Vitamin B12 in the blood is the norm of the indicator in the analysis of the biological role of

University Medical Center, Dallas, Texas, USA. Vitamin b12 deficiency manifests itself in the form of megaloblastic anemia, and is also accompanied by depression (

With age, the level of vitamin b12 (methylcobalamin – a type of vitamin b12) in the brain decreases and there may be a deficiency of total vitamin b12 in the brain due to a decrease in methylcobalamin, even if it is within the generally accepted reference values ​​(see picture on the left). Researchers at the Harvard School of Medicine in 2016 showed that various types of cobalamin (Cbl), vitamin b12, are located in the frontal lobes of the brain.

The level of methylcobalamin (MeCbl) in brain cells in 61-80 year olds was 12,4 times lower than in people aged 0-20 years and 6,7 times lower than in people aged 40 to 60 years. Then, as of all types of vitamin b12 (of all cobalamins), at a young age, methylcobalamin (MeCbl) is predominant.

At the same time, the level of Hydrocobalamin (OHCbl) increased with age due to the fact that a lower level of Glutathione (GSH) does not allow conversion of Hydrocobalamin (OHCbl) to Glutathionylcobalamin (GSCbl), and as a result, the most important Methylcobalamin (MeCbl). And this despite the fact that the level of total vitamin b12 in the blood could be quite high.

The study measured the levels of five types of vitamin b12 (Cbl) in the posthumous human frontal cortex of 43 patients. Among the patients were people aged 19 weeks of fetal development to 80 years. Among them were both healthy people and people with autism (12 people), schizophrenia (9 people). The form of vitamin b12 methylcobalamin (MeCbl) in the brain in 60 year olds was 10 times lower than in newborns.

As this study showed, the levels of Methylcobalamin (MeCbl) and Adenosylcobalamin (AdoCbl) were more than 3 times lower in patients with autism than in their peers, which corresponded to the level of healthy people at 50 years old. In autists, a lower level of Methylcobalamin (MeCbl) was associated with a decrease in methionine synthase activity and an increased level of homocysteine, as well as a decrease in glutathione (GSH).

In patients with schizophrenia, a decrease in Methylcobalamin (MeCbl) in the frontal lobes of the brain was associated with a decrease in glutathione (GSH). And now it’s well documented that lowering glutathione levels is perhaps a key factor in the etiology of schizophrenia. Perhaps senile dementia and schizophrenia have a common development factor.


The official reference values ​​of total vitamin b12 in the blood should be 187-883 pg / ml. But studies show that even if the total vitamin b12 in the blood was below 500 pg / ml, it can still be deficient in the cells of the body and in the brain. The figure shows the level of methylmalonic acid (MMA) in urinalysis – one of the best markers of intracellular levels of vitamin b12 in cells.

According to the Department of Clinical Nutrition (USA) from 2009, it was shown that current standards of vitamin b12 in the blood do not reflect its real intracellular level. And with a deficiency of vitamin b12, irreversible damage to the nerve cells of the brain and a decrease in cognitive functions of the brain occur. Methyl malonic acid in urine reflects intracellular vitamin b12 levels well.

But the analysis for methylmalonic acid is expensive and incorrect in case of impaired renal function. Urinary methylmalonic acid concentrations below 271 nmol / L correlate with improved cognitive function. Vitamin b12 in the blood at any level below 500 pg / ml can occur both in patients with methylmalonic acid below 271 nmol / L and above 271 nmol / L.

However, vitamin b12 above 500 pg / ml only correlates with urinary methylmalonic acid levels below 271 nmol / L. In addition, the same data was shown at the University of California in 2014, when vitamin b12 levels of at least 500 pg / ml were used in a successful pilot study to remit symptoms of Alzheimer’s disease using the protocol of measures (ncbi.nlm.nih.


