A member asked:

What is the most accurate blood test to check b-12 levels?

2 doctors weighed in across 2 answers

Serum tests: B12 levels can be testing in the blood directly but I also order a methylmalonic acid level if I have high clinical concern. This is elevated prior to B12 levels being low (could be normal range). B12 is the cofactor for the enzymatic reaction involving methylmalonic acid so without B12 the MMA levels increase. Then issue is why is one deficient in Vit B12?

Answered 12/5/2014

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Blood level: If the blood level does not match the clinical scenario.....check Methinine and Homocystine level.

Answered 12/4/2014

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