As a statement made by one of the leaders in vitamin B12 field more than 10 years ago, Carmels idea of cobalamin deficiency should not be diagnosed unless megaloblastic changes are found is still followed by many physicians and health authorities when accepting B12 deficiency diagnosis.1 But as time goes by, evidence and clinical cases showed that B12 deficiency symptoms can be seen even when B12 level in blood is within the reference range, as 200 900 pg/mL in the United States,2 and 135-650 pmol/L in Australia.3 In clinical practice, signs and symptoms of B12 deficiency start when plasma B12 levels are normal, and long historical studies showed that neurological symptoms of deficiency occur in patients without sign of anaemia
At La Vie Clinic, new patients often ask similar things when starting B12 therapy
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Recent B12 blood test results
B12 reduces pro-inflammatory cytokines and oxidative stress in nerve cells (Yang et al., 2021)
Cobasorb test (the patient is given a small dose of oral B12 and then tested to see if it increases the B12 in their blood) 4 d