2009, University of Oxford, United Kingdom. Addison in 1849 noted that patients with cognitive function started having anemia associated with vitamin b12 deficiency (“the mind sometimes wanders” in his patients). At the beginning of the 12th century, there were several reports of mental symptoms in patients with anemia due to vitamin b1913 deficiency, and in , Barrett also described histopathological changes in the cerebral cortex, in particular, neurodegeneration and damage to white matter and blood vessels.

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The amount of vitamins in plasma or serum is determined by:

  1. by biochemical research,
  2. high performance liquid chromatography.
  3. An enzyme-linked immunosorbent assay for vitamins, ELISA, which expands the range of studies, is also used.
  4. The biological material for analysis is plasma, blood serum, urine.

Vitamin B1, or thiamine, promotes the synthesis of amino acids, is actively involved in carbohydrate metabolism.

  • With thiamine deficiency, specific polyneuritis develops.
  • It is found in large quantities in the shell and seed germ of cereal and other plants.

Vitamin B1 analysis indicators:

  1. Normally, blood plasma contains 8-30 nmol / l,
  2. Whole blood – from 70 to 180 nmol / l thiamine.
  3. 80% of the vitamin is in red blood cells.
  1. The standard value of riboflavin in the blood is from 5 to 50 nmol / L.
  2. Vitamin B2 (riboflavin) is common in nature, is part of plant and animal cells.
  3. A rich source of riboflavin is yeast, especially brewer’s yeast, dairy products, liver, kidneys, and heart.
  4. Vitamin B2 is involved in hematopoiesis and tissue respiration, and is responsible for the state of the mucosa.
  5. Promotes the absorption of folic acid and iron from food,
  6. prevents the occurrence of cataracts.

Vitamin B9, or folic acid, is an important element in all metabolic processes of our body.

  • Vitamin B9 involved in the maturation of red blood cells.
  • Normally contains 5,4-40,0 ng / ml B9.

Vitamin B12, or cyancobalamin, is necessary for hematopoiesis, with its deficiency, the synthesis of DNA and RNA is disrupted.

  1. The standard value of cyanocobalamin (Vit. B12):
  2. varies from 210 to 911 pg / ml.
  3. The only vitamin that is synthesized by microorganisms (intestinal bacteria).
  4. Some of it comes with animal food.
  5. The richest source of liver and kidney.
  6. Absorption of vitamin B12 requires the presence of Castle factor, which is produced in the stomach.

Vitamin C, or ascorbic acid, is an active antioxidant that is involved in redox processes in the body.

  1. Responsible for iron absorption,
  2. the state of the immune system
  3. walls of blood vessels.

With Vitamin C Deficiency

  1. fragility of blood vessels increases
  2. growth retardation occurs
  3. susceptibility to infections.
  4. With a large deficiency, gum disease, scurvy occurs.

Blood test indicators:

  1. Blood serum normally contains from 0,04 to 0,2 mg / l of vitamin C.
  2. The value of 0,02 mg / l indicates a deficiency of ascorbic acid.

A large amount of vitamin is found in wild rose, blackcurrant, oranges, lemons, red pepper and other fruits and vegetables.

Vitamin A, retinol, plays a critical role in the human body. Belongs to the number of fat-soluble vitamins.

  • Plants rich in pigments – carotenoids, have the most pronounced A-vitamin activity.
  • Sources of carotene are carrots, red peppers, tomatoes, sea buckthorn, mountain ash.
  • Vitamin A is found in animal products.
  • The liver and internal fat of cod, halibut, whales, seals are especially rich in them.
  • A lot of vitamin A and carotene contain milk and dairy products.

The normative value in a blood test:

  1. from 0,30 to 1,20 mg / l – for adults,
  2. 0,18-0,70 mg / l – for children.

Currently, according to the accepted nomenclature, distinguish:

  1. retinol (vitamin A1),
  2. dehydroretinol (vitamin A2),
  3. retinal (vitamin A-aldehyde),
  4. theinoic acid (vitamin A acid).

