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Serum vitamin B 12 is a medical laboratory test that measure vitamin B 12 only in the blood binding to both transcobalamins. [1] Most of the time, 80–94% of vitamin B 12 in the blood binds to haptocorrin, while only 6–20% is binds to transcobalamin ll. [2] Only transcobalamin ll is "active" and can be used by the body. [1]
For this reason, elevated serum homocysteine over 15 micromol/L and methylmalonic acid (MMA) over 0.271 micromol/L are considered better indicators of B 12 deficiency, rather than relying only on the concentration of B 12 in blood. [2]
References range may vary with age, sex, race, pregnancy, [10] diet, use of prescribed or herbal drugs and stress. Reference ranges often depend on the analytical method used, for reasons such as inaccuracy, lack of standardisation, lack of certified reference material and differing antibody reactivity. [11]
Evidence exists linking elevated homocysteine levels with vascular dementia [10] and Alzheimer's disease. [11] [12] [13] There is also evidence that elevated homocysteine levels and low levels of vitamin B6 and B12 are risk factors for mild cognitive impairment and dementia. [14]
Diagnosis is not always straightforward as serum levels can be falsely high or normal. [10] Elevated methylmalonic acid levels may also indicate a deficiency. [2] Individuals with low or marginal values of vitamin B 12 in the range of 148–221 pmol/L (200–300 pg/mL) may not have classic neurological or hematological signs or symptoms. [2]
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Hypervitaminosis is a condition of abnormally high storage levels of vitamins, which can lead to various symptoms as over excitement, irritability, or even toxicity. Specific medical names of the different conditions are derived from the given vitamin involved: an excess of vitamin A , for example, is called hypervitaminosis A .
Deficiencies of Vitamin B 12 or folate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two-thirds of all cases. However, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases.