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B12 and Ferritin from LMHR on facebook

Member Forum >> Diabetes and Pre-Diabetes Protocol >> B12 and Ferritin from LMHR on facebook

docmaas

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Posted: 7/25/2020 8:32:45 PM
 
Picked this up on facebook today.  Some of us will have read the research published sometime this year about all cause mortality and high B12 levels.  This was kind of disconcerting because high B12 is usually viewed as a positive.

This reaction to a question about ferritin levels and B12 came from Dr. Paul Mason from NZ and may help to elucidate the conditions under which B12 may be high and a sign of liver damage.  Dr. Mason indicates that alt/sgpt levels greater than 20 is likely consistent with liver damage. 

Personal aside: My most recent tests have my SGPT at 30 and my B12 at 914.  I don’t have a recent ferritin but in June 2019 it was low at 26 after what I think was bout of anemia from low B12 levels though by the time I got the test the b12 was back up over 1500 by the time it was checked took several sublinguals when I figured out what my problem (pernicious anemia) probably was.

Paul Mason
Serum B12 often ’high’ on animal based diets. May also be high with active liver damage, which is associated with high ferritin. Interestingly, this skews the all cause mortality data on serum B12, suggesting that high may not always be good. High B12 with low levels of liver enzymes (especially ALT) and normal ferritin likely represents ’nutritional’ supply, and I have seen no issues with this. As an aside, serum B12 is an unreliable marker. ’Active B12’ is a better test, while homocysteine and methylmalonic acid are ’functional’ tests. In a nutshell, liver damage which may be associated with elevated ferritin can release B12 and increase serum levels. Check liver enzymes to exclude as a likely cause.

Nik Ferrarella
What about very high B12 (~1700), moderate ferritin (~200), and normal liver enzymes? Is that "nutritional supply"?

Paul Mason
I am unable to comment on specific cases. Any ALT over 20 is likely consistent with liver damage. Ferritin also needs to be interpreted in the context of inflammatory state. If CRP or ESR is elevated (understanding the reference ranges are ridiculously high), then ferritin is likely ’artificially’ elevated.


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Iron Man

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Posted: 7/26/2020 5:13:17 AM
Edited: 7/26/2020 5:36:44 AM (2)
 
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