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Vitamin B12
Test Results & Interpretations
Patient Concerns

Overview of Vitamin B12

Test Description

A vitamin B 12 test is ordered when you have an abnormal complete blood count (CBC) with a blood smear showing large red blood cells (macrocytosis) or abnormal (hypersegmented) neutrophils; when you have symptoms of anemia (weakness, tiredness, pale skin) and/or of neuropathy (tingling or itching sensations, eye twitching, memory loss, altered mental status); when you are being treated for vitamin B12 or folate deficiency.

Why Get Tested

  1. If you have symptoms of anemia like weakness, tiredness, pale skin 
  2. If you have an abnormal complete blood count and your blood smear shows large red blood cells or neutrophils with more than 5 lobes 
  3. If you have symptoms or signs of nerve problems like numbness, burning in hands, feet, arms or tingling sensation 
  4. If you are being treated with vitamin B12 or folate therapy


  • Do not eat or drink anything except water at least 9 to 12 hours before the test.

What Results of Vitamin B12 mean?


Low levels indicate Vitamin B12 deficiency. 

Causes of vitamin B12 deficiency include:
a.Vegetarian diet
b.Improper absorption from intestine (malabsorption)
c.Lack of intrinsic factor (Pernicious anemia)
d.Rarely hyperthyroidism

Very rarely, levels of vitamin B12 can be increased. Various causes may be:
a.Liver disease
b.Myeloproliferative disorders like chronic myeloid leukemia

Patient Concerns about Vitamin B12

Frequently Asked Questions

Q. Should everyone have vitamin B12 or folate tests done routinely?
These tests are usually not necessary if you do not have symptoms associated with deficiency like a complete blood count with blood smear showing large red cells or neutrophils with more than 5 lobes.

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