Test Detail
Overview
Interpreting Results
FAQ's
Tests Included

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Written by
Dr. Betina Chandolia
BDS, MDS - Oral Pathology and Microbiology
Reviewed by
Dr. Ashish Ranjan
MBBS, MD (Pharmacology)
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Vitamin Profile

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Vitamin Profile Test Includes 3 testsView All
Vitamin Profile
You need to provide
Blood
This test is for
Male, Female
Test Preparation
  1. No special preparation required

Overview


What is Vitamin Profile?

Vitamins and minerals are essential nutrients for human life. Unhealthy eating habits and adulteration of food can lead to depletion of these vital nutrients and limit the ability of our body to fight against infections. This profile is specially designed to test for common vitamin deficiencies, especially Vitamin D, Vitamin B12, and folic acid.


Why is Vitamin Profile done?


  1. If you have symptoms of vitamin D deficiency like bone malformation in children (rickets), bone weakness, or fractures in adults (osteomalacia)

  2. If you have risk factors for vitamin D deficiency like old age, limited sun exposure, obesity, or you have undergone gastric bypass surgery 

  3. If you have symptoms of anemia like weakness, tiredness, pale skin (deficiency of B12), or folic acid deficiency

  4. If you have symptoms or signs of nerve problems like numbness, burning in hands, feet, arms, tingling sensation which may be due to vitamin B12 deficiency


What does Vitamin Profile Measure?

For healthy living, vitamins play a very important role. However, any deficiency or increased presence of these vitamins are not good for health. The deficiency of vitamins can be due to not taking proper diet while excess can be due to excessive supplementation. 

Vitamins are classified as Water soluble and Fat-soluble vitamins.

Fat-soluble vitamins include: Vitamin A, K, D, and E

Water-soluble vitamins include Vitamin B-1 (Thiamine), B-2 (Riboflavin), B-3 (Niacin), B-5 (Pantothenic acid), B-6 (Pyridoxine), B-7 (Biotin), B-9 (Folate), B-12 (Cobalamin), and  Vitamin C. 

The most common vitamins which are found deficient include Vitamin D, Vitamin B12, and Vitamin B9. 


Vitamin D helps our body absorb calcium and phosphorus, and maintain strong bones and teeth. Vitamin D (25-OH) test measures the level of Vitamin D (25-OH) in the blood which is a useful indicator of osteoporosis (bone weakness), rickets (bone malformation), and osteomalacia.

Vitamin B12 is also called Cobalamin. It is a water-soluble vitamin. Vitamin B12 plays an important role in the formation of normal red blood cells, repair of tissues, DNA synthesis, and genetic material in cells. It is not produced in the body and has to be taken in the diet. The diet sources which includes Vitamin B12 are red meat, fish, milk, poultry, yogurt, eggs, fortified cereals, bread, and other grain products. It can also be taken in the form of Vitamin B12 tablets or multivitamin pills. Low levels of Vitamin B12 results in macrocytic anemia (size of red blood cells larger than normal).

Vitamin B9 along with Vitamin B12 and iron plays an important role in the formation of red blood cells. It plays an important role in the functioning of nerves and cell replication in the body. In pregnant ladies, it is required for proper development of fetus spinal cord. Low levels of Vitamin B9 can lead to anemia. 




Interpreting Vitamin Profile results


Interpretations


    The normal range of Vitamin B12 is 211 - 911 pg/mL irrespective of sex and age.

    High levels of Vitamin B12 may be seen in:

    • Kidney failure

    • Diabetes

    • Liver disease


    Low levels of Vitamin B12 may be seen in:

    • Anemia

    • Hyperthyroidism (high levels of thyroid)

    • Worm infection


    The normal range of vitamin D is measured as nanograms per milliliter (ng/mL) or nmol/L and can vary from lab to lab.

    Level

    Reference range (ng/mL)

    Deficiency

    <20 

    Insufficiency

    20-29

    Sufficiency

    30-100

    Toxicity

    >100


    • There can be seasonal variation in 25 (OH) vitamin D levels. The values can be 40-50% lower in winter than in summer. It is also influenced by sunlight, latitude, skin pigmentation, sunscreen use, and hepatic function.

    • 25 (OH) vitamin D levels can vary with age.

    • 25 (OH) vitamin D levels increase during pregnancy.

     The normal range of Vitamin B9 is measured as nanograms per milliliter (ng/mL) 

     

    Result in ng/mL

    Remarks

    0.35 - 0.37

    Deficient

    3.38 - 5.38

    Indeterminate

    > 5.38

    Normal

     

    • Certain medicines like methotrexate and leucovorin can cause changes in levels of Vitamin B9.

    • Methylmalonic acid in urine and serum homocysteine test is suggested to differentiate between deficiencies of Vitamin B9 and Vitamin B12.

