Vitamin B12 (Cobalamin) and Folate Panel, Serum Most Popular

The Vitamin B12 (Cobalamin) and Folate Panel, Serum test contains 1 test with 2 biomarkers.

Brief Description: A Vitamin B12 and Folate test, also known as a B12 and Folate assay, is a laboratory test that measures the levels of vitamin B12 and folate in the blood. It provides valuable information about the status of these essential nutrients in the body.

Also Known As: Vitamin B12 and Folate test, Cobalamin and Folic Acid Test, Vitamin B12 and Vitamin B9 Test, Vitamin B12 Test, Vitamin B9 Test, Cobalamin Test, Folic Acid Test, Folate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is Vitamin B12 and Folate panel test ordered?

A Vitamin B12 and Folate test may be ordered in the following situations:

1. Evaluation of Anemia: It is commonly ordered when a patient presents with symptoms of anemia, such as fatigue, weakness, or pale skin. Both vitamin B12 and folate deficiencies can cause certain types of anemia.

2. Nerve-related Symptoms: When a patient experiences neurological symptoms like numbness, tingling, or difficulty with coordination, a B12 and Folate test can help identify if these symptoms are related to deficiencies in these vitamins.

3. Malnutrition or Malabsorption: In individuals with a history of malnutrition or conditions that impair nutrient absorption, such as celiac disease or Crohn's disease, a B12 and Folate test can assess the levels of these vitamins.

What does a Vitamin B12 and Folate panel blood test check for?

The B complex of vitamins includes vitamins including vitamin B12 and folate. They are required for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. Both are nutrients that the body cannot make and must be obtained from the diet.

Vitamin B12 and folate tests diagnose vitamin deficiencies by measuring vitamin levels in the liquid section of the blood. The amount of folate in red blood cells is sometimes tested as well.

Folate is a naturally occurring form of the vitamin, whereas folic acid is a supplement that can be added to foods and beverages. Leafy green vegetables, dry beans and peas, citrus fruits, yeast, and liver all contain it. Vitamin B12, also known as cobalamin, can be found in animal-based foods such red meat, fish, poultry, milk, yogurt, and eggs. Fortified cereals, breads, and other grain products have become key sources of B12 and folate in recent years.

A lack of B12 or folate can cause macrocytic anemia, a condition in which red blood cells are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet counts are two more test results linked to megaloblastic anemia.

B12 is also necessary for nerve function, and a lack of it can induce neuropathy, which causes tingling and numbness in the hands and feet of those who are affected.

Folate is required for cell division, which occurs in the developing fetus. In a growing fetus, a lack of folate during early pregnancy can raise the chance of neural tube abnormalities such spina bifida.

B12 and folate deficiency is most commonly caused by not getting enough of the vitamins through diet or supplements, poor absorption, or increased requirement, as observed during pregnancy:

• Dietary deficiencies are uncommon in the United States since many meals and beverages are fortified with vitamins that the body stores. Adults normally have many years' worth of vitamin B12 and around three months' worth of folate stored in their liver. Dietary deficiencies normally do not manifest symptoms until the body's vitamin supplies have been exhausted. Vegans and their breast-fed infants can suffer from B12 deficiency.
• Inadequate absorption—the absorption of vitamin B12 is a multi-step process. B12 is normally released from food by stomach acid and then bound to intrinsic factor, a protein produced by parietal cells in the stomach, in the small intestine. After being absorbed by the small intestine and bound by carrier proteins, the B12-IF complex reaches the blood. B12 absorption is hampered if any of these processes are disrupted by a disease or condition.
• Increased demand—this can occur as a result of a range of diseases and disorders. When a woman is pregnant or nursing, in early childhood, with malignancies, or with chronic hemolytic anemias, there is an increased demand for folate.

