Reasons behind the Deficiency State
Experts who specialize in the diagnosis and treatment of B12 deficiency suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL.
Experts suggest that B12 deficiency could be missed for two reasons:
- No routine tests are conducted by most physicians.
- The low end of the laboratory reference range is too low
They suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL.
They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).
The normal serum B12 levels considered in Indians is between 350 to 900 pg/ml. Levels between 220 to 350 pg/ml are considered borderline deficient.
An eight-year-long India based survey and research study conducted by the Pune-based King Edward Memorial Hospital and Research Centre in collaboration with the Medical Research Council, Southampton (UK) revealed that 81% of urban middle class men in Pune were vitamin B12 deficient. Research clearly indicates that people with depression respond better if they have high levels of vitamin B12 in their blood. Neurologist Sudhir Kothari says that a dose of vitamin B12 supplements or injectables can brighten up the lives of those with the blues. Vitamin B12, along with other vitamins, plays a major role in the production of certain neurotransmitters which are important in the regulation of mood and other brain functions.
It is also established that Vitamin D is instrumental in maintaining high levels of B12. Low level of vitamin D coexists with calcium and vitamin B12 deficiency.
