Dried Blood Spot Testing

Stability

Refrigerated: 2 days

Low levels of vitamin B12 can be seen in vegetarians who do not eat animal products, diseases that cause malabsorption such as pernicious anemia, celiac disease, and inflammatory bowel disease, with the use of certain medications like proton pump inhibitors and metformin and alcoholism. Conditions that can increase B12 level include: Liver diseases, such as cirrhosis or hepatitis, and Myeloproliferative disorders like polycythemia vera and chronic myelogenous leukemia.

• High doses of biotin (> 5 mg/day) may interfere with assay results. Patient assumed to be refraining from biotin supplementation for at least 3 days prior to blood draw.

Increase dietary intake of vitamin B12, or replace with B12 injections, or oral supplements to normalize vitamin B12 levels.