Vitamin D (calciferol) is involved in the metabolism of calcium and the formation of the skeletal system.

  • Calciferol deficiency is very dangerous and can lead to serious diseases: rickets in childhood and osteoporosis in adulthood.
  • No less dangerous is the excess of this compound, especially in children.
  • Therefore, it is so important to take a periodic blood test for vitamin D to prevent the development of these diseases.

Vitamin D blood counts

  1. Physiological norm – from 30 to 100 ng / ml
  2. The disadvantage is from 10 to 30 ng / ml
  3. Deficiency – from 0 to 10 ng / ml
  4. It is possible to use an alternative unit of measurement – nmol / l.
  5. The formula for converting units: ng / ml multiplied by 2,496 = nmol / l
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Fat-soluble Vitamin E – is a group of tocopherols. It is found in products of plant and animal origin, especially a lot of it in vegetable oils, apples, in wheat germ, wheat flour, potatoes and beans.

  1. Is a powerful antioxidant.
  2. forms collagen
  3. regulates lipid metabolism.
  4. It contributes to the normalization of metabolic processes in the myocardium and skeletal muscle.
  5. Reduces the frequency and intensity of angina attacks.
  6. The need for vitamin E increases during pregnancy.

Disease if Vitamin E Deficiency

A blood or urine test for vitamins is performed in the following cases:

  1. pregnancy and lactation;
  2. gynecological problems
  3. for example, heavy menstruation;
  4. period of active growth and puberty of children;
  5. the appearance of signs of hyper- or hypovitaminosis;
  6. mono diets;
  7. harmful working conditions;
  8. ecologically unfavorable territories;
  9. resection of the stomach or intestines,
  10. pathology of the gastrointestinal tract and pancreas;
  11. after chemotherapy;
  12. people in prolonged stress.
  13. elderly people.

The cause of cyanobalamin deficiency may be:

  1. Internal factor: diseases and resection of the stomach, helminthic invasions, folic acid deficiency.
  2. The external cause of vitamin deficiency can be: with insufficient intake of it with food, with anemia of pregnant women, vegetarians, etc.

B12 deficiency can cause:

  • macrocytic anemia, characterized by a decrease in the number of red blood cells and their increase in size.
  • Perhaps the development of funicular myelosis – damage to cells of the nervous system.
  • The study is conducted to identify the causes of damage to the systems and organs of the blood and nervous system.
  1. responsible for the reproductive and immune systems,
  2. vision,
  3. provides epithelial integrity.
  4. The role of retinol in embryonic development is important.
  5. With his participation, the heart, bone system, ears and eyes are formed.
  6. Retinol transmits neural signals at dusk to the retina.

Vitamin A deficiency can cause diseases:

  1. skin (up to dermatitis),
  2. hair (dryness, thinning and brittleness).
  3. Vision decreases at dusk.
  4. Inflammation of the conjunctiva and eyelids.
  5. There is a decrease in immunity.
  6. A blood test for vitamin A is very important.
  7. Determining vitamin A deficiency will reveal the cause of the disease and balance the diet.

An analysis of blood serum vitamin D is performed to determine the body’s absorption of calcium. Studies are prescribed for indications, which include diseases:

  1. parathyroidism;
  2. lupus erythematosus ;
  3. pancreatitis
  4. gastritis and enterocolitis.

With a deficiency of vitamin E, the activity of enzyme systems that are functionally associated with cell membranes decreases. Hypovitaminosis of tocopherol (vitamin E) causes:

  1. peripheral nervous system dysfunction,
  2. skeletal myopathy
  3. visual disturbance (retinopathy).
  4. Vitamin E deficiency can be associated with gonadal disorders in men.
  • It is associated with the saturated rhythm of life,
  • refined nutrition
  • hobbies of mono-diets,
  • constant stress.
  • Under these conditions, a comprehensive study on
  • trace elements and vitamins will identify the cause of the disease
  • and restore body resources

A lack of vitamin in the body can be determined by various symptoms. Some of them are explicit, others, on the contrary, are insignificant.

