Can someone help me understand my B12 results?

hello

i received my complete lab results back.

Vitamins A, E, and K were in normal range.

As was B12..normal range indicted is 211-911. Mine is 514.

What is high is the RBC Folate(red blood count folate). Normal range 280.0- 791.0. My reading was 850.1.

I was told to increase B12 1000ml shot from one time per month to 2 times per month.

What I am confused about is if I am absorbing the B12 or not?

My other question is, if I am absorbing the fat vitamins what would cause me not to absorb the B 12 appropriately? Could this be indicative of intestinal bacterial over growth?

im so confused by this...

and yes I am contacting my doctor..

thanks for your response

I can't totally answer your question, except to say B-12 is one of the vitamins  they watch for malabsorption when you have RNY. Many people including myself feel better when their B-12 is at the high end of normal, or even over 'normal'.... When mine was in the 400's I was having symptoms of B-12 deficiency, even though technically I should have been OK.

Normally, absorbing vitamin B12 requires intrinsic factor produced in the stomach. RNY, VSG and DS produce very little intrinsic factor, because of the removal of part of the stomach or bypassing it, and no longer absorb B12 through food OR regular multivitamins or B12 tablets. We need either injections or sublingual B12. Yours isn't bad, but B12 can drop very quickly. This is likely why they want yours in the upper part of the range. I'd want mine higher than 500 as well.

Non WLS people can also lack intrinsic factor, and don't absorb B12 from food. Before vitamins were well understood, the condition was called pernicious anemia, and caused permanent nerve damage and even death. It's incredibly easy to treat with the right vitamin now, but not 100 years ago.

I have no idea what exactly you are taking for upplements. Folic acid, or folate, is also known as vitamin B9. Some programs have people on extra B complex vitamins, so that might be why you're high. It's not so high that I'd worry about it, but you don't want it to keep climbing, either.

Thanks Grim,

You are a wealth of information as usual.

Believe this or not, but I was prescribed Carafate and Prilosec in the ER for severe heartburn and stomach upset. No dx of ulcer though. Previously diagnosed with gastritis. At any rate, my NUT and PCP advised that these products can inhibit our vitamins from properly absorbing. If this is true why wasn't I informed of this prior to taking? Took these for 21 days faithfully not even knowing the cross connection between those and vitamins ...did myself a true disservice. Have you heard of this interaction before?

I'm not sure that Prilosec interferes with vitamins, but Carafate does. Csrafate works by coating your stomach and intestines, protecting it and allowing it to heal if it needs to. In doing so,,it keeps the receptors from absorbing some of your vitamins.

Vitamins are absorbed in different places in your digestive tract. Some primarily at the beginning, others further down. Carafate will interfere more with those absorbed higher up than further down.

Many are on Prilosec or other PPIs long term, but Carafate is usually temporary. Not taking vitamins for a few weeks is not a huge deal unless you are dangerously low to begin with. The numbers you shared are fine, so I wouldn't worry. For the short term, taking Carafate is more important than vitamins.

You won't absorb B12 that you eat because you don't have enough intrinsic factor in your pouch.

You are absorbing B12 from the shot, but one shot a month isn't enough.

Your B12 is low.  Below 550, people start getting symptoms like fatigue and depression and poor short term memory.

Thanks Poet....

I have started a "mega blast" dose of b12 shots. 

8 days of 1000 ml then a shot a week for a month, moving to monthly injections.