Lab tests often ordered with a Vitamin B12 and Folate panel test:

When a Vitamin B12 and Folate Panel is ordered, it is typically part of an evaluation to diagnose or rule out causes of anemia and to assess overall nutritional status. Vitamin B12 and folate are essential vitamins for various bodily functions, including the production of red blood cells and the maintenance of the nervous system. To gain a more comprehensive understanding of a patient’s health, especially related to anemia and neurological function, several other tests are often ordered alongside this panel:

1. Complete Blood Count (CBC):

   • Purpose: The CBC provides a comprehensive evaluation of the different cells in the blood, including red blood cells, white blood cells, and platelets.
   • Why Is It Ordered: To assess for anemia (low red blood cell count or hemoglobin) and to evaluate the size and shape of red blood cells, which can be affected by B12 or folate deficiency.

2. Methylmalonic Acid (MMA):

   • Purpose: MMA levels increase when Vitamin B12 levels are low.
   • Why Is It Ordered: To confirm a diagnosis of Vitamin B12 deficiency, as MMA is a more sensitive and specific test than B12 levels alone.

3. Homocysteine:

   • Purpose: Elevated levels of homocysteine can be caused by low levels of Vitamin B12 and folate.
   • Why Is It Ordered: To help in diagnosing B12 and folate deficiencies, as well as to assess cardiovascular risk, since high homocysteine levels are associated with heart disease and stroke.

4. Liver Function Test:

   • Purpose: To assess liver health, which can impact the levels of various vitamins and nutrients.
   • Why Is It Ordered: Liver diseases can affect the metabolism and storage of B12 and folate.

5. Kidney Function Test:

   • Purpose: To evaluate kidney function.
   • Why Is It Ordered: Kidney disease can affect the overall nutritional status and the metabolism of various nutrients, including B12 and folate.

6. Iron Studies:

   • Purpose: To assess the body’s iron stores and iron-binding capacity.
   • Why Is It Ordered: To rule out or diagnose iron deficiency anemia and to distinguish it from anemia caused by B12 or folate deficiency.

7. Reticulocyte Count:

   • Purpose: To measure the number of young red blood cells in the blood.
   • Why Is It Ordered: To assess how the bone marrow is responding to anemia, particularly after treatment for vitamin deficiencies..

8. Lactate Dehydrogenase (LDH) and Bilirubin:

   • Purpose: To assess for hemolysis (breakdown of red blood cells).
   • Why Is It Ordered: To evaluate for conditions that might cause anemia in addition to B12 and folate deficiencies.

These tests, when ordered alongside a Vitamin B12 and Folate Panel, provide a holistic view of a patient’s hematological and nutritional status. They are essential in diagnosing the cause of anemia and neurological symptoms, monitoring the effectiveness of supplementation, and assessing overall health. The specific combination of tests depends on the individual's symptoms, medical history, and initial test results.

Conditions where a Vitamin B12 and Folate panel test is recommended:

A Vitamin B12 and Folate test is useful in evaluating various conditions, including:

1. Macrocytic Anemia: Vitamin B12 and folate deficiencies can lead to macrocytic anemia, where red blood cells are larger than normal. This test helps determine if the anemia is due to deficiencies in these vitamins.

2. Malnutrition or Malabsorption: Individuals with inadequate dietary intake, malnutrition, or conditions that affect nutrient absorption may require a B12 and Folate test to assess their nutritional status.

3. Neurological Disorders: Deficiencies in vitamin B12 and folate can contribute to neurological symptoms, such as peripheral neuropathy or cognitive impairments.

How does my healthcare provider use a Vitamin B12 and Folate panel test?

Healthcare providers use the results of a Vitamin B12 and Folate test to:

1. Diagnose Deficiencies: Abnormal levels of vitamin B12 and folate can indicate deficiencies, helping healthcare providers determine the appropriate treatment and management strategies.

2. Guide Treatment: In cases of deficiencies, supplementation with vitamin B12 and/or folate may be recommended to correct the deficiency and alleviate associated symptoms.

3. Monitor Response to Treatment: If an individual is receiving vitamin B12 or folate supplementation, periodic testing can assess the effectiveness of treatment and guide adjustments if necessary.

Remember, the interpretation of test results and subsequent medical decisions should always be made by qualified healthcare professionals in consideration of the patient's overall clinical picture.

What do my Vitamin B12 and Folate test results mean?

