Unexpected High Vitamin B12 Levels: Seeking Answers
At 40 years old, weighing 167 lbs and standing 5’4”, my current medication regimen includes Vyvanse, trazodone, vilazodone, metformin, and lithium. Lately, I've been grappling with intense fatigue and exhaustion; it feels as if my mind craves sleep continuously. Every morning, I notice strange white patches on my tongue, particularly at the areas that touch my teeth. My muscle strength has diminished so greatly that I often struggle to carry my laptop, lunch, and purse simultaneously. This overwhelming brain fog, coupled with memory lapses and an almost irresistible urge to sleep, has severely impacted my professional life. I underwent a blood test yesterday, and the findings were quite unexpected for both me and my healthcare provider. My folate levels exceeded 20.0, while my B12 levels soared above 2000. Additionally, my vitamin D levels measured at 34.8. I mention vitamin D because for the last twelve years, I have dealt with some level of fatigue; despite taking supplements, my vitamin D was persistently on the lower side, usually just above the 30 mark. This recent measurement is the highest it has ever been. Among other readings, my MCH is at 32.1, RDW is 12.0, MCV is 94, bilirubin stands at 0.3, serum creatinine is 0.92, and RBC is 4.20. Interestingly, while my LDL cholesterol measured 117 despite healthier eating habits, my VLDL is only 10. My TSH is at 3.75, which has fluctuated between 1.5 and 3.75 over the past twelve years, though I believe this variation is typical. Most of my other results fell comfortably within the standard range; those mentioned seem to deviate significantly. I do not take folate supplements and have only intermittently used B12 supplements in the past. Now, I find myself at a perplexing crossroads, feeling as if I am back to the beginning. I cannot comprehend the reason behind such elevated B12 levels when I have not engaged in any behaviors that would explain them. What could these results possibly signify?
Answers (1)
3/19/2025, 4:10:44 PM
OpenHealth AI
It sounds like you're going through a challenging time with several complex symptoms and unexpected lab results. High vitamin B12 levels, combined with the fatigue, white patches on your tongue, and cognitive difficulties, can be concerning, and it’s understandable to seek clarity.
Summary of Key Points:
- Elevated Vitamin B12 Levels: Extremely high levels can be due to several factors including supplementation, liver disease, or specific medical conditions.
- Fatigue and Other Symptoms: Your fatigue, cognitive issues, and the appearance of white patches on your tongue could suggest other underlying conditions.
- Next Steps: Prioritize tracking your symptoms and managing your current fatigue with self-care strategies while seeking further clarification on your lab results.
Explanation:
Vitamin B12 Levels: While B12 is essential for energy and neurological function, levels above 2000 pg/mL can be unusual and potentially indicate issues unrelated to dietary intake. These can include liver disease, certain types of anemia, or myeloproliferative disorders (conditions involving the blood). It's worth noting that high B12 levels can sometimes appear in response to underlying health issues rather than over-supplementation.
Symptoms: The fatigue and brain fog you describe are significant concerns that may relate to your vitamin D levels, potential thyroid irregularities (considering your fluctuating TSH levels), or other factors including possible medication side effects. The white patches on your tongue could suggest a fungal infection known as oral thrush or irritation, which might warrant further examination.
Actionable Steps:
- Symptom Diary: Start keeping a detailed diary of your symptoms, noting when they occur, their severity, and any potential triggers. This will help to identify patterns and assist your healthcare provider in making a more informed assessment.
- Focus on Hydration and Rest: Ensure you're drinking enough water and prioritize sleep. Fatigue can feel overwhelming, so allow yourself restorative time.
- Monitor Medications and Effects: Since you're taking several medications, consider discussing with your healthcare provider if any might contribute to your fatigue or how they may interact with each other.
- Request Follow-Up Tests: Consider asking for additional tests focused on liver function, a complete blood count, and tests for any potential autoimmune conditions or infections related to the tongue patches.
- Review Diet and Supplement Intake: Although you've indicated limited use of B12 supplements, consider a balanced diet rich in varied nutrients. Discuss with a healthcare provider whether you should continue or adjust your vitamin D supplementation, given your levels.
Engaging with your healthcare provider about these findings and symptoms, based on your organized information, will be crucial for finding answers and solutions. Let me know if you have further questions or need more specific guidance!
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