So, the patient may experience:

  1. Dysfunction of the digestive tract (gastrointestinal tract). Characteristic signs of B12 deficiency are defecation disorders, loss of appetite or digestive disorders.
  2. Disturbances in the central nervous system (central nervous system). This is insomnia, headaches, dizziness, apathy, irritability, aggressiveness, overwork, irritability. They can also be the result of hypovitaminosis.
  3. Anemia can be the main symptom of a lack of vitamin in the body. Moreover, anemia caused by a deficiency of B12 can be of two types – megaloblastic and pernicious anemia.

In this case, the patient may experience general manifestations characteristic of hypovitaminosis.

  • mild itching
  • numbness;
  • yellowness;
  • inflammation of the tongue.

To one degree or another, characteristic symptoms of dysfunction of those organs that suffer due to a lack of B12 are manifested.

Causes of deficiency of vitamins and trace elements in the blood

The causes of vitamin deficiency are:

  1. unbalanced diet,
  2. digestive disorders
  3. some physiological conditions – pregnancy, lactation.
  4. Vitamins are substances that affect all biochemical processes in the body.

Vitamin D Disease Indications

Vitamin deficiency can provoke irreversible disorders not only in the work of various organs, but also cause neurological disorders. Therefore, when symptoms characteristic of a lack of B12 appear, the doctor prescribes a test for vitamin b12.

A study can be assigned in a number of cases:

  • large red blood cells were detected during a general blood test;
  • with suddenly changing patient behavior;
  • with vitamin deficiency or anemia.
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The analysis is necessary in order to help restore some disorders in the body.

Research helps in cases where:

  1. It is required to establish the cause of mental disorders.
  2. It is necessary to establish the cause of loss of appetite or balance the patient’s nutrition.
  3. With chronic vitamin B12 deficiency.
  4. To establish the causes of developing macrocytic anemia.

In order for the results of the analysis to be correct, you need to know how to donate blood correctly at b12. The fence is done on an empty stomach in the morning, it is advisable to donate blood before 11 in the morning. At the same time, doctors recommend that you refrain from eating 12 hours before the tests. It is not recommended on the eve to drink alcohol, overeat and engage in active physical activity. The day before the test, you should refuse fried or spicy food.

In addition, it should be remembered that factors such as taking hormonal pills or contraceptives, alcohol dependence, vegetarianism, taking antibiotics, and pregnancy can influence the level of B12 in the body.

Causes of deficiency of vitamins and trace elements in the blood

  • Vitamin B6 (pyridoxine) is involved in amino acid metabolism,
  • responsible for the state of connective and muscle tissue,
  • significantly improves liver function.
  • The norm is considered a value from 20 to 125 nmol / l in blood plasma.
  • The norm for adults is considered to be from 5,0 to 20,0 mg / l.
  • Normal Serum Vitamin K
  • ranges from 0,10 to 2,20 ng / ml.

Sometimes doctors can not identify the cause of the disease, which lies on the surface and is associated with an insufficient content of a certain vitamin in the body. The problem is easily fixed if

  • adjust diet
  • or use the necessary vitamin preparations.
  1. pass the examination
  2. Get vitamin test results.
  3. Research results will allow
  4. conduct differential diagnosis of hyper- or hypovitaminosis
  5. with a similar clinical picture of the disease.
  6. This will provide an opportunity to balance diet and treatment.
  • iron, zinc, molybdenum, copper, chromium,
  • selenium, iodine, cobalt, manganese.
  • These micronutrients are structural elements
  • hormones, enzymes, protein compounds.
  • A blood test for trace elements will help
  • identify not only essential, but also toxic substances.

As a biomaterial for analysis, not only blood can be used, but also urine, hair, nails.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.