From the Guidelines
Your vitamin B12 level of 1476 pmol/L is above the normal reference range, which typically falls between 200-900 pmol/L, but according to the most recent evidence, this elevated level is not typically a concern for most healthy individuals. No specific treatment is needed to lower this level, and you do not need to stop any B12 supplements immediately unless advised by your healthcare provider. Elevated B12 levels can occur from taking supplements, consuming foods fortified with B12, or certain medical conditions. While high B12 levels are generally not harmful, they can sometimes be associated with liver disease, certain blood disorders, or kidney disease.
Key Points to Consider
- The normal reference range for vitamin B12 is between 200-900 pmol/L 1
- Elevated B12 levels are not typically a concern for most healthy individuals, but can be associated with certain medical conditions 1
- B12 plays a crucial role in various bodily functions, including mitochondrial metabolism, immune response, and neurological functions 1
- Recent studies suggest that B vitamins, including B12, can reduce the risk of stroke by lowering homocysteine levels 1
Recommendations
- I recommend discussing this result with your healthcare provider at your next appointment, especially if you're experiencing any unusual symptoms or if you have other abnormal lab results. They may want to investigate potential underlying causes or simply monitor your levels over time.
- Continue your regular diet and medication regimen unless specifically instructed otherwise by your healthcare provider.
- Consider the importance of B12 in maintaining overall health, particularly in preventing stroke and other cardiovascular diseases, as highlighted in recent studies 1.
From the Research
Vitamin B12 Levels and Myeloproliferative Disorders
- The provided vitamin B12 level is 1476 pmol/L, which is considered high.
- Studies have shown that high serum vitamin B12 levels can be observed in patients with myeloproliferative disorders, despite actual vitamin B12 deficiency 2, 3, 4.
- This is because myeloproliferative disorders can lead to an increase in transcobalamin, a protein that binds to vitamin B12, resulting in elevated serum vitamin B12 levels 3.
Diagnosis of Vitamin B12 Deficiency
- Vitamin B12 deficiency can be masked by high serum vitamin B12 levels in patients with myeloproliferative disorders 4.
- Methylmalonic acid (MMA) level is a sensitive marker of vitamin B12 deficiency and can be used to diagnose deficiency in patients with myeloproliferative disorders 2, 4.
- Holotranscobalamin level may be the best initial test to evaluate vitamin B12 status in patients with myeloproliferative disorders 2.
Myeloproliferative Disorders and Vitamin B12 Deficiency
- Myeloproliferative disorders, such as polycythemia vera, can be associated with vitamin B12 deficiency 5, 6.
- Vitamin B12 deficiency can be caused by insufficient dietary intake, impairment of its utilization, or other factors, and its association with myeloproliferative disorders is not fully understood 6.
- Diagnosis and treatment of vitamin B12 deficiency in patients with myeloproliferative disorders can be challenging due to the complexity of the disease and the atypical presentation of vitamin B12 deficiency 6.