New Vitamin B12 Test

Who should get tested for vitamin B12 (cobalamin) deficiency and which is the best test to use: serum B12, methylmalonic acid (MMA), or holotranscobalamin levels?

February 9, 2012
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  • Michael Greger M.D.

    This concludes our five-part video series on B12 this week. Please leave any questions you may have below. If you’re new to the issue, Vegan B12 Deficiency: Putting It into Perspective and Safest Source of B12 are good places to start. The consequences of B12 deficiency can be grave (see Inverted Rabbit Sign), but getting enough is easy: B12 can be taken weekly (see Cheapest Source of Vitamin B12) or daily (see Daily Source of Vitamin B12). See my full recommendations and check out the other 1000+ topics I cover here at NutritionFacts.org.

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    • http://VeganExcellence.com/ JD Mumma

      In my research B12 seems to be the most confusing and unadressed  nutrient in the vegan community and is fraught with ignorance and misinformation.

      This is how I see the B12 problem:
      1) Ignore the topic as because they don’t perceive it to be an issue or at least no issue since they have no symptoms.
      Many vegans are people who spent years destroying their health – especially damaging their digestive track, decreasing intrinsic factor… and those and many other factors lower B12 creation and absorption and tend not to just magically get fixed immediately on a vegan diet.
      2) Many vegans do not eat very health vegan foods.
      3) RE: 1) do don’t get tested or tested using methods that are well known to be fairly inaccurate (e.g. blood tests)
      4) RE: 1.2.1) Try increasing with things that have either not been scientifically vetted yet to increase B12 and/or no proven scientific track record of increasing B12 levels.
      5) RE: 1.2.2) Believe they just need to eat better and don’t need to test or can skip the retesting.Comments, additions, corrections…?

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      • Toxins

        There are indeed junk food vegans and healthy vegans. The issue of vitamin b12 though is fairly well addressed and this is an absolutely necessary nutrient to supplement when on a vegan diet unless one is consuming fortified foods.
        check out this video on supplements worth taking.
        http://nutritionfacts.org/videos/vitamin-supplements-worth-taking/

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        • http://VeganExcellence.com/ JD Mumma

          Thanks for the reply!

          Q: On a separate topic – What’s with the “Toxins” name?

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  • http://www.facebook.com/profile.php?id=1333777681 Mark Biddy

    I just read on my bottle of B12 that it “Contains various fish species”. What’s a good all vegan source of getting B12?

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  • working at it

    Question for you: My husband, who has been vegan for 4 years, has numbness in the balls of his feet. He went to his doctor, who did a blood test which indicated his B12 levels were ok. From there he went to a neurologist, where no reason for the numbness could be found. He is suggesting that he take a high dose of B12 without bothering to get a test. Thoughts?

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    • http://VeganExcellence.com/ JD Mumma

      What was the type of test(s) given?

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  • Birdy

    Hi Dr. Greger,
    I’ve viewed the videos on vitamin B-12 and have a question regarding supplementing just this one B vitamin. I read somewhere a long time ago that taking single B vitamins alone can cause imbalances in the other B vitamins. Is there anything to this?
    Thanks for Nutrition.org which is a great resource.

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    • Michael Greger M.D.

      No worries–there is no problem taking vitamin B12 in isolation.

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  • Veguyan

    Raw Food World has B-12 patches available. But it’s confusing because the B-12 researcher who spoke about B-12 states that the cobalamin is not the human active form and that we need to consume the methylcobalamin form. He says the MMA score should be between .58 and 3.56. The Homocystine test should score between 2.2 and 13.2. It’s confusing because you are recommending oral cobalamin.

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  • madisontm

    So, after watching a couple videos about the importance of B12, I decided to break down and buy a bottle of B12 supplements at the health foods store. But I noticed while I was there that there are also “B-Complex” supplements which contain other B-vitamins such as B1, B2, and B6. Should vegans supplement their diet with these vitamins as well or just with B12? Are all the other B’s not as important or are they like the multivitamin – leading to higher mortality rates in excess? It seems that they are not talked about as much as B12. Why is that?

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    • Toxins

      A b complex vitamin is unnecessary. We can acquire more than enough of all the b vitamins through food except vitamin b12. Vitamin b12 is the only byproduct of bacteria. If you search http://nutritiondata.self.com/ for any plant food you can see a full vitamin and mineral profile. You will find that all plant foods not only contain all b vitamins, but they also are all complete proteins and all contain sufficient levels of omega 3.

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