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Very Low B12 levels, taken B12 shots and supplements, no result.Cause?

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my wife is only 40 years old....her B12 levels are extremely low. She has been getting B12 shots twice a week and taking B12 supplementation for 8 weeks. Yesterday she had her levels checked again and she is at 121pg/ml. The Dr. isn't sure why the levels aren't higher...her previous levels were 114 pg/ml. What can we check? What else could be causing this and a low intrinsic factor?
Posted Sun, 15 Apr 2012 in Vitamins
Answered by Dr. Rakhi Tayal 1 hour later
Thanks for posting your query.
When the B12 therapy is started, for some initial weeks, the body stores are repleted and the serum levels might not show an increase initially. Waiting for 3-4 weeks more might show a considerable improvement.
Serum Homocysteine and Methylmalonic acid levels are considered more reliable indicators of B12 deficiency and its recovery than the concentration of B12 in blood. The levels of these substances are high in B12 deficiency and can be helpful in situations like yours.
Routine monitoring of methylmalonic acid levels in urine is an option for people like you, as a rise in methylmalonic acid levels may be an early indication of deficiency. The decrease in its levels will indicate recovery.
Hope this answers your query.I will be glad to answer the follow up queries that you have.
Wishing you good health.

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