Accurately Testing for Vitamin B12 Deficiency can be Complicated

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The conclusions scientific studies are bringing to light is that many people suffer from the symptoms of vitamin B12 deficiency and are not properly diagnosed and treated for their deficiencies. The main reasons for this are that the tests ordered by doctors are often not thorough enough to properly conclude whether a person is suffering from a B12 deficiency. For unknown reasons, many doctors do not take their patients complaints seriously enough to rule out vitamin B12 deficiency as the root cause of their signs and symptoms.

Yes, your test can show normal vitamin B12 levels but you can still be deficient and suffering from the symptoms. Regarding this I will briefly touch on the tests and reasons this occurs.

Issues Diagnosing Vitamin B12 Deficiencies

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Some Main Reasons B12 Deficiencies Go Undiagnosed

  1. Serum B12 is a commonly used test but often delivers false results.
  2. Doctors often don’t take their patient’s complaints seriously.
  3. Combined testing delivers the best diagnoses for B12 deficiency testing, but some outside factors can interfere and render those tests unreliable.
  4. Testing for vitamin B12 deficiencies is not as straight forward as once thought, thus multiple tests need to be performed to properly diagnose, but can still provide inclusive or false proof of a deficiency. This is usually manifested in neurological symptoms that are present even though B12 levels appear in the appropriate range.
  5. Other diseases can mimic some of the signs and symptoms of vitamin B12 deficiency and must be eliminated from suspicion.

If you are suffering from the signs and symptoms of vitamin B12 deficiency, then diagnosing and treating the B12 deficiency is of the utmost importance. After supplementation to correct the deficiency has begun, the condition causing the deficiency must be identified and treated. This is the only way to gain control over your B12 levels and remain healthy.

Some people have medical conditions that require regular vitamin B12 injections for the remainder of their lives or only for a short time to regain normal levels. After injections and causal diagnosis, some patients might be able to ingest vitamin B12 supplements and eat B12 enriched foods to keep their deficiency in check, while others must continue B-12 injections. The supplementation regimen will depend upon your doctor’s diagnosis and prescribed treatments.

Testing Your Vitamin B-12 Levels
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When you decide to undergo testing for a vitamin B-12 deficiency, it is recommended to have a Serum B-12 test or active vitamin B-12 test combined with an MMA test. Many doctors are unaware of these tests (MMA, homocysteine, Active B-12) and how to properly interpret the results, so choose your doctor wisely and don’t be afraid to seek other council if you are getting nowhere with your current doctor. Another factor in diagnosing B-12 deficiency is cost, and this might deter some doctors from ordering proper testing, some insisting on your part might be necessary.

Even the above combined testing can miss a B-12 deficiency that is causing obvious neurological symptoms, and if no other cause can be identified, then the person should be treated using vitamin B-12 injections. Despite normal blood tests there have been innumerable patients whose symptoms have improved after undertaking B-12 injections.


It turns out that many vitamin B12 deficiencies are being diagnosed as fibromyalgia, anemia (iron deficiency), chronic fatigue syndrome, depression, MS or simply as hypochondria. Common stories are that patients have to see multiple doctors and undergo numerous tests before discovering the B12 deficiency is real. This results in unnecessary suffering, high societal costs (insurance payments) and the risk of permanent neurological damage.

Seven out of ten patients report neurological symptoms signaling that this is a big problem, and better, quicker and easier diagnoses procedures should globally be placed into effect. The sooner a patient is a diagnosed the less chance for long-term or permanent suffering and damage.

Proper testing and treating with vitamin B12 injections until other potential causes are ruled out is the best practice at this juncture. It is possible better and more efficient testing will be discovered so that less people have to live with an undiagnosed vitamin B12 deficiency.

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Serum B12 Test: Sciencey Stuff for the More Curious

dropping blood on a glass slideThe serum B12 test is the most commonly used test to confirm or rule out a vitamin B12 Deficiency. A looming issue with this test is that it cannot rule out a B12 deficiency. Even though a deficiency is present, serum B12 tests often deliver false results as either high or normal, so when diagnosing a deficiency this test should never solely be relied upon for final diagnoses.

The fault lies within the large gray area that exists. A normal serum B12 value cannot rule out a deficiency due to the presence of a large gray area where a deficiency is possible. This is because a lower value does not automatically equate into a deficiency, and a value above the normal level does not automatically rule out a deficiency.

For further scientific analysis go to the sources listed at the bottom of this article.

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