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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Endocrinology
Satisfied Customers: 8999
Experience:  Neurologist/Internist with academic and clinical experience.
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How long does it take b12 levels to go from

Customer Question

Hi, how long does it take for vitamin b12 levels to go from borderline to being classed as low?
Submitted: 8 months ago.
Category: Endocrinology
Customer: replied 8 months ago.
I had my b12 tested almost 16 months ago and was told it was borderline. If I were to have it tested now what kind of level should I expect. I haven't been taking supplements.
Expert:  Dr. Frank replied 8 months ago.
Hello. Welcome to JA. What was your number? If it was above 200 then it is still probably around that value. Studies have shown that certain families will group their Vit B12 (cyanocobalamine) levels closely. Patients with levels below 200, if left untreated, and with significantly elevated MCV (mean corpuscular volume) on their CBC's will have markedly lower levels, but those in the borderline will stay there. There are factors that play into this equation, however. If you have an inflammatory small bowel disease, like crohn's, and have known intrinsic factor production problems as part of that disease, then you will continue to have declining B12 levels, sometimes despite supplementation. So it does depend if you have a reason for malabsorption other than dietary considerations. Please get back to me to discuss this further and I will reply. Or if satisfied, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work. I can also call you to discuss this further if you like. Thanks *****
Customer: replied 8 months ago.
I don't know what my levels were but four years ago I did need to get injections for low b12.
Customer: replied 8 months ago.
That time I think it was 160.
Expert:  Dr. Frank replied 8 months ago.
Well, normal range is quite variable, from 200 to 900 or so. If you recieve shots monthly, you can get your level above 1000. But as mentioned, if you were in the normal range, not to worry as much. 160 is not in the normal range, so I would ask you if you have a recent CBC (complete blood count, it measures your hemoglobin, hematocrit, etc). If you do, than tell me the MCV value. Is it over 100? Let me know. Dr Frank
Customer: replied 8 months ago.
I haven't had any recent cbc.
Expert:  Dr. Frank replied 8 months ago.
So that would be a quick way to look at your B12. You look at your MCV, and look at the lobulations of the nuclei within the neutrophils which also suggests B12 depletion. The level can go up and down to some extent, so it is better for the hematologist to review the red cell indices as I mentioned to look at your bodies reaction to low B12, because as mentioned, the normal range is quite wide as certain individuals do not need a high B12 level. I hope that helps. Please get back to me if you have further questions about this, and I will reply. Or, if satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks *****
Customer: replied 7 months ago.
So is it possible that in 16 months my levels will have gone from borderline to the stage where I will need injections ( seen as I got them four years ago)?
Expert:  Dr. Frank replied 7 months ago.
Yes. That is possible that if you are not using supplement, are living a vegetar***** *****festyle, and/or have a problem like non-tropical sprue or pernicious anemia where you have intrinsic factor deficiencies that your levels are lower than normal and have dropped over 16 months. I would ask you doctor for a level and to start the shots again, or to consider oral supplementation with methylcobalamine. I hope that helps. Dr Frank
Expert:  Dr. Frank replied 7 months ago.
I hope I was able to answer your question. please get back to me anytime, like if you get the CBC or another B12 level and want to discuss subacute combined degeneration, or any other aspect of B12 deficiency. If satisfied with the answer to this question, please remember to rate my service by clicking on the rating stars, as that is how I am compensated for this work thanks Dr frank
Expert:  Dr. Frank replied 7 months ago.
I hope I was able to answer your questions of vitamin levels and supplementation. Please get back to me if you have further questions. Please remember to rate this service by clicking on the rating stars favorably, as that is how I am compensated for this work thanks *****

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