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High serum B12 WITHOUT B12 supplements. What could this mean?

NilaJones

Senior Member
Messages
647
Hello folks :).

I'm trying to puzzle out a blood test result I got recently. As I understand it, high serum B12 normally means B!2 supplementation with too little folate. But I don't see how that could be true in this case.

At the time of testing, I was on my 9th day of no B12. Previous to that (10 an 11 days prior) I had taken 1/12 of a perque for those two days. Before that, no B12 for a month. I have never taken very much or for more than a day or two at a time, due to side effects. I've had a total of less than 2 perque in my life.

I was also off folapro at the time of testing. It was my 4th day without it and I was quite sick as a result of not having the folate. I am heterozygous for A1298C, and I feel much better with folapro, even without B12.

The test showed >1500 pg/mL of B12. Can you folks suggest what this might imply?

I don't know if it's related, but B12, with or without folate, feels similar to caffeine to me. I only recently learned that is not normal.

Ideas? Questions? Mad hunches? Thank you!
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
Serum B12 is often not a good test for the B12 levels that you are actually able to utilize. You can have high serum B12 and actually be deficient.

Sushi
 

NilaJones

Senior Member
Messages
647
Serum B12 is often not a good test for the B12 levels that you are actually able to utilize. You can have high serum B12 and actually be deficient.

Sushi

I know this :). But my doc requested the test.

Don't high levels mean you are not utilising B!2 from supplements? What if there are no supplements?

I also eat very little meat, and almost no red meat.
 

helen1

Senior Member
Messages
1,033
Location
Canada
NilaJones, I have almost the same situation & was wondering why too. High serum B12, no suppl from b12 or mfolate in the past 10 weeks, although I do eat meat. I thought it must mean I'm not able to transport or absorb b12 into cells. I think this is from low intrinsic factor & (or lithium according to Yasko) but am not sure. Does anyone have a good understanding of this?
 

rlc

Senior Member
Messages
822
Hi NilaJones, high serum B12 levels as well as being artificially raised by supplementation, that can take some time to return to normal levels, can also be caused by some serious medical conditions these are listed here http://en.diagnosispro.com/differential_diagnosis-for/vitamin-b12-serum-lab-increased/10103-154.html My opinion is that it would be a good idea to ask your doctor to investigate if you high B12 level is caused by previous suplimentation, and if not ask them to investigate if any of the possibilities on this list is causing your high B12.

Hope this helps

All the best
 

NilaJones

Senior Member
Messages
647
I'm wondering if it would be dangerous to supplement B12, if my serum level is already high. I was planning to start supplementing today but now i'm unsure :(.

I could call my doc tomorrow and ask her opinion, but it would cost $200 to ask and I doubt she would know the answer. She is always willing to run more tests, though, if I request specific ones.

Can anyone suggest further reading or a course of action? I am feeling stymied, here.

--

helen1: It's good to know I am not alone!

rlc: Thank you for the list. I do have IDA sometimes, but my iron levels weren't checked in this round of tests. They 'felt' ok, though. I can ask my doc to check markers for the various cancers and stuff.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
Have you tested methlymalonic acid? Rich used to think this was one of the better ways to measure your "B12 status."


The best test for low functional use of B12 is the urine methymalonate test. This is part of several of the urine organic acids tests that are offered, such as the one from Genova Diagnostics (Metabolic Analysis Panel) or the one from Metametrix (Organix). I think it's also on the Great Plains Lab urine organic acids test.

Conventional doctors usually measure blood serum B12. This test is not as useful in CFS, because it usually comes out normal or high, suggesting that the B12 status is O.K. However, the problem is that the B12 is not being converted into the active forms for use in the biochemistry. So measuring urine methylmalonate is a better indicator of what's going on. Of course, having both is great, because that enables one to determine better where the problem is. For example, if the person has pernicious anemia (inability to absorb B12 in the gut), then the serum B12 will be low, too.

I think this was posted on ProHealth but the date was 06/28/08



Sushi
 

NilaJones

Senior Member
Messages
647
Have you tested methlymalonic acid? Rich used to think this was one of the better ways to measure your "B12 status."

