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High folate and high B12 in blood tests

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by SOC, Nov 6, 2013.

  1. SOC

    SOC Moderator and Senior Member

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    My daughter just got labs back that show high folate (>20, ref range 3.1-17.5) and B12 (1093, ref range 211-911). A simple Google search brings up a lot on deficiencies of both, but nothing on excesses. Does this mean it's no big deal?

    She does not deliberately take extra folate or B12, although I'm sure her multivitamin contains folate and methyl B12.

    Any ideas about what's going on here or if these lab results mean anything other than she's not deficient?
  2. Mij

    Mij Senior Member

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    I'm wondering if your daughter should have her MMA and homocysteine levels tested to make sure there isn't a B12 deficiency. My understanding is that high levels of B12 in serum could mean it is not being utilized properly, so it's possible she might have a functional B12 deficiency.
    allyb, Crux, Valentijn and 2 others like this.
  3. helen1

    helen1 Senior Member

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    I agree, high serum levels can mean that your daughter is unable to transport B12 into the cells. She may be functionally deficient. MMA and MCV tests can help you see if this is the case.
  4. SOC

    SOC Moderator and Senior Member

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    She has not yet had an MMA test, but her MCH has been high for 3 years and her MCV has been fluctuating between high and very high normal over the same time period. So maybe macrocytic anemia is a possibility?

    Is functional B12 deficiency a well-accepted diagnosis or is this another thing my rabidly evidence-based medicine local clinic is going to turn their noses up at in scorn? :rolleyes:
    allyb likes this.
  5. helen1

    helen1 Senior Member

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    High MCV is an accepted marker in mainstream medicine for B12 deficiency, as is MMA, although MMA has been criticized as being too variable to be really accurate. However your GP may not know her mainstream medicine; mine didn't know the implications of high MCV.
    Crux likes this.
  6. SOC

    SOC Moderator and Senior Member

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    Sheesh. :rolleyes: I guess they get some kind of cognitive dissonance when they see high MCV and high B12, so they just pretend they didn't see either one to avoid the stress of having to figure out the apparently discordant info. :cautious:
    allyb and Valentijn like this.
  7. Sparrow

    Sparrow Senior Member

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    Yup. My MCV and MCH have been consistently high. But the standard response to that is to check B12 and folate levels. If B12 and folate aren't low, they ignore it.
    SOC likes this.
  8. Sparrow

    Sparrow Senior Member

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    ...Or at least, that has been my experience, and the experience of others who've mentioned it. I'm sure there must be better doctors out there, or ones who've had reason to become more familiar with that particular problem. It doesn't seem to be a common knowledge thing, though.

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