*Reference range may vary from lab to lab

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Vitamin Profile


Frequently Asked Questions about Vitamin Profile

Q. Is there any preparation required before the test?
Inform the doctor about the medications you may be taking. No other specific preparations are usually required before this test.
Q. What does the Vitamin D test result mean?
A below normal level indicates vitamin D deficiency, it can occur in conditions such as lack of exposure to sunlight, dietary deficiency of vitamin D, liver and kidney diseases, poor food absorption in cystic fibrosis and Crohn’s disease, and in patients who have undergone gastric bypass surgery. Along with that, using certain medicines such as phenytoin, phenobarbital, and rifampin, etc. can cause vitamin D deficiency. These reduced levels of vitamin D can also be observed in infants who only feed on breast milk. Such infants can be given formula milk, as it is fortified with vitamin D. An increased level of vitamin D is called hypervitaminosis D or vitamin D toxicity. This is most commonly caused by taking too much vitamin D and can result in increased calcium levels in the body (hypercalcemia). It can also cause kidney and blood vessel damage.
Q. Who should be tested for Vitamin D?
Vitamin D 25 (OH) should be tested in individuals who are undergoing therapy to prevent or treat osteoporosis, patients having signs and symptoms of low calcium level (hypocalcemia) or high calcium level (hypercalcemia). It should also be done in patients with cystic fibrosis, Crohn’s disease, and with gastric bypass surgery, patients receiving vitamin D therapy who do not demonstrate clinical improvement. Along with that, these tests can be done in elderly people, especially those with minimal exposure to sunlight, children and adults with suspected rickets and osteomalacia, respectively, and infants who are exclusively breastfed.
Q. What are the factors which can affect the 25-OH Vitamin D levels?
There can be various factors that can affect 25-OH vitamin D levels, some of them are explained below: Seasonal variation: Ideally, all samples should be collected in one season. The reason being, there can be seasonal variation in 25 (OH) vitamin D level, with values being 40-50% lower in winter than in summer. This can affect the absorption rate of Vitamin D. Age: Older adults have a reduced level of 7-dehydrocholesterol, so they cannot synthesize 25(OH) vitamin D. Along with that, the production of active hormone (1,25 dihydroxyVitamin D3) gets reduced by their kidneys. Skin color: Melanin in the darker skin reduces the ability to produce 25(OH) Vitamin D from sunlight exposure, as it absorbs the sunlight. Body mass index/nutrition: Obese individuals (body mass index >30 kg/m2) are deficient in Vitamin D, as Vitamin D is fat-soluble. This is because it gets sequestered in the fat and not able to circulate. As a result, the rate of absorption of Vitamin D remains low in obese patients as compared to other healthy individuals. Certain medicines like phenytoin (seizure drug), phenobarbital, and rifampin, cholestyramine, orlistat, steroids, stimulant laxatives can reduce Vitamin D level. Other than these, Vitamin D can also get influenced by sunlight, latitude, sunscreen use, and hepatic function.
Q. What is osteoporosis?
Osteoporosis is a condition of fragile bones with increased susceptibility to fracture. Vitamin D and calcium deficiency are one of the leading causes of osteoporosis. Other risk factors can be genetics, lack of exercise, personal history of fracture as an adult, cigarette smoking, excessive alcohol consumption, history of rheumatoid arthritis, low body weight, and family history of osteoporosis. Usually, osteoporosis does not manifest itself until bone fractures occur. X-rays and bone mineral density test can help diagnose osteoporosis.
Q. What is osteomalacia?
Osteomalacia is softening of the bones due to demineralization (the loss of mineral) and most notably by the depletion of calcium from bone. It is a characteristic feature of vitamin D deficiency in adults. Osteomalacia can also be caused by poor dietary intake or poor absorption of calcium and other minerals needed to harden bones.
Q. What are the sources of Vitamin D?
Vitamin D is derived from endogenous sources and exogenous sources. Endogenous sources are produced in our body when our skin is exposed to sunlight. Whereas, exogenous sources can only be derived from other sources, as they are not produced in our bodies. Dietary sources of vitamin D include fish, eggs, fortified dairy products, and dietary supplements.
Q. What are the signs and symptoms of Vitamin B12 deficiency?
The signs and symptoms of Vitamin B12 deficiency include delirium (confusional states), paranoia (an unrealistic distrust of others), dizziness, diarrhea, muscle weakness, loss of appetite, and pale skin. Some may also experience fast heart rate, irregular heart beat, shortness of breath, painful tongue and mouth, tingling or numbness or burning sensation in feet, hands, arms, and legs.
Q. In what conditions there can be malabsorption of Vitamin B12 test?
Conditions like pernicious anemia (decrease in red blood cells due to deficiency of Vitamin B12), celiac disease (immune reaction to gluten), inflammatory bowel diseases (inflammation of digestive tract), and gastric bypass (surgery that removes part of the stomach) can cause malabsorption of vitamin B12 test. However, other conditions can also cause malabsorption such as overgrowth of bacteria or presence of parasites such as tapeworms in the intestines, reduction in stomach acid production (due to long-term use of antacids), and insufficiency of pancreas (inability to digest food properly).
Q. Can any medicine cause deficiency of Vitamin B12?
Yes, some medicines such as metformin, omeprazole, methotrexate or phenytoin can cause deficiency of Vitamin B12.
Q. How is the blood sample taken?
The healthcare provider takes a blood sample from the arm. The site from where the blood is to be withdrawn is cleaned with a swab of rubbing alcohol. This is then followed by inserting a small needle which has a tube attached to it for collecting blood. Once the sufficient blood for analysis is withdrawn, the needle is removed. The site is then covered with a gauze pad.
Q. Is there any risk associated with the withdrawal of blood sample procedure?
As such there is no risk but in few cases, bruising, bleeding, and infection at the puncture site can be seen. In very few cases, there can be swelling of the vein after the blood is withdrawn.
Q. Are there any other factors which can cause deficiency of Vitamin B12?
Yes, factors such as smoking, drinking heavy alcohol or chronic (from a long time) alcoholism, and pregnancy can cause a deficiency of Vitamin B12.
Q. What does low levels of Vitamin B9 indicate?
Low levels of Vitamin B9 indicate folic acid deficiency anemia, malabsorption syndromes, malnutrition, and chronic alcoholism.
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Tests Included (3 tests)


  • Vitamin B12
  • Vitamin D
  • Vitamin B 9

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