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Dr. Andrew Rynne

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What does this Vitamin B 12 value of 925 indicate?

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Dr. Archana Verma

Pediatrician

Practicing since :2006

Answered : 1129 Questions

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Posted on Wed, 21 Oct 2015 in Child Health
Question: I'm worried about a vitamin B12 level of 925 pmol/L - although the pathologist didn't make any comments other than to label it as high - pls can you provide some information, thanks
doctor
Answered by Dr. Archana Verma 48 minutes later
Brief Answer:
Do not worry

Detailed Answer:
Hi
Welcome to the HCM

I completely understand your concerns but don't worry. Your child's B 12 levels although on the higher range are still considered not very abnormal as it is affected greatly by food intake, bowel functions and vitamin supplements. It will not cause any harm to him.


Sometimes, the cause may be pathological such as:
-Liver disease (such as cirrhosis or hepatitis)
-Myeloproliferative disorders (for example, polycythemia vera and chronic myelocytic leukemia)

So, if your child is asymptomatic, then restrict his oral intake of vitamin B 12 for a few days to minimal. Meat, organ meat, fish, seafood, dairy and eggs are rich sources of vitamin B12.
Treat any associated constipation if present by stool softener such as Lactulose.

Thereafter you may recheck ( after 2 weeks) the levels along with a complete blood count and liver function test. This will rule out the pathological causes.

Hopefully this will help you. I would be happy to help you in any further questions.
Take care
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Archana Verma 15 minutes later
thank you Doctor...just to make sure the levels were H925 pmol/L not pg measurement - not sure if that changes your view...he is typically quite constipated - just wanted to clarify if you thought that constipation could cause higher than normal B12 levels and he also takes a milk supplement drink a few times a day for poor eating habits and a lot of fish fingers....
doctor
Answered by Dr. Archana Verma 9 minutes later
Brief Answer:
Constipation and fish both can increase levels

Detailed Answer:
Hi

Don't worry, these levels are not very alarming at all. Normal levels range up to 900-950 mmol/l in some kids.

Constipation can lead to overgrowth of gut flora. This can be the likely reason along with increased oral intake (fish) for the B12 levels in your child.

So, just treat constipation with plenty of fluids, fibre rich diet and stool softener such as lactulose. Also, try to make his diet more balanced in terms of carbohydrates, proteins, fats, vitamins and minerals.

Hopefully this will help you.
Take care
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Archana Verma 20 minutes later
Hi Dr XXXXXXX

thank you for your reply - on googling high vitamin B12 levels it seemed to point to terrible kidney, liver and leukemia diseases - I was also worried as I took him for the tests for fatigue which I know you get from blood cancers...his ferritin is low at 18 and he is likely celiac so perhaps that is why he gets tired - I just checked the serology results and at the same time they tested for the B12 they did a full blood count which the pathologist has noted 'full blood count is within reference limits' - his biochemistry was all within normal limits except for albumin being slightly over at H50 (normal 37-48) - I was also worried that the unit measurement used of pmol/L vs mmol/L or pgmol/L might mean the results were scaringly high.
doctor
Answered by Dr. Archana Verma 6 hours later
Brief Answer:
I completely understand your concerns

Detailed Answer:
Hi XXXXXXX

I understand your concerns but don't worry. Reports help us to reach diagnosis and required treatment. But any reports should be related to clinical picture before getting into any conclusions.

The reason for your child's tiredness seems to be due to iron deficiency. So, supplementing his diet with iron rich foods and supplements is to be continued.

Also, rule out any thyroid function abnormalities which are commonly associated with celiac disease.

Follow the measures I advised earlier for B12 levels and please don't worry.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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