Uncertainty Surrounding B12 Levels
I’m a 26-year-old female, standing at 5'4" and weighing 109 pounds, living in the UK. For the past few years, I've been experiencing peculiar symptoms in my feet that resemble nerve pain. The sensations include a profound itchiness that scratching fails to alleviate. Interestingly, these feelings tend to improve when exposed to cold, worsen with heat, feel better when subjected to deep pressure, but become more intense with light touches. They tend to be particularly troublesome at night. Despite being aware of my symptoms for quite some time, I often delay visiting a doctor about my health concerns. However, the discomfort eventually became so severe that I felt compelled to seek medical advice. During my consultation, the doctor conducted a series of blood tests, which included measuring my Vitamin B12 levels. I was informed that the reading was 114 ng/l. Until recently, this level would have been classified as abnormal, given that the previous reference range was set between 180 and 999 ng/l. Yet, only six months prior, the lab revised their reference range to a lower threshold between 65 and 750 ng/l, thus categorizing my level as normal. This change raised my skepticism, prompting me to ask about it. However, two different general practitioners assured me that my results are perfectly acceptable. One suggested I consider taking oral B12 supplements for peace of mind, while the other advised against it altogether. Furthermore, the first doctor implied that my concerns were unreasonable, even making me feel guilty for conducting my own research. I'm left feeling perplexed. I cannot wrap my head around the justification for the lower limit of 65 ng/l, especially since it contradicts nearly everything I’ve found online, including the NHS's NICE guidelines. I wondered if the test was for active B12, but the report simply labeled it as "serum vitamin B12," and the upper limit of 750 seems to cast doubt on that. I’m seeking clarity here; should I pursue this matter further or am I missing something significant in all of this?
Answers (1)
3/29/2025, 7:00:57 PM
OpenHealth AI
It sounds like you're dealing with quite a complex situation regarding your vitamin B12 levels and the associated symptoms you've been experiencing. Here are the main points regarding your concerns:
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Vitamin B12 Levels: Your vitamin B12 level of 114 ng/l is on the lower end of current reference ranges, but there is still debate about what constitutes an optimal level for everyone, especially given your symptoms.
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Symptoms: The peculiar sensations in your feet, characterized by itchiness and changes with temperature and pressure, can be associated with neurological issues, which sometimes link to low B12.
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Advice from Doctors: It's understandable that conflicting advice from healthcare professionals can create uncertainty. It's important to trust your instincts about your health while also considering their expertise.
Explanation:
Vitamin B12 is essential for nerve function, and low levels can lead to neurological symptoms. Although recent changes in lab reference ranges might categorize your levels as "normal," some healthcare providers and researchers argue that optimal levels for health may be higher. Symptoms like the ones you described could indicate a deficiency, even if your blood test results fall within the revised normal range.
Healthcare guidelines vary, and it’s essential to balance the information you receive from medical professionals with your own experience and research.
Next Steps:
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Consider a Supplement: Given your symptoms and the ongoing uncertainty, it might be beneficial to start taking a vitamin B12 supplement. This can help if your symptoms are related to low B12 levels. A common oral dosage is between 500-1000 micrograms daily; however, it would be best for you to start at a lower dose and adjust based on how you feel.
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Track Symptoms: Keep a detailed diary of your symptoms, noting their frequency, intensity, and any changes with different activities (like temperature exposure). This information can be helpful for further discussions with your healthcare provider.
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Seek a Second Opinion: If the discomfort continues or worsens, consider seeking a second opinion from another healthcare professional, possibly a neurologist or a specialist in nutrition. They may provide clarity on your test results and guide you more effectively on managing your symptoms.
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Stay Informed: Continue researching and gathering information from reliable sources, such as the NHS or reputable medical journals, to understand more about vitamin B12 and its effects.
Your health is paramount, and you're doing the right thing by actively seeking answers. If you feel your symptoms significantly interfere with your quality of life, don't hesitate to pursue further medical evaluation.
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