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B12 blood test

Messages
80
How much attention should we pay to the B12 blood test levels? Mine was at 230(200-900) so The doctor had me start self injections twice a week. After two months, we checked the levels again. Now I am at 2500. I wasn't taking nearly the amount some people here are taking, so are your levels that much higher also? Or do you even keep testing? If we ignore the tests when they are high, but are concerned about them when they are low, that doesn't sound logical.
 

allyb

Senior Member
Messages
127
Location
yorkshire/lancashire border, England
So glad you raised this AH, though I can't offer any advice but do share your concerns. I had my b12 levels done April 29th and have only just found out they were 1,320. At this time I wasn't taking any b12 supplements. I stared sub-lingual b12 on the 30th April and they made such a difference neurologically, so I assumed they must have been rock bottom. In a phone appointment with my consultant on Monday, I asked if I could have b12 injections, this was when I was hit with the high figure and told I didn't need them. I was stunned because I have felt so much better on the sub-lingual b12 . A friend explained my levels maybe high because my body is unable to utilize b12 at this time and I wondered what is the science behind this (In simple terms pls :confused:)
 

Seven7

Seven
Messages
3,444
Location
USA
Ditto! I love b12 and I feel better On it (Hydroxy) I was on 3,000 level, Dr asked me to stop. But I got tired of been on relapse, so I just started again, but I am worried to get the levels too high again!!!
 
Messages
80
I was hoping maybe Rich or Fredd would weigh in on this. Just wondering how much attention I should pay to the test results. Unfortunately, I didn't feel any different or better because of the B12 injections.
 
Messages
80
I am disappointed that I didn't get more responses to this. I just need to know if I should continue with the injections or not. Has anyone been on the methylation protocol for 3-4 months and then checked their B12 blood levels? Or do we ignore them?
 

richvank

Senior Member
Messages
2,732
Hi. AH.

High serum B12 levels can be caused by a functional B12 deficiency. Based on testing in a lot of people, it looks as though this is pretty generally found in ME/CFS. It is consistent with the Glutathione Depletion-Methylation Cycle Block model for ME/CFS.

A functional B12 deficiency means that even though you have enough B12 in your body, your cells are not able to use it properly. In ME/CFS, this is caused by depletion of glutathione. When glutathione goes too low, the affinity of the CblC complementation group (part of the intracellular processing pathway for B12) for B12 goes way down, based on research published last year from Korea. Thus, even though there is enough B12 present for normal operation, this group is not able to bind strongly enough to B12 to keep the rate of B12 processing high enough to meet the demands of the cells for methyl B12 and adenosyl B12, which are normally produced in the cells themselves from whatever form of B12 comes in from the diet and supplements.

This is confusing to the docs, who have not been trained to understand it. They know about absolute B12 deficiency, but not about functional B12 deficiency. When they see high serum B12, they tell people to stop taking it. Unfortunately, this is not the right advice. It's necessary to take relatively large dosages of B12 (such as 2 milligrams per day or so), either sublingually or by injection to get enough into the blood, together with oral methylfolate at about RDA levels (a few hundred micrograms per day). This is what is in the simplified methylation protocol, together with some other supplements to cover possible deficiencies of essential nutrients. Over a period of a few months, this usually overcomes the vicious circle involving glutathione depletion, functional B12 deficiency, methylation cycle partial block, and loss of folates from the cells.

It is only since the work in Korea that we have an explanation for the observation of Lapp and Cheney in the late 80s and into the 90s that it was necessary to inject at least 2,000 or 2,500 micrograms of B12 per injection to have a therapeutic benefit from it in ME/CFS. It now makes sense. We have to overcome the low affinity due to glutathione depletion, and it takes a big dosage to do that. Eventually, glutathione comes back up, and the B12 demand becomes more normal.

It's good to know that B12 has not been found to be toxic, even at very high concentrations in the blood, so high serum B12 is not something to worry about. It is an indicator of functional B12 deficiency. Most of the B12 in the blood serum has actually been rejected from the cells because it couldn't be used. It is bound to haptocorrin, and the only cells that can pick it up are liver cells. It stays in the blood for about a week, which is why the levels can get so high if the cells are rejecting it. Eventually the liver picks it up and puts most of it out in the bile, which goes to the gut. It then has a chance to be bound to intrinsic factor and be reabsorbed. But if there is more than can be absorbed, the rest goes out in the stools.

