What Can I Expect From B12 Testing? Part 2
B12 deficiency can play a significant role in neurological health.In the face of refractory or chronic Migraine it is often prudent to be sure the patient's B12 status is sufficient and that B12 deficiency is neither a comorbid condition nor a trigger for Migraine attacks.
What do my results mean?
Blood work will be *flagged* as low or high if results outside of the normal parameters are found. In the case of B12 deficiency it is important to recognize that damaging B12 deficiency begins well before the stage at which these flags will be noted and your physician made aware of the problem. This is one reason why it is very important to ask for and keep paper copies of all your lab work and imaging studies, as you may catch abnormalities your doctor and office staff may miss or not be aware of. This includes results garnered over time which will indicate patterns, or trends that may signal a problem.
Vitamin B12, Serum
. In the US B12 levels are not flagged as abnormal until deficiency is severe and probably long-standing. For neurological health, neurologists recommend levels no lower than 400. B12 is currently considered non-toxic and many physicians encourage patients to maintain a level around 1000 pg/ml. However, current normal range is considered approximately: Age 4-8 250-1205 pg/ml. Age 9-16 260-935 pg/ml. Age 17 and up 200-1100 pg/ml.
Homocysteine (nutritional and congenital)
. B12 is required for the metabolism of homocysteine and is an early indicator of B12 and/or folic acid deficiency. Elevated homocysteine levels are found in patients with increased risk for coronary heart disease and stroke. Research has shown that a greater percentage of Migraineurs than non-Migraineurs tend to have elevated levels of homocysteine. Normal range is approximately 5.4-11.9 umol/L
Methylmalonic Acid GC/MS/MS.
Because MMA requires B12 to be metabolized, it is an early indicator of B12 deficiency and may show elevations long before B12 levels have fallen. This test is used in concert with homocysteine to give the overall impression of B12 status. Normal range is approximately 87-318 nmol/L
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