No, I haven't. Would this be to help determine tissue vs blood B12?

I am still wondering if there is a danger in adding to my blood B12 -- I am guessing sublingual supplements would do that?

I feel so ignorant, here.
 

Victronix

Senior Member
Messages
418
Location
California
Yes, supplements will increase the B-12 that shows up in labs.

With almost every nutrient, there are a lot of different processes involved in making it, using it, breaking it down, etc., and each of those processes involve specific enzymes, precursors, etc. You can sometimes have high levels of a nutrient in your blood, but your body may have a defective gene for doing anything with it, or transporting it to a place it needs to go in order to be used, etc.

Too much B-12 is like too much Vitamin C -- what is the upper limit? I don't know of any. The body merely dumps what it doesn't need.

The main thing you want to ensure is that you have enough for the needs of folate, which you probably do if your labs are over 1000. But there is no danger in that. That's a preferred status.
 

NilaJones

Senior Member
Messages
647
Yes, supplements will increase the B-12 that shows up in labs.

I understand. My concern is that I was NOT supplementing B12 at the time of the labs.

With almost every nutrient, there are a lot of different processes involved in making it, using it, breaking it down, etc., and each of those processes involve specific enzymes, precursors, etc. You can sometimes have high levels of a nutrient in your blood, but your body may have a defective gene for doing anything with it, or transporting it to a place it needs to go in order to be used, etc.

Yes. Is it then dangerous to supplement? Do I need to first find the problem with absorption and address that?

Too much B-12 is like too much Vitamin C -- what is the upper limit? I don't know of any. The body merely dumps what it doesn't need.

The main thing you want to ensure is that you have enough for the needs of folate, which you probably do if your labs are over 1000. But there is no danger in that. That's a preferred status.

That is encouraging :).

Do you think it would be best to retest now, when I AM supplementing folate, but still not taking B12? Or just go ahead and begin the B!2?

I am having a fuzzy brain day, and really appreciate the help in thinking this stuff through :).
 

allyb

Senior Member
Messages
127
Location
yorkshire/lancashire border, England
Hi All,
Thank you NilaJones for posting this. I was going to start a post of my own but my high B12 issues are somewhat similar so I thought posting here might bump up the thread and hopefully catch someone's attention. Hopefully it will benefit others too.

Last April 2012 I had standard routine bloods taken whilst at an appointment; at this point I never ever taken B12 supplements and I NEVER had. After this appointment I began the methylation programme supplementing with sublingual B12. I have to say that of all the supplement that I have taken it is with B12 that I have the most noticeable results, especially cognition. However, I found that Folate fell at the opposite end of the spectrum and I was unable to tolerate the tiniest amount of methyl folate.

3 and a half months later in August 2021 I have a follow up phone consultation. I thought I'd report the susses of the B12 supplementation and ask if I could have injections. I was really shocked when the clinician told me that MT B12 levels were high at 1310
told by a clinician over the phone that my B12 levels were 1310 (remember I had never had B12 when the bloods were taken) (And yes it took 3and a half months to get my results)

I stopped for a while but there was a marked deterioration and again a noticeable positive change when I took B12 again. I asked my GP to check again in Feb 2013 and my levels were 1480 and I asked my GP for advice (brace yourself) he said "it was one of those things some people are 5ft 6" and others 6ft 5" and that both was normal:confused:
In March I saw an immunologist he took my bloods and the report says

Active B12 *>256.0 pmol/L 25.1 - 165.0

Red cell folate *1667 nmol/L 158 - 1099

Both were flagged red,
What does the high folate indicate?
could this be why I felt ill with the folate?
And why then do I feel better on sublingual B12??
And should I/we with elevated levels be taking it?

I haven't been taking it consistently since march but I notice a difference.
Has anyone else had high Folate?

As with the earlier posters, any help or suggestions would be appreciated?

