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<blockquote data-quote="Winnie53" data-source="post: 2089605" data-attributes="member: 160246"><p>The best test for B12 deficiency is the methylmalonic acid test, but the serum homocysteine test is "probably a good starting place". Chris Kresser explains why here...</p><p></p><p><a href="https://chriskresser.com/why-b12-deficiency-is-significantly-underdiagnosed/" target="_blank">https://chriskresser.com/why-b12-deficiency-is-significantly-underdiagnosed/</a></p><p></p><p>Here's an excerpt...</p><p></p><p><span style="font-size: 18px"><strong><em>Lab Results: What to Look For</em></strong></span></p><p><em>I would encourage everybody to, at the very least, have their serum B12 measured. But as I have mentioned, that’s in many cases inadequate to detect stage one and stage two deficiency. Homocysteine is a marker that you shouldn’t have any trouble getting your primary care practitioner to order. It’s well known. It’s recognized as a marker for cardiovascular disease, and it’s pretty cheap. They should at least be familiar with that, and if you request a serum homocysteine, that’s probably a good starting place. Remember though, if it comes back high, it doesn’t guarantee you a B12 deficiency. It could also be folate or B6, but that might be enough ammunition to then get your clinician to order some of the more advanced tests for detecting B12 deficiency like serum or urine methylmalonic acid. I personally have found that urine methylmalonic acid is superior to serum, possibly because it’s more concentrated in urine than in the blood. I’ve just seen it be more sensitive and more consistent with the other markers of B12 deficiency then than serum methylmalonic acid. If you live in Europe or outside of the United States, you also might be able to get a holotranscobalamin, or a holoTC, which is again, the most sensitive marker for B12 deficiency.</em></p><p><em></em></p></blockquote><p></p>
[QUOTE="Winnie53, post: 2089605, member: 160246"] The best test for B12 deficiency is the methylmalonic acid test, but the serum homocysteine test is "probably a good starting place". Chris Kresser explains why here... [URL]https://chriskresser.com/why-b12-deficiency-is-significantly-underdiagnosed/[/URL] Here's an excerpt... [SIZE=5][B][I]Lab Results: What to Look For[/I][/B][/SIZE] [I]I would encourage everybody to, at the very least, have their serum B12 measured. But as I have mentioned, that’s in many cases inadequate to detect stage one and stage two deficiency. Homocysteine is a marker that you shouldn’t have any trouble getting your primary care practitioner to order. It’s well known. It’s recognized as a marker for cardiovascular disease, and it’s pretty cheap. They should at least be familiar with that, and if you request a serum homocysteine, that’s probably a good starting place. Remember though, if it comes back high, it doesn’t guarantee you a B12 deficiency. It could also be folate or B6, but that might be enough ammunition to then get your clinician to order some of the more advanced tests for detecting B12 deficiency like serum or urine methylmalonic acid. I personally have found that urine methylmalonic acid is superior to serum, possibly because it’s more concentrated in urine than in the blood. I’ve just seen it be more sensitive and more consistent with the other markers of B12 deficiency then than serum methylmalonic acid. If you live in Europe or outside of the United States, you also might be able to get a holotranscobalamin, or a holoTC, which is again, the most sensitive marker for B12 deficiency. [/I] [/QUOTE]
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