: Kamini Center, Boring Pataliputra Road, Patna

Lab No. : BOR/04-09-2022/SR6709851 Lab Add.

- 800013
Patient Name : ONKAR KUMAR Ref Dr. : Dr.MEDICAL OFFICER
Age : 34 Y 9 M 1 D Collection Date: 04/Sep/2022 09:37AM
Gender :M Report Date : 04/Sep/2022 01:22PM
Test Name Result Unit Bio Ref. Interval Method

VITAMIN B12 (CYANOCOBALAMIN) , GEL SERUM

VITAMIN B12 (CYANOCOBALAMIN) 215 pg/mL 211-911 pg/mL CLIA

•The reported result values relates to the sample item tested ONLY and ONLY to the time of estimation process.
•All the quantitative results are technically & clinically validated, before release of the report. In case of inadequate patient history inputs, report
demands further clinical correlation.
•Biological reference interval/reference limits incorporated here, are based on current kit literature and also on national and international
references wherever applicable/established.
•In case where there is lack of correlation between the test results and the clinical condition, the patient /attendant should be referred back to the
laboratory at the earliest.
•As per labs policy, for majority of the test parameters, laboratory maintains the storage of examined sample at optimal condition for 48 hrs
before disposal.

Clinical Information

1. Vitamin B12 (cobalamin) is necessary for hematopoiesis and normal neuronal function. In humans, it is obtained only from animal
proteins and requires intrinsic factor (IF) for absorption. The body uses its vitamin B12 stores very economically, reabsorbing vitamin B12
from the ileum and returning it to the liver; very little is excreted.

2. Vitamin B12 deficiency may be due to

lack of IF secretion by gastric mucosa (eg, gastrectomy, gastric atrophy)

intestinal malabsorption (eg, ileal resection, small intestinal diseases)
inadequate dietary intake
increased requirements, which cannot be met from the diet
failure of utilization of absorbed vitamin.

3. Vitamin B12 deficiency frequently causes macrocytic anemia, glossitis, peripheral neuropathy, weakness, hyperreflexia, ataxia, loss of
proprioception, poor coordination, and affective behavioral changes. These manifestations may occur in any combination; many patients
have the neurologic defects without macrocytic anemia.

4. Vitamin B12 excess may be due to

Excess B12 intake

Excess production of Transcobalamins TCBs (liver disease, Myeloproliferative disorders, neoplasms, inflammation)
Defect in clearance of TCBs (Renal failure, anti TCB antibodies)
Congenital deficiency in TCBs
Defect in TCB-B12 affinity
Hepatic release of B12 and TCBs (Liver disease)

Clinical Reference
1. Babior BM: The megaloblastic anemias. In Hematology. Fifth edition. Edited by WJ Williams, E Beutler, MA Lichtman, et al. New York,
McGraw-Hill Book Company, 1995, pp 471-490
2. Shenkin A, Baines M, Fell GS, et al: In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE
Bruns. St. Louis, Elsevier, Inc., 2006, pp 1100-1105
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Lab No. : SR6709851 Name : ONKAR KUMAR Age/G : 34 Y 9 M 1 D / M Date : 04-09-2022
3. Klee GG: Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clin Chem
2000 August;46(8 Pt 2):1277-1283
4. Fairbanks VF, Klee GG: Biochemical aspects of hematology. In Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood.
Philadelphia, WB Saunders Company, 1999, pp 1690-1698
5. George L, Mills JL, Johansson AL, et al: Plasma folate levels and risk of spontaneous abortion. JAMA 2002 October 16;288:1867-1873
6. Benoist BD: Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food and Nutrition Bulletin 2008(volume
29, number 2) S238-S244
7. Elevated plasma vitamin B12 levels as a marker for cancer: a population-based cohort study. Arendt et al. J Natl Cancer Inst. 2013 Dec
4;105(23):1799-805.
8. High serum cobalamin levels in the clinical setting—clinical associations and holo-transcobalamin changes. Carmel R et al. Clin Lab
Haematol. 2001;23(6):365–37

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