Many health conditions can hinder the absorption of vitamin B-12 in the gastrointestinal tract, leading to low levels. Vitamin B-12 plays an important role in neurological function, metabolism and red blood cell formation. Vitamin B-12 deficiency can cause serious symptoms and, in severe cases, permanent nervous system and neurological damage. Consult your doctor for B-12 tests if you suspect you have vitamin B-12 deficiency.
Signs of B-12 Deficiency
Your doctor may perform a B-12 blood test if you show symptoms of vitamin B-12 deficiency. Common symptoms of megaloblastic anemia caused by vitamin B-12 deficiency include general weakness and fatigue, loss of appetite, constipation, weight loss, difficulty concentrating and sore tongue. Diagnosing and treating vitamin B-12 deficiency early can help prevent permanent damage to neurological and nervous system functions. Untreated B-12 deficiency can cause numbness and tingling in hands and feet, confusion, memory loss and dementia.
Testing B-12 Levels
To test vitamin B-12 levels, doctors typically draw blood from a vein at the inside of the elbow or the back of the hand after cleaning the site with antiseptic, according to MedlinePlus Medical Encyclopedia. Patients should avoid eating or drinking for 6 to 8 hours prior to the test. Vitamin B-12 test results measure B-12 levels in picograms per milliliter. B-12 levels between 200 and 900 pg/mL are normal in healthy adults, while levels below 200 pg/mL may indicate a deficiency, according to MedlinePlus Medical Encyclopedia. In older adults, B-12 levels below 500 pg/mL may indicate a deficiency.
Schilling Test
If a B-12 blood test determines that you have low levels of vitamin B-12, your doctor may perform a Schilling test to determine the cause of the deficiency. The test involves four stages. After each stage, a urine sample can show whether you have absorbed vitamin B-12 normally. In the first stage, the doctor provides an oral vitamin B-12 dose and a B-12 injection. If urine test results from this stage are abnormal, the doctor will continue to the following stages to determine whether a lack of intrinsic factor, abnormal bacteria growth or problems in the pancreas are causing the B-12 deficiency.
Treatment
Treatment for vitamin B-12 deficiency varies according to the deficiency's underlying cause. Oral B-12 supplements can treat deficiencies caused by inadequate intake due to vegetarianism, veganism or poor diet. Oral supplements can also treat deficiencies caused by low levels of hydrochloric acid in individuals with atrophic gastritis. Individuals with pernicious anemia, Crohn's disease or celiac disease may need treatment with intramuscular B-12 injections that can bypass absorption problems.
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