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Is Vitamin B12 Level Of 250 A Cause For Concern?
Question: I have been taking Prevacid for about 4 years. For about last two have been having balance issues. a recent blood test revealed a b-12 reading of 250, which is considered low normal. The neurologist placed me on B-12 oral vitamins. Have stopped taking the Prevacid because of the low reading, while I am still undergoing additional MRI scans. Doctor at this point is suspecting either cervical stenosis or neuropathy due to to numbness, tingling, balance, etc.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your symptoms vitamin B12 deficiency related neuropathy is among the list of possibilities, it can manifest both the abnormal sensations as well as the balance issues. The values you mention are inside the norm though, so not enough to make a diagnosis. However since at times levels can result low normal even in the presence of a deficiency some more tests are usually required to evidence deficiency, testing about metabolites such as methylmalonic acid (MMA) and homocysteine (HC). If those result in normal range actually vitamin B12 deficiency is ruled out.
Among other tests MRI of the spine (and depending on other test results of the brain as well), is of course necessary as it will confirm or rule out cervical stenosis, but apart from it I wonder if nerve conduction studies have been done or scheduled, they are the exam of choice for peripheral nerve damage.
So more tests and test results are needed for the diagnosis for the moment.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your symptoms vitamin B12 deficiency related neuropathy is among the list of possibilities, it can manifest both the abnormal sensations as well as the balance issues. The values you mention are inside the norm though, so not enough to make a diagnosis. However since at times levels can result low normal even in the presence of a deficiency some more tests are usually required to evidence deficiency, testing about metabolites such as methylmalonic acid (MMA) and homocysteine (HC). If those result in normal range actually vitamin B12 deficiency is ruled out.
Among other tests MRI of the spine (and depending on other test results of the brain as well), is of course necessary as it will confirm or rule out cervical stenosis, but apart from it I wonder if nerve conduction studies have been done or scheduled, they are the exam of choice for peripheral nerve damage.
So more tests and test results are needed for the diagnosis for the moment.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Would you venture to recommend another medication that could be used in the place of the Prevacid?
Brief Answer:
Read below.
Detailed Answer:
Well trouble is that other medication would work in a similar way whether belonging to the same class, or to other class such as histamine H2 receptor antagonists. They inhibit acid secretion and that may lead to non absorption of Vitamin B12. However that deficiency should be proven first, millions of people take these drugs without developing a deficiency, up to now your deficiency is only an assumption, that is why I suggested the MMA and HC tests.
Anyway if you have been taking Prevacid for peptic ulcer disease then an alternative may be cytoprotective agents like sucralfate and misoprostol which act by protecting the gastric lining and not directly inhibiting acid secretion. If you are taking it for reflux disease though then I don't think they are of much benefit.
Read below.
Detailed Answer:
Well trouble is that other medication would work in a similar way whether belonging to the same class, or to other class such as histamine H2 receptor antagonists. They inhibit acid secretion and that may lead to non absorption of Vitamin B12. However that deficiency should be proven first, millions of people take these drugs without developing a deficiency, up to now your deficiency is only an assumption, that is why I suggested the MMA and HC tests.
Anyway if you have been taking Prevacid for peptic ulcer disease then an alternative may be cytoprotective agents like sucralfate and misoprostol which act by protecting the gastric lining and not directly inhibiting acid secretion. If you are taking it for reflux disease though then I don't think they are of much benefit.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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