Test Description

Vitamin B12 and folate are primarily ordered to detect deficiencies and to help diagnose the cause of certain anemias. One type of associated anemia is pernicious anemia, an autoimmune disease that affects the absorption of B12. This megaloblastic anemia occurs when the body produces antibodies against the gastric parietal cells or the intrinsic factor, resulting in B12 malabsorption.

Folate, B12, and an assortment of other tests may be ordered to help evaluate the general health and nutritional status of a person with signs of significant malnutrition or dietary malabsorption.

When should this test be ordered?
B12 and folate should be ordered, or may be ordered when evaluating signs and symptoms of anemia, the presence of large red blood cells. Some physical symptoms may include weakness, dizziness, tiredness or sore mouth and tongue. These tests may also be ordered when [elderly] patients are showing signs of mental or behavioral changes.
High Risk · Outside Reference Range
Lower than reference range:
(0-6569) days : <= 210 (pg/mL)
(>= 6570) days : <= 210 (pg/mL)

Greater than reference range:
(0-6569) days : >= 912 (pg/mL)
(>= 6570) days : >= 947 (pg/mL)

Folate: <= 4.5 (ng/mL) or >= 34.9 (ng/mL)
Associated with anemia, malnutrition, and malabsorption. Treat underlying cause.
Borderline Risk · none
Not applicable for this test.
Low Risk · Within Reference Range
Reference Range:

(0-6569) days: 211-911 (pg/mL)
(>=6570) days: 211-946 (pg/mL)

Folate: 4.6-34.8 (ng/mL)
B12 and Folate is typically ordered as part of a routine health evaluation .
Testing Method Used
Competitive Binding

Sample is stable for 2 days at 2-8°C.

Please ship samples daily.
Improvements and Prevention
If you have an iron deficiency, eating foods high in iron or taking iron supplements can help, however if you have other conditions not related to folate or B12 deficiency other measures should be considered.
Specimen Type
Serum; this sample should be protected from light.
Fasting Required
No, but may be ordered with other tests that require fasting.
Drawing and Processing

tube1

  1. Draw from a vein into a SST tube
  2. Invert tube (do not shake) 1-2 times to mix adequately
  3. Let stand upright in tube rack for 30 minutes
  4. Centrifuge for 15 minutes at 3300rpm
  5. Do not leave at room temperature for more than 1 hour
  6. Keep cold in a refrigerator to maintain stability, until ready to ship
Shipping Instructions
  1. Freeze ice packs 24 hours prior to use
  2. Place ice packs inside the Styrofoam insulated kit
  3. Place processed tubes inside biohazard bag, place inside kit
  4. Seal box, print airbill and adhere to box and wait for courier to pick up
Rejection Criteria
Any level of hemolysis; QNS; temperature out of range upon receipt; moderately lipemic; wrong sample type; sample stability exceeded for this analyte; unlabeled or improperly labeled specimen
References
1. Mason JB. Vitamins, trace minerals, and other micronutrients. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 225.
2. Salwen MJ. Vitamins and trace elements. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 26.
The information provided here is intended for educational purposes only and should not be used or substituted as medical advice. You should consult a healthcare practitioner regarding medical diagnosis or treatment.