The vitamin B12 level is a blood test that measures how much vitamin B12 is in your blood.
How the Test is Performed
A blood sample is needed.
How to Prepare for the Test
You should not eat or drink for about 6 to 8 hours before the test.
Certain medicines may affect the results of this test. Your health care provider will tell you if you need to stop taking any medicines. Do not stop any medicine before talking to your provider.
Medicines that can affect the test result include:
- Colchicine
- Neomycin
- Para-aminosalicylic acid
- Phenytoin
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.
Why the Test is Performed
This test is most often done when other blood tests suggest a condition called megaloblastic anemia. Pernicious anemia is a form of megaloblastic anemia caused by poor vitamin B12 absorption. This can occur when the stomach makes less of the substance the body needs to properly absorb vitamin B12.
Your provider may also recommend a vitamin B12 test if you have certain nervous system symptoms. A low level of B12 can cause numbness or tingling in the arms and legs, weakness, and loss of balance.
Other conditions for which the test may be done include:
- Sudden severe confusion (delirium)
- Loss of brain function (dementia)
- Dementia due to metabolic causes
- Nerve abnormalities, such as peripheral neuropathy
What Abnormal Results Mean
Values of less than 160 pg/mL (118 pmol/L) are a possible sign of a vitamin B12 deficiency. People with this deficiency are likely to have or develop symptoms.
Older adults with a vitamin B12 level less than 100 pg/mL (74 pmol/L) may also have symptoms. Deficiency should be confirmed by checking the level of a substance in the blood called methylmalonic acid. A high level indicates a true B12 deficiency.
Causes of vitamin B12 deficiency include:
- Not enough vitamin B12 in diet (rare, except with a strict vegetarian diet)
- Diseases that cause malabsorption (for example, celiac disease and Crohn disease)
- Lack of intrinsic factor, a protein that helps the intestine absorb vitamin B12
- Above normal heat production (for example, with hyperthyroidism)
- Pregnancy
An increased vitamin B12 level is uncommon. Usually, excess vitamin B12 is removed in the urine.
Conditions that can increase B12 level include:
- Liver disease (such as cirrhosis or hepatitis)
- Myeloproliferative disorders (for example, polycythemia vera and chronic myelogenous leukemia)