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Doctor Warns ‘Normal’ B12 Results Can Mask Functional Deficiency

He urges testing methylmalonic acid or homocysteine to identify cellular shortfalls.

Overview

  • UK outlets Mirror and Bristol Live on Nov. 22 highlighted Apollo Delhi surgeon Dr Anshuman Kaushal’s message that patients can have deficiency symptoms despite normal serum B12.
  • Standard assays typically report total B12 and may miss shortages of the biologically active form, as much circulating B12 is bound to an inactive carrier protein.
  • Dr Kaushal recommends ordering methylmalonic acid and homocysteine to detect functional deficiency that routine serum measurements can overlook.
  • He notes that patients with confirmed cellular deficiency may require vitamin B12 injections to restore adequate availability.
  • Coverage reiterates symptoms such as fatigue, brain fog and tingling, with experts and the NHS cautioning that missed deficiency can lead to lasting nerve problems.