Remember the post I wrote quite recently about the importance of B12 and how blood tests can really be misleading:
B12 Deficiency: Fatigue, Muscle Pain, Brain Fog, Neuropathy
Well, I have now finished my research on that so here’s an update for you…
How to confirm B12 and folate deficiency when your blood tests look ok…
First: the testing. Remember I kept finding high serum B12 on blood tests yet the person was showing clear B12 deficiency signs? Well, this is termed a functional B12 deficiency where actually the B12 is not being utilised properly, as we thought. You can do an MMA (Methylmalonic Acid) urine test if you suspect a deficiency even though your blood tests look OK and I have done several recently for people. Most had elevated MMA which is confirmation of a B12 deficiency rather than an excess. Here’s what the lab says:
The most common cause of methylmalonic aciduria is cobalamin (vitamin B12) insufficiency, since the nutrient is needed for its metabolism. Expected symptoms of B12 dependent methylmalonic aciduria may be those of B12 deficiency, including fatigue, ataxia, sensory losses, paresthesias and other neurological problems. Anemia may or may not be present.
Vitamin B12 administration is the most appropriate therapy when MMA is high.
The treatment is therefore taking a measured dose of B12 and re-testing to check the levels of MMA are reducing. I have now worked out a protocol to follow.
Whilst I was at it, I looked at functional folate deficiency too. Again, many people show high folic acid on blood tests yet show signs of folate deficiency. This you can test by measuring FIGLU (Formiminoglutamic acid).
Both tests can be done separately but it is easier and cheaper to do it as part of the Metabolic Analysis urine test, which measures both and a lot more besides.
A Methylcobalamin B12 liquid
In the previous post, you may recall we were talking about the importance of the type of B12 you take. The best is methylcobalamin rather than cyanocobalamin because cyanocobalamin has to be converted to the active methyl form in the body anyway. I asked Dr O several times for confirmation of the source of the probable grain-derived ingredients in his product but have drawn a big fat blank, which is more than a little disappointing.
I gave you a TGF safe cyanocobalamin to use. But, I didn’t give up the fight on the liquid one I mentioned too. At last, after two months of emailing reminders, here’s a methylcobalamin liquid which I am 99% sure of being TGF safe. The manufacturer couldn’t confirm the nature of the flavourings, please note, but we assume they are chemically-synthesised and that doesn’t involve any grain. The liquid might be easier to absorb for many of you.
So, lots of stuff for you on the all-important B12 that many of us are deficient in – even if our tests make them look like they are OK.
Just call me Sherlock…