There's been a couple topics floating around on B12 lately so I though this would be relevent..
I decided to get my B12 levels checked this week with a uMMA test (the most accurate method, by far).
The test is based on the fact that B12 is required to convert MMA to succinic acid, so high levels of MMA in the urine indicate that B12 is not doing its job. The test is great because it checks if your B12 is actually functional, so absorption issues are accounted for. No false negatives have ever been demonstrated, and the accuracy record with positives is 99%.
So anyway, I sent an overnight urine sample to NCL (www.b12.com) for testing yesterday, and got an email back from them today.
-> Normal MMA levels are ~0.5-3.8 ug/mg creatinine, whereas anything above 3.8 indicates a deficiency.
-> My level was measured at 1.3 ug/mg, indicating no deficiency.
So this shows that, barring variable problems like not being able to produce intrinsic factor, a vegan/fruit based diet does allow perfectly sufficient B12 absorption. In my case, the level is not even close to deficiency. I never had a B12 test before transitioning to this diet, but I doubt the MMA level would have been any lower, since it's already near the low end of the spectrum.
Awesome, thanks for sharing Nathan! Glad to hear you're doing well. :)
Did you start supplementing after, and did your levels return to normal?
Also, what test did you use?
You asked a very important question David!
There are many factors at play in B12 use and depletion - stress, increased intake of B12 analogs, reduction of intrinsic factor, nutritional deficiencies, bacterial overgrowth, alcohol, certain medications, antibiotics, nitrous oxide anesthesia given during surgery and nitric acid from normal metabolism...
Those many factors explain why one persons B12 stores might only last a year while someone else might last 12 years.
Good work Nathan.
Still, one test doesnt mean much. When people live on fruits and veg, they dont eat supplement b12 food like animal products (they give farm animals b12 supps routinely), b12 enriched cereals etc. So in the long run, certain people that have low absorption rates can have issues cos now they are not supplementing. All of my raw meat eating friends have low serum b12. They only eat the animal products that are organic/wild and these are not given b12 supps at any stage unlike other animal products. So the people I know that eat the most raw eggs, oysters, meat etc actually ALL have low serum b12 status. Interesting stuff. They too, like the fruit and veg crew, dont eat conventional foods.
So we can have 'stores' from our past lifestyle of supping and be 'ok' for ever or just a year or so. Depends on the individual. Thats why Im a fan of injections a few times a year. Your DEFINITELY good as gold then vs having to do expensive testing etc.
Most people in society have no clue about b12 and just chance it. Like a lot of things. I guess Im just a stickler for certainty. U/MMA testing is considered the gold standard but its not even available in Australia and if it was, Id say it would be way more exy then some self administered b12 shots.
Ive NEVER met a person that didnt supp b12 at some level. Either via a direct supp, supped animal/plant food products or in a multivitamin. When people go raw, they cut these things out and it exposes where we stand. Ignorant people are quick to judge but its like someone jumping out of a car and deciding to walk to their destination. When they get some blisters, morons shout 'see! walking isnt natural, you NEED to drive a car!!'
You're making a valid point in that a lot of people get 'hidden' B12 (and other) supps from fortified foods. I read thousands of medical journals of seriously sick (I basically only get to see the cases who end up on disability pension), mostly 50+ SAD-eaters every year and B12 deficiency is incredibly uncommon (they only test serum B12 though), one in a thousand cases if that. Vit D deficiency doesn't happen practically ever, even though we're dealing with people living in Finland who certainly do not get enough vit D from sun; they're all tested normal for vit D.
Fortified foods are the only reasonable explanation I can come up with. I know they add vit D to milk, which is consumed in large amounts by most Finns, but they don't list B12 (milk is supposed to contain B12 anyway). I can't recall ever having seen B12 listed in any food item but they could be adding it anyway.
I agree that the meat eaters are unaware that their diet is already B12 supplemented, or at the very least the animals are given cobalt supplements.
In case anyone asks, Australia Paul Golding claims on his website (paulgolding.id.au/THE_B12_BETRAYAL/PublicPages/VitaminB12Informatio...) that he has a few places that test for B12 in Australia
"If you live in WA
Your sample for MMA will be sent to Princess Margaret Hospital, so you do not need to worry about where to send it. I am unable to comment on the quality of the assay performed at this lab, because they do not accept samples from interstate.
If you do not live in WA
I suggest that you specify that your samples be tested by the NSW Biochemical Genetics Service at The Children’s Hospital Westmead in Sydney. I suggest the following wording for the pathology request form:
“Serum Methylmalonic Acid and Total Homocysteine – NSW Biochemical Genetics Service, Children’s Hospital Westmead – please collect in one SST tube, spin, separate and send frozen”
If you do not specify this, and if you live in QLD, your samples will be sent to Mater Pathology or QHPS in Brisbane. I have explained in detail, in The Investigation section, the reasons that I strongly recommend against using either of these Brisbane labs.
You could let your local lab do the homocysteine, but I suggest that you ask for Westmead to do it. Most labs use immunoassays for tHcy, which can be unreliable; Westmead uses Stable Isotope Dilution Tandem Mass Spectrometry, for both MMA and tHcy, which is the reference method used by Mayo Labs.
The MMA test will cost you $130 each, and there is no Medicare rebate; you might also have to pay the cost to have samples sent to Westmead. The total homocysteine will cost you $75 each; there should be some Medicare rebate for this test."
How much did it cost to do this test? I don't have insurance and I live in Kauai, where everything is exponentially more expensive.