This is especially true for vegans and long-term vegetarians. Vitamin supplements can make up for a shortfall in the diet, especially for vegans and strict vegetarians. As it can be easier for their body to absorb supplements than naturally occurring vitamin B, older adults should aim to meet their vitamin B needs through fortified foods and vitamin supplements. Adults and adolescents over 14 years of age require 2.
This increases to 2. Vitamin B is an essential nutrient that plays a vital role in overall health. A doctor may recommend this test to people who have symptoms of a deficiency or who have a higher risk of low vitamin B in the body. People can avoid vitamin B deficiency by eating a balanced diet and including several sources of vitamin B daily or taking supplements. If they have issues absorbing vitamin B from food sources, oral supplements or injections of the vitamin can help to prevent symptoms and complications.
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Learn more here. New research in mice examines the impact of a Western diet on cognitive decline and neurodegenerative disorders. What is the purpose of a vitamin B level test? Medically reviewed by Alana Biggers, M. What is it used for? Risk factors How does it work? Results Treatment for low vitamin B levels Treatment for high vitamin B levels Food sources Takeaway We include products we think are useful for our readers. Why is a vitamin B level test useful?
Share on Pinterest Depression can be a sign of vitamin B deficiency. Risk factors for low vitamin B levels. Share on Pinterest Children and older adults are more likely to experience low vitamin B levels.
How does the vitamin B level test work? In patients being evaluated for vitamin B12 deficiency who have intrinsic factor blocking antibodies IFBA , false elevations of vitamin B12 may occur due to IFBA interference, potentially obscuring a physiological deficiency of vitamin B Patients who have received a vitamin B12 injection or radiolabeled vitamin B12 injection within the previous 2 weeks may have high serum vitamin B12 levels, which can interfere with this assay leading to falsely elevated results.
Many other conditions are known to cause an increase or decrease in the serum vitamin B12 concentration and should be considered in the interpretation of the assay results, including:. The evaluation of macrocytic anemia requires measurement of both vitamin B12 and folate levels; ideally, they should be measured simultaneously. Some patients exposed to animal antigens, either in the environment or as part of treatment or imaging procedure, may have circulating anti-animal antibodies present.
These antibodies may interfere with the assay reagents to produce unreliable results. Babior BM: The megaloblastic anemias. McGraw-Hill; Elsevier; chap Klee GG: Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clin Chem. J Nutr. Front Mol Biosci. Intrinsic factor and parietal cell antibody tests are available. Surrogate markers for B12 deficiency include methylmalonic acid MMA and homocysteine. For this reason, MMA is not routinely recommended in the elderly.
Homocysteine is also elevated in B12 deficiency and the plasma tHcy assay for homocysteine can be used as a screen. Other markers include IF blocking antibody test for autoimmune B12 deficiency and the holo-TC II test The significance of a low value for this not entirely understood. In the past, the Schilling's test was advocated as a method of determining whether oral vs nasal or intramuscular B12 supplementation will be required. In the Schillings test it can be determined whether or not oral B12 is absorbable using a radioassay.
One microgram of radioactive B12 is given by mouth. One hour later, 1 mg of non-radioactive B12 is given as a "flushing dose", to prevent further absorption. Radioactive B12 is counted in the blood and urine. The test can be also done with the addition of intrinsic factor, pancreatic extract, and after therapeutic attempts to improve absorption such as gluten free diet, use of antibiotics.
The Schillings test is expensive and inconvenient. The clinical benefit of the Schillings test is also sometimes difficult to follow, as the cost of the test greatly exceeds the cost of supplementing B12 and rechecking B12 later. Some authors advocate simply providing B12 to the patient via an oral or nasal route, and then retesting the patient after a few months as a simpler and more direct method of determining whether shots will be needed.
All modes of treatment should include a method of checking for response i. If clinical syndromes do not improve on oral B12 supplementation, and B12 level is normalized we would look for a level of about assess surrogate markers MMA, homocysteine.
In situations where there is a treatable cause of malabsorption, treatment should also be directed towards this cause. A 45 year old man presented with dizziness. In the course of an evaluation for gastritis it was determined that he was infected with H-pylori. B12 levels were checked and found to be low His dizziness eventually resolved with injections of B B12 Deficiency and Unsteadiness Timothy C. A list of diseases that can present with a similar picture is given below: Subacute combined degeneration B12 deficiency Tabes Dorsalis neurosyphilis Fredreich' ataxia a cerebellar disorder , with damage with sensory input to the cerebellum.
Peripheral neuropathy common Thoracic spinal cord lesions very rare Subacute sensory loss a rare paraneoplastic syndrome.
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