Short answer
Get tested for B12 and active B12 (holotranscobalamin). In case of confirmed deficiency, nutritional correction or injections as prescribed by the doctor. Monitor levels every 3–6 months.
Cobalamin deficiency affecting hematopoiesis, nervous system and energy metabolism
The mechanism in three steps, and where you can intervene.
Trigger
Lack of meat/fish, atrophic gastritis, intestinal diseases (celiac disease, Crohn's disease), veganism without B12 supplement
Mechanism
Impaired DNA synthesis → megaloblastic hematopoiesis + demyelination of nerve fibers
Symptom
Fatigue, tingling in extremities, pallor, cognitive impairment, glossitis
Answer 3 questions to see likely causes and a baseline lab list.
How long has this been going on?
Is there marked fatigue?
Is stress high?
Likely causes
What to check
We will show a preliminary result before registration
Create an action plan in one click with a checklist, reminders, and a timeline.
Get tested for B12 and active B12 (holotranscobalamin). In case of confirmed deficiency, nutritional correction or injections as prescribed by the doctor. Monitor levels every 3–6 months.
A baseline panel for the most common causes.
Basic screening test, but may produce false normal values
More accurate marker, reflects the bioavailable fraction
Increased in tissue B12 deficiency, even if serum levels are normal
Increased levels due to B12, folate or B6 deficiency
Detection of macrocytic anemia and hypersegmented neutrophils
How each marker relates to vitamin b12 deficiency.
B12 deficiency is more often due to malabsorption than a dietary deficiency. Autoimmune gastritis (pernicious anemia) leads to a lack of intrinsic factor Castle. Resection of the stomach or intestines, chronic pancreatitis, taking metformin or proton pump inhibitors also reduce absorption. Vegans and strict vegetarians are at risk - B12 is only found in animal products.
Optimal algorithm: B12 + holotranscobalamin (more sensitive than serum B12). At borderline values - MMA and homocysteine. CBC reveals megaloblastic anemia (increased MCV, decreased red blood cells and hemoglobin). In Axioris, you can download PDF analyzes and track the dynamics of indicators on graphs, and the AI assistant will indicate deviations in the context of symptoms.
Urgent consultation is needed for neurological symptoms (numbness, unsteadiness of gait) or severe anemia (Hb < 80 g/l). Planned - in case of persistent fatigue, cognitive complaints or identified deficits in tests. The doctor will determine the cause (autoimmune process, malabsorption) and prescribe a treatment regimen (cyanocobalamin injections or oral forms).
1) Taking folic acid without B12 - “masks” anemia, but does not stop neurological damage. 2) Self-medication with injections without monitoring tests - an overdose is possible. 3) Ignoring the deficiency with “normal” B12, but increased MMA. 4) Underestimation of the association with dementia and depression in the elderly. Axioris has reminders for repeat tests - this helps avoid relapses.
«Планировала тратить деньги на трихолога, но оказалось дефицит B12. Простой анализ, простая причина — нашла за 2 минуты.»
«Витамин D был 12 — я даже не знала, что это влияет на усталость и иммунитет. После коррекции заметила разницу через 6 недель.»
«СРБ был высоким несколько лет, но никто не акцентировал внимание. Axioris выделил его как ключевой — начала разбираться.»
Основано на структурированном медицинском подходе, не на хаотичных советах из интернета.
Не заменяет очную консультацию и постановку диагноза врачом.
Срочные симптомы требуют немедленного обращения за медицинской помощью.
In case of nutritional deficiency (veganism) - yes, but it takes 3-6 months. In case of malabsorption (gastritis, intestinal resection), injections are needed. In foods, B12 is found in liver, beef, fish, eggs, and milk.
After correction - every 3-6 months. For chronic gastrointestinal diseases or pernicious anemia - lifelong monitoring. In Axioris, you can set up reminders for analyzes and record dynamics in graphs.
Metformin interferes with the absorption of B12 in the ileum. With long-term use, monitoring of levels is necessary (once a year); prophylactic administration of B12 is possible.
Increases the risk of neural tube defects in the fetus, preeclampsia and anemia. For pregnant women, B12 levels > 300 pg/ml are recommended. Monitor with folate and iron supplements.
Both cause macrocytic anemia, but neurological symptoms (numbness, paresis) are characteristic only of B12. MMA and homocysteine tests help differentiate.
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