Normal B12 and folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms are caused by something else. Normal levels, on the other hand, may indicate that a person's stored B12 and/or folate has not yet been depleted.

A health practitioner may request a methylmalonic acid test as an early sign of B12 insufficiency if a B12 level is normal but a deficiency is still suspected.

A low B12 and/or folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low B12 or folate levels can be caused by a variety of factors, including:

Dietary folate or B12 deficiency is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products.

Both B12 and folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following:

• Pernicious anemia.
• Celiac disease
• Crohn's disease and ulcerative colitis
• Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms
• Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production.
• Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass.
• Insufficiency of the pancreas
• Chronic alcoholism or heavy drinking
• Some treatments, such as omeprazole, metformin, methotrexate, and/or anti-seizure medications like phenytoin.
• Increased requirement for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. People who have cancer that has spread or who have chronic hemolytic anemia require more folate.
• Smoking

If a person is taking supplements to treat a B12 or folate deficiency, normal or higher findings indicate that the treatment is working.

High amounts of B12 are uncommon, and they aren't routinely evaluated clinically. If a person has a condition such chronic myeloproliferative neoplasm, diabetes, heart failure, obesity, AIDS, or severe liver disease, their vitamin B12 level may be elevated. High B12 levels can also be caused by using estrogens, vitamin C, or vitamin A.

Most Common Questions About the Vitamin B12 and Folate Panel test:

Understanding the Test

What is a Vitamin B12 and Folate Panel test?

A Vitamin B12 and Folate Panel test is a blood test that measures the levels of vitamin B12 and folate (vitamin B9) in your blood. These vitamins play a crucial role in brain function, the production of DNA and red blood cells, and the overall health of your nervous system.

Why is a Vitamin B12 and Folate Panel test done?

A Vitamin B12 and Folate Panel test is typically done to diagnose or rule out a deficiency in these vitamins, which could lead to conditions like megaloblastic anemia. It can also help to determine the cause of symptoms like weakness, fatigue, loss of appetite, weight loss, and more.

Interpreting the Results

What do the results of a Vitamin B12 and Folate Panel test mean?

The results of this test provide a snapshot of the levels of vitamin B12 and folate in your blood. Lower-than-normal levels might indicate a deficiency that could be due to inadequate intake, absorption issues, or certain medical conditions. High levels might suggest supplementation or an inability to metabolize these vitamins.

How are the results of a Vitamin B12 and Folate Panel test presented?

Results of the test are presented in nanograms per milliliter (ng/mL) for vitamin B12 and nanograms per deciliter (ng/dL) for folate. The typical reference ranges are 200-900 ng/mL for vitamin B12 and >3 ng/mL for folate, but ranges can vary by lab.

Understanding the Implications

What conditions can cause abnormal Vitamin B12 and Folate Panel test results?

A variety of conditions can cause abnormal results, including dietary deficiency, pernicious anemia, malabsorption syndromes, celiac disease, Crohn's disease, certain medications, alcoholism, and overconsumption of these vitamins from supplements.

What are the implications of abnormal Vitamin B12 and Folate Panel test results?

Abnormal results could indicate a deficiency or excess of these vitamins. Both situations could lead to health issues. For instance, a deficiency can cause anemia and neurological problems, while excess levels (especially of folate) can hide a B12 deficiency.

Risks and Precautions

What can cause a low Vitamin B12 level on a Vitamin B12 and Folate Panel test?

Possible causes include inadequate dietary intake (common in vegans), malabsorption (as in celiac disease or after gastric surgery), pernicious anemia, certain medications, and overconsumption of alcohol.

What can cause a high folate level on a Vitamin B12 and Folate Panel test?

High folate levels are usually due to excessive dietary supplementation. However, it's also seen in certain medical conditions like leukemia and liver disease.

Dealing with Abnormal Results

What steps should be taken if the Vitamin B12 and Folate Panel test results are abnormal?

If your results are abnormal, further evaluation might be needed to determine the cause. This could include additional laboratory tests, a review of your diet and medications, or possibly a referral to a specialist.

Interpreting the Test Results

What is considered a "normal" range for Vitamin B12 and folate?