Kindest regards
allyb
 

helen1

Senior Member
Messages
1,033
Location
Canada
Thanks for the link, Beyond, most informative. However I don't think that explains your or my situation and possibly others, with high B12 and folate, as we had not supplemented with any inactive forms (at least in my case - no b12 supps, no 'enriched' foods or folic acid in suppls) so why would there be high amounts of inactive forms building up and blocking receptor sites?
I had supplemented with active only forms of B12 and folate 4 months before for about 4 months; would that have caused high levels?
 

Beyond

Juice Me Up, Scotty!!!
Messages
1,122
Location
Murcia, Spain
Well, in the link they conclude that accumulation of inactive folate (which its the one they measure in blood) its a symptom of MTHFR. The high levels of B12 on the other hand account for both the inactive and active forms. I can only guess as you did that somehow it stays in our blood, maybe because our faulty cycle or gut? Notice that no one in this thread have his genetic mutations in ther signature, so we cannot know. But I definetely think that its the case, these abnormal lab results weeks after any supplementation must be because of our methylation mutations. My 23andme tests will take 6 weeks or so to be available. Finally, high serum B12 can be associated rarely with serious medical conditions such as hepatic disease, disseminated neoplasia, myeloproliferative disorders, and hypereosinophilic syndromes. There are other possible reasons for it, however, such as in this case: http://www.clinchem.org/content/52/11/2107.full
 

helen1

Senior Member
Messages
1,033
Location
Canada
I'm MTHFR 677 +- actually amongst others. So the small amounts of enriched flour foods I've eaten over the years have a negative impact for a long time? I've eaten so little of that kind of food though, it's surprising but another reason to stay away from them completely...
 

caledonia

Senior Member
You can also do the HDRI methylation panel, which will give you a peek into what's going on inside your cells. (link to Rich Vank's interpretation of the panel in my signature.)

In general, it's almost better to go by signs and symptoms of deficiency, than a blood test. My B12 tested 800-ish, which is nice and normal. However, I have many signs of deficiency, and MTR with several MTRRs - so a high need for it.
 

helen1

Senior Member
Messages
1,033
Location
Canada
I am waiting for my methylation panel results. @Calendonia, maybe you can help me figure it out when I get it?

Recent OAT showed methylmalonic acid now in range, same improvement with the folate metabolites. I am very pleased. This is without supplementation in the last 4 months which is a bit mystifying. Can anyone explain this?
 

triffid113

Day of the Square Peg
Messages
829
Location
Michigan
The only 2 B12 test sthat are worth anything are urinary MMA (methylmelonic acid) test (for aB12) and homocysteine (for mB12, P5P, mfolate). The serum B12 test shows active and inactive B12 all lumped together. If you can't use inactive B12 it will be there a long time. I wouldn't worry about it. Just go by the oter 2 tests. I think the MTHFR 1298AC is a LOT worse than Yasko and others make out. Your big concern is going to be kidney function as you need BH4 for the ornithine cycle. My father tested as having NO BH4 in his system and he died on dialysis. If I was +/+ on that one I would take BH4. There is a Metametrix test for BH4 (biopterin) which is how I had my Dad tested. BH4 is available as a prescription called kuvan and is very expensive. You can get a small small dose of inexpensive BH4 OTC from Dr. Roberts at www.heartfixer.com. I posted several times in the past a list of thigs that would raise BH4 like ESTROGEN, mfoate, and vitamin C. I don;t remember everything. I really wouldn't worry about te B12 reading. Only pay attention to the organic acids tests. The reason those are useful is that tell you whether or ot you had enogh B12 in the right FORM to do anything useful.
 

triffid113

Day of the Square Peg
Messages
829
Location
Michigan
Sorry I never used to leave off letters typing. Not sure why it is such a problem for me now. Different keyboard? early Alzheimer's?
 

Beyond

Juice Me Up, Scotty!!!
Messages
1,122
Location
Murcia, Spain
I think I have some juvenile Alzheimer´s :cautious: with some mystiping as well, but lately some memories are coming back. It might be because I am juicing ginger. In the book Yasko indeed says she suspects that mutation to be worse than what it seems initially.