What everybody (especially vegetarians) should know about B12 deficiency

When I first meet with a new client one of the questions I always ask them is when did they last have a blood test with their family physician, and were their any abnormalities in their results. 
When I have my annual checkup, my doctor will always check my B12 levels, and so far my levels have always appeared within normal limits according to the lab carrying out the testing. I have just learnt however that like a couple of other standard blood tests run by doctors the one used for B12 is not necessarily showing us a true picture and is the reason why it only picks up a fraction of the people that are B12 deficient, despite having obvious symptoms.

The main problem with the standard B12 blood test is that it only measures total B12 in the blood. 

There are in fact many types of B12. The most well known types are cyanocobalamin and methylcobalamin. The former is the inactive form which is most common in supplements. The latter is the most active form or the most useful to the body. So with this fact in mind, your total B12 appear within normal limits but the majority of that total may be made up by the inactive form. There are now blood tests available that can show whether you have low levels of the active form of B12. The markers you should ask your doctor to measure are either methylmalonic acid (MMA) and holotranscobalamin II (holo-TC). Studies using these more sensitive measures of B12 have reported much higher levels of B12 deficiencies than studies using standard testing.

For example, one study using standard B12 testing showed that 52% of vegans and 7% of vegetarians were B12 deficient. But a study using the more sensitive techniques found much higher rates of deficiency: 68% for vegetarians and 83% of vegans, compared to just 5% of meat eaters. That’s a huge, difference and means that standard testing is missing 61% of vegetarians and 31% of vegans that are B12 deficient. 

Another, interesting fact is that there are a number of diseases that can mimic B12 deficiency which include:

• Alzheimer’s, dementia, cognitive decline and memory loss (collectively referred to 
• as “aging”)
• Multiple sclerosis (MS) and other neurological disorders
• Mental illness (depression, anxiety, bipolar disorder, psychosis)
• Cardiovascular disease
• Learning or developmental disorders in kids
• Autism spectrum disorder
• Autoimmune disease and immune dysregulation
• Cancer
• Male and female infertility

If you, or somebody you know, has been diagnosed with any of these diseases you might want to ask your doctor to recheck B12 using the more sensitive testing.

Finally

I hope you found these ideas useful. More importantly, I hope you do something with them.