I hope this helps.

Best regards,

Rich
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
Does handling all of that rejected B12 put stress on the liver? Mine is already unhappy - high ALT enzymes. Would increasing B12 make it worse?
 

richvank

Senior Member
Messages
2,732
Does handling all of that rejected B12 put stress on the liver? Mine is already unhappy - high ALT enzymes. Would increasing B12 make it worse?

Hi, LB.

I don't know the answer to this, but I do think that if the liver has problems, it should be dealt with first, before doing methylation treatment, because the liver is the main organ that carries on methylation. Milk thistle has been found very helpful to the liver in several ways. B-complex vitamins, selenium, and perhaps NAC or whey protein concentrate, if it is tolerated, can also help the liver. I recommend working with a physician.

Best regards,

Rich
 

richvank

Senior Member
Messages
2,732
Hi, Celeste.

Here's the abstract of the Korean study I mentioned. It was done using bovine CblC and cyanocobalamin, but I think the results are also valid for human CblC and other forms of B12. Note that the affinity is inversely proportional to the value of K(d), and glutathione lowered K(d), and thus raised the affinity, by a factor of over 100. I think this is a big enough effect to explain why, in treating ME/CFS, the dosage of B12 has to be so much greater than the RDA for B12, which is only a small number of micrograms per day:

Biochem Biophys Res Commun. 2011 Aug 26;412(2):360-5. Epub 2011 Jul 29.
Glutathione increases the binding affinity of a bovine B₁₂ trafficking chaperone bCblC for vitamin B₁₂.

Jeong J, Kim J.
Source

School of Biotechnology, Yeungnam University, 214-1 Dae-dong, Gyeongsan-si, Gyeongsangbuk-do 712-749, Republic of Korea.
Abstract

Intracellular B(12) metabolism involves a B(12) trafficking chaperone CblC that is well conserved in mammals including human. The protein CblC is known to bind cyanocobalamin (CNCbl, vitamin B(12)) inducing the base-off transition and convert it into an intermediate that can be used in enzyme cofactor synthesis. The binding affinity of human CblC for CNCbl was determined to be K(d)=≈6-16 μM, which is relatively low considering sub-micromolar B(12) concentrations (0.03-0.7 μM) in normal cells. In the current study, we discovered that the base-off transition of CNCbl upon binding to bCblC, a bovine homolog of human CblC, is facilitated in the presence of reduced form of glutathione (GSH). In addition, GSH dramatically increases the binding affinity for CNCbl lowering the K(d) from 27.1 ± 0.2-0.24 ± 0.09 μM. The effect of GSH is due to conformational change of bCblC upon binding with GSH, which was indicated by limited proteolysis and urea-induced equilibrium denaturation of the protein. The results of this study suggest that GSH positively modulates bCblC by increasing the binding affinity for CNCbl, which would enhance functional efficiency of the protein.
Copyright © 2011. Published by Elsevier Inc.
PMID: 21821010
Best regards,
Rich
 
Messages
80
Thanks Rich, you are always willing to share useful info.

But here is another reason I am asking about high B12 levels. The very last injection I took, 2hours later I began having tingling and numbness in my hands and feet. Then I did the blood test that came back high. Since I really wasn't taking anything else new at time, we figured it had to be the high B12. So we stopped the injections hoping it would go away as the B12 levels came down. That was 2 months ago and I still have the tingling. So I am wary of taking more B12! Nothing about this disease ever makes sense!!
 

Asklipia

Senior Member
Messages
999
But here is another reason I am asking about high B12 levels. The very last injection I took, 2hours later I began having tingling and numbness in my hands and feet. Then I did the blood test that came back high. Since I really wasn't taking anything else new at time, we figured it had to be the high B12. So we stopped the injections hoping it would go away as the B12 levels came down. That was 2 months ago and I still have the tingling. So I am wary of taking more B12! Nothing about this disease ever makes sense!!
alwayshopeful, have you considered maybe B2 deficiency?