Normal ranges can vary slightly by lab, but generally:

Vitamin B12: 200-900 ng/mL

Folate: >3 ng/mL Lower or higher values may be considered abnormal, but interpretation should always be in the context of individual health status and symptoms.

How can I interpret my Vitamin B12 and Folate Panel test results?

Interpreting your results should be done with your healthcare provider, who can consider the context of your overall health, symptoms, and other lab results. Generally, levels outside of the normal range may indicate a deficiency or excess.

Understanding the Importance of the Test

Why is a Vitamin B12 and Folate Panel test important in pregnancy?

Folate is particularly important in early pregnancy to prevent neural tube defects in the developing fetus. Women of childbearing age, and especially those planning a pregnancy or in early pregnancy, are often advised to take a folic acid supplement. A Vitamin B12 and Folate Panel test can ensure adequate levels.

Discussion with Healthcare Provider

What should I discuss with my healthcare provider after receiving the Vitamin B12 and Folate Panel test results?

Discuss any abnormalities, potential causes, what further testing might be needed, and whether changes to your diet, medications, or supplements are recommended.

Relationship with Other Tests

Why might a healthcare provider order a Vitamin B12 and Folate Panel test with a Complete Blood Count (CBC)?

A CBC can help identify signs of anemia, which can be caused by a deficiency in vitamin B12 or folate. If anemia is detected, a Vitamin B12 and Folate Panel test can help determine if a deficiency in these vitamins is the cause.

Understanding the Test Components

What role does Vitamin B12 play in the body?

Vitamin B12 is essential for proper brain function, the formation of red blood cells, and the synthesis of DNA. It also plays a role in the health of nerve cells and the production of energy from proteins and fats.

What role does folate play in the body?

Folate is crucial for the creation of DNA and other genetic material. It's also necessary for the body's cells to divide and for the proper development of the neural tube in a fetus.

Beyond the Test

Can a Vitamin B12 and Folate Panel test detect anemia?

The test itself can't detect anemia, but it can help identify whether a deficiency in these vitamins might be causing anemia. A separate test, such as a CBC, would be needed to diagnose anemia.

What are some common symptoms of Vitamin B12 and folate deficiency?

Symptoms may include fatigue, weakness, pallor, loss of appetite, weight loss, constipation, numbness or tingling in the hands and feet, balance problems, confusion, poor memory, and mood changes.

Comparison with Other Tests

How does a Vitamin B12 and Folate Panel test compare with a serum homocysteine test?

High levels of homocysteine can be a result of vitamin B12 or folate deficiency, as these vitamins help break down homocysteine in the body. The tests are complementary and can both help determine if a vitamin deficiency is present.

Potential Next Steps

What might be the next steps if a Vitamin B12 and Folate Panel test shows a deficiency?

If a deficiency is detected, treatment could include dietary changes, oral supplements, or in severe cases, injections of vitamin B12. Follow-up testing would likely be needed to ensure the deficiency is corrected.

What might be the next steps if a Vitamin B12 and Folate Panel test shows high levels?

High levels might suggest over-supplementation or an inability to utilize these vitamins. Further investigation would be needed to determine the cause and appropriate intervention.

Additional Information

How often should a Vitamin B12 and Folate Panel test be done?

The frequency of this test depends on individual health status, risk factors for deficiency, and whether you're being monitored for response to treatment. Your healthcare provider can provide personalized advice.

Can a Vitamin B12 and Folate Panel test indicate malabsorption issues?

Yes, low levels of these vitamins can indicate a malabsorption issue, as they could suggest the body isn't properly absorbing nutrients from the diet.

How can I increase my vitamin B12 and folate levels naturally?

Increasing your intake of foods rich in these vitamins can help. Good sources of B12 include animal products like meat, poultry, fish, and dairy, while folate is found in leafy green vegetables, fruits, nuts, beans, and fortified grains.

What are the risks of having too much vitamin B12 or folate in my body?

Excessive levels of these vitamins are generally not harmful because they are water-soluble and excess is excreted in urine. However, high folate can hide a B12 deficiency, which can lead to nerve damage.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.