Your Vitamin B12 Level

What Causes Abnormal Vitamin B12 Levels?

Abnormal vitamin B12 levels can have various causes, ranging in severity from 'serious' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose abnormal vitamin B12 levels, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "abnormal vitamin B12 levels" as a symptom.  Here are eight of many possibilities (more below):
  • Diabetes II
  • Breast Cancer
  • Stomach Cancer
  • Myeloproliferative Neoplasm
  • Hepatitis
  • CML Leukemia
  • Cirrhosis Of The Liver
  • Liver Cancer

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
recent non-cyclical breast pain
very great unexplained weight gain
2hr postprandial glucose 201-250mg%
current birth control pill use
regular unexplained nausea
late birth of first child
hepatitis B or C
extended bra wearing
gradual decline in speaking ability
constant fatigue
frequent unexplained nausea
regular bizarre dreams
... and more than 90 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of abnormal vitamin B12 levels:
Cause Probability Status
Myeloproliferative Neoplasm 98% Confirm
Hepatitis 24% Unlikely
Cirrhosis Of The Liver 24% Unlikely
Diabetes II 5% Ruled out
Liver Cancer 5% Ruled out
Breast Cancer 0% Ruled out
Stomach Cancer 0% Ruled out
CML Leukemia 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate having had recent lab tests, The Analyst™ will ask further questions including this one:
Vitamin B12 (cobalamin). Unit: pg/mL [pmol/L]
Possible responses:
→ Don't know
→ Confirmed deficiency in the past
→ Under 200 [150] (low)
→ 200-950 [150-700] (normal)
→ Over 950 [700] (elevated)
Based on your response to this question, which may indicate history of B12 deficiency, B12 deficiency, normal B12 levels or elevated B12 levels, The Analyst™ will consider possibilities such as:
Vitamin B12 Requirement

A urine MMA test is recommended for properly diagnosing B12 deficiency due to the possible lack of sensitivity of serum B12 tests.  A normal or high B12 level makes B12 deficiency less likely, but does not rule it out.

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