Methylcobalamin form helps replenish Vitamin B12 AND provides the methyl groups necessary for methylation … it’s a win-win!Sublingual B12 lozenges come in a wide variety of strengths ranging from 500 mcg – 10,000 mcg. Most people get the best results taking 1000-2000mcg/day, although people with Pernicious Anemia or neuropathy often take much higher doses. When shopping for a sublingual B12 supplement, try to find one that is fairly tiny and which does not contain a lot of fillers, artificial flavors and sugars. My favorite OTC options include: Natural Factors Methylcobalamin (1000 mcg), Solgar Methylcobalamin B12 (5000mcg), No-Shot Methylcobalamin B12 (10,000mcg). (Most people probably don’t need 10,000mcg on a daily basis, but those with neuropathy, a severe B12 deficiency or severe absorption issues may benefit from using a dosage this high.)Methycobalamin B12 is also available as an injection. If you take B12 by injection, be aware that it must be injected into a muscle (intramuscularly) and cannot be injected into fat tissue under the skin (subcutaneously). The advantage of taking B12 by injection is that higher doses can be taken and that the injections only need to be taken once per week in most cases. (Some people with severe deficiencies or with Pernicious Anemia may need to take the injections daily or multiple times per week, but most people only need the injections once per week.) You can either receive B12 injections in your doctor’s office or can ask for a prescription for B12 injections you can give yourself at home. Work with your doctor to monitor your B12 levels to determine which option is best for you. Another advantage of the B12 injections is that they don’t contain the fillers that many sublingual lozenges do. The injections may therefore be a better option for anyone with chemical sensitivities or extreme food allergies.On a personal note, my husband has used high doses of sublingual methylcobalamin Vitamin B12 for several years to control neuropathy in his feet. He found that switching to weekly B12 injections was far more effective than the sublingual lozenges.
- Cyanocobalamin B12: This is the cheapest, most commonly found form of B12 in supplements. It is a synthetic form and was the first one created in a laboratory Your body must convert the cyanocobalamin form of B12 into methylcobalamin before it can absorb it. The conversion process creates cyanide, which is a known poison. The amount of cyanide created is very tiny and is not dangerous, but why take the risk? I only use the methylcobalamin form and it is the only form I recommend to my patients and clients. The cyanocobalamin form is only acceptable, in my opinion, if and only if the methylcobalamin form is not available.
- Other Forms: There are a few other forms of Vitamin B12 available, such as Hydroxocobalamin, but the other forms are disappearing from use because there is more commercial demand for the cyanocobalamin and methylcobalamin forms.
My passion is helping people improve their health by identifying and correcting systemic imbalances. I have helped thousands of people eliminate their health challenges using a holistic approach If you are ready to improve your health, please feel free to contact me to schedule a consultation.
As always, these statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure or prevent any health condition. Please check with your practitioner before adding any supplement to your daily care regimen and never stop taking prescription medications without consulting with your physician.
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