Vitamin B12 (Cobalamin) and Folate
Vitamin B12 (cobalamin) and folic acid (folate, vitamin B9) are part of the B complex family of vitamins. Folate is necessary for the normal function of red blood cells (RBCs) and white blood cells (WBCs) and for DNA synthesis.
The research shows that deficiencies in vitamin B12 and folate can lead to macrocytic anemia, elevated homocysteine, and neurologic and psychiatric disorders. Low vitamin B12 has been linked to impaired memory; irritability; depression; numbness and tingling in the extremities such as the feet and hands; dementia and psychosis.
- Vitamin B12, serum
- Folate, serum
Methodology: Immunoassay (IA)
Fasting: Not required.
Water: Drink plenty of water to stay well hydrated.
Medications: Take all medications as prescribed.
Special considerations: Discontinue dietary supplements containing B vitamins three days before testing.
2-3 business days
Result turnaround times are estimates and not guaranteed. Due to factors outside of our control, such as weather, holidays, confirmation/repeat testing or equipment maintenance, our lab may require additional time to complete tests.
Since folate is found in green leafy vegetables, low serum folate can indicate not eating enough whole foods. Folic acid is absorbed through the intestines. Therefore, malabsorption diseases, such as Celiac Disease, can lead to folic acid deficiency.
When folic acid is low it can cause developmental problems in fetuses, called neural tube defects. It can also create problems with red blood cells, causing the red blood cells to be abnormally large and interfere with their ability to carry oxygen.
Vitamin B12 is necessary for converting the inactive form of folate to its active form, playing an important role in the production and function of RBCs. A deficiency in vitamin B12, like folate, can cause anemia. Low vitamin B12 levels associated with cognitive impairment and dementia, including Alzheimer’s disease, vascular dementia, and Parkinson’s disease.
The absorption of B12 depends on a protein called intrinsic factor (IF). Without IF, vitamin B12 cannot be absorbed. The most common causes of vitamin B12 deficiency are a lack of intrinsic factor and low stomach acid, which is also required for vitamin B12’s absorption. In vegans and vegetarians, a lack of dietary intake of B12 is the most common cause of B12 deficiency.
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Lachner C., Steinle N.I., Regenold W.T. The neuropsychiatry of vitamin B12 deficiency in elderly patients. J. Neuropsychiatry Clin. Neurosci. 2012;24:5–15.
Moore E., Mander A., Ames D., Carne R., Sanders K., Watters D. Cognitive impairment and vitamin B12: a review. Int Psychogeriatr. 2012 Apr;24(4):541-56.
Owczarek D., Rodacki T., Domagala-Rodacka R., Cibor D., Mach T. Diet and nutritional factors in inflammatory bowel diseases. World J. Gastroenterol. 2016;22:895–905.