From the Guidelines
No, B12 levels do not typically increase when ferritin levels are lower, as these are two separate nutrient measurements that function independently in the body. Ferritin is a protein that stores iron, while vitamin B12 is involved in red blood cell formation, neurological function, and DNA synthesis. Low ferritin indicates iron deficiency, while low B12 indicates vitamin B12 deficiency. These deficiencies can coexist but one does not cause the other to rise. In fact, both deficiencies can occur simultaneously in conditions like malabsorption or poor dietary intake.
Some key points to consider:
- Iron deficiency is typically indicated by low serum ferritin levels, with a threshold of < 30 mcg/L in the absence of inflammation and < 100 mcg/L in the presence of inflammation 1.
- Vitamin B12 deficiency is indicated by low serum vitamin B12 levels, and can be treated with supplements, typically 1000-2000 mcg daily orally or injections if absorption is impaired 1.
- Both nutrients should be monitored independently through blood tests to ensure proper levels are maintained, with serum folate, vitamin B12, ferritin, and iron studies being checked at least every 3 months in women planning to become pregnant after bariatric surgery 1.
- It is essential to identify and treat the underlying cause of the deficiency, whether it be iron, vitamin B12, or another nutrient, to prevent complications and improve quality of life.
In terms of treatment, if you have low ferritin, you should focus on iron supplementation (typically 45-60 mg elemental iron daily) and iron-rich foods, while also monitoring your vitamin B12 levels and treating any deficiency with separate supplements. Additionally, a multivitamin and mineral supplement should be taken daily, containing essential nutrients such as copper, zinc, selenium, folic acid, and vitamin E 1.
Overall, while ferritin and vitamin B12 are two separate nutrient measurements, it is crucial to monitor and maintain proper levels of both to prevent deficiencies and related complications, and to prioritize treatment based on the most recent and highest quality evidence, such as the 2019 consensus recommendations for periconception, antenatal, and postnatal care after bariatric surgery 1.
From the Research
Vitamin B12 and Ferritin Levels
- The relationship between vitamin B12 levels and ferritin (iron storage protein) levels is not directly addressed in most of the studies provided 2, 3, 4, 5.
- However, one study found an inverse correlation between serum ferritin and hemoglobin (Hb) concentration in men with pernicious anemia, which is often caused by vitamin B12 deficiency 6.
- The same study found that serum ferritin levels were higher in patients with untreated megaloblastic anemia (a condition often associated with vitamin B12 deficiency) compared to normal control subjects, and that ferritin levels decreased after vitamin B12 therapy 6.
- This suggests that vitamin B12 levels may be higher with lower ferritin levels, but more research is needed to confirm this relationship 6.
- Other studies have found that vitamin B12 deficiency can occur in conjunction with other nutritional deficiencies, such as vitamin D deficiency 3, but do not provide direct evidence on the relationship between vitamin B12 and ferritin levels.
- One study found that iron deficiency anemia is a common condition that can be treated with oral iron supplements, but does not discuss the relationship between iron stores (as measured by ferritin) and vitamin B12 levels 4.
- Another study found that prolonged use of omeprazole (a medication that can affect nutrient absorption) did not appear to cause significant malabsorption of iron, vitamin B12, or folic acid 5.