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Hi, I have recently done a 24hour urine collection for B12 deficiency in the uk, I have been given the following results methylmalonic acid – urine 1.44 mg/l creatinine 1.17 g/l methylmalonic 1.23 mg/g crea <2.0 acid/creatinine

I was told I am not B12 deficient, would you agree, Thanks in advance


Mark Walles says

Wow – what an inspirational article and blog. Great stuff Chris!

So many people suffering from such an easily resolved problem…. I used to be one of them…

I used to suffer UC/Crohn’s and B12 deficiency (recorded as 210) as well as cold extremities, fatigue, jaundice gallbladder problems, joint pains and breathing problems. I am back to good health now – in fact even better than it was before I got ill. I have never taken a B12 supplement and my B12 levels have gone up to over 500 now.

Obviously B12 deficiency can cause a whole host of problems, as can zinc, magnesium or any other deficiency. When I was struggling to get well my research of the causes of B12 deficiency, digestive disturbances and chronic health conditions kept on returning to a condition called hypochlorhydria. In simple terms, a lack of stomach acidity. Achlorhydria is a total absence of stomach hydrochloric acid (HCL). Reasons for it are not certain, but I suspect levels drop as we age due to chronic stress…

I found that by addressing the cause (restoring my digestive ph) by supplementing with “Betaine HCL” within 3 weeks my energy returned and within a month ALL my symptoms resolved. I would suggest looking into restoring gastric ph, since not only might it help increase B12 levels, it will most likelyimprove absorption of all the other minerals dependent on gastric acid and intrinsic factor!

If stress is the cause of low gastric HCL then I suspect daily relaxation techniques such as breathing exercises and meditation could help the situation…

To your health!


Would B12 values appear normal on a blood test if large amounts of folic acid were being supplemented even if B12 was low enough to cause deficiency symptoms?

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No, but keep in mind that blood tests for B12 are looking at cyanocobalamin, the inactive form. It’s possible to have normal levels of the inactive form, but low levels of methylcobalamin and adenosylcobalamin, the active forms. This is quite common in my practice.


I don’t know what it is with the B12 and the throat. When I was at my worst I actually got a paralyzed vocal cord and couldn’t speak for 3 months. Injecting B12 every week brought the cord back to life but it was scary. Now I know I need extra B12 when I get hoarse for no apparent reason because I know that the feeling is of the vocal cords getting weak and the irritation is them not vibrating properly.

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Finndian, Wow, I had no idea those could be connected, thanks for the information.



I didn’t see a reply button under your post so am replying to one down, hope it works. Great to hear you got your results and are finding some improvements. Was your hematocrit really low? If you feel like sharing that level that might be helpful too. And hopefully you’ll get some responses about your other concerns — I’m not familiar enough with this issue to be able to respond, but it really helps to hear your story. Did you say you are also working with a practitioner? My levels were B12 >2000 pg/mL (and I unfortunately never tested it before this) Folate 17.4 ng/mL (first time I tested) Hcy 5.53 umol/L (first time I tested) MMA (serum) .14 nmol/mL (I only did serum because that’s what I did once before) and my HCT was 41.7 I was diagnosed with pernicious anemia (by a naturopath) two years ago based on blood work and symptoms and that’s why I started the injections (weekly up to now), but now I am revisiting it all to see what will be the best path forward. I also have an autoimmune condition (psoriasis) and have been off gluten for 10 years and most dairy for about a year. So it’s been really helpful to hear what people are doing and Chris’ responses, since I had no idea this affected so many people.

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Btw Amber, my practitioner responded today already about the test results and said the high levels of serum B12 were not a concern but the low level of MMA is, perhaps a sign that the pernicious anemia is acting up, so I will see her this week. So glad I got these tests done so I can follow up for now, so I will be staying on weekly injections for now until I learn more.


A headache after stating b12, and orthwer symtoms too, two entire groups of symptoms can often appear. They are hoifger up on this page. They usually are low potassium wich can be dangerous. People start helaing and and on the 3 or after day potassium can go low as cells get made. Somewhere between 1200 and 3000mg of additional potassium can be helpful. The other set of symptoms are often folate insufficiency. Often people get so much healing started that other deficiencies are induced and folat l-methyfolate deficiency often is the one.


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Philip M. Chang , Rahul Doshi , Leslie A. Saxon
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Circulation. 2014; 129: e644-e646
Philip M. Chang
From the University of Southern California, Los Angeles.
Rahul Doshi
From the University of Southern California, Los Angeles.
Leslie A. Saxon
From the University of Southern California, Los Angeles.


For nearly 3 decades, the implantable cardioverter-defibrillator (ICD) has been available to patients who survived life-threatening rapid heart rhythms or are at risk of experiencing them. The ICD comprises a device generator coupled with a defibrillation lead. Traditional ICDs are implanted under the skin with the generator positioned beneath the collar bone. The defibrillation lead is inserted through the veins in the chest that course to the heart, permitting direct attachment to the inside of the heart, specifically the right ventricle. Figure (A) shows an x-ray of an ICD and leads.

The subcutaneous ICD (SICD) is a novel defibrillator developed over the past decade that has become available to patients in the United States this year. The SICD provides an alternative option for patients whose physicians are recommending an ICD. Manufactured by Boston Scientific, Inc, a company that makes and sells ICDs, the SICD consists of an ICD generator and a defibrillation lead, similar to a traditional ICD. However, the defibrillation lead remains completely outside the chest cavity. Figure (B) shows an x-ray of the SICD. The SICD is implanted under the left breast, and the lead is placed under the skin along the left side of the breastbone. Early experience with the SICD has shown that it can terminate life-threatening rapid heart rhythms within seconds of their detection.

Patients who are candidates for an ICD should understand the differences between a traditional ICD and the SICD. The greatest advantage of the SICD is that the lead does not course through the central veins in the chest, nor is it attached to the tissue within the heart chambers. Patients who opt for an SICD avoid the need for possible lead removal, or extraction, from the central veins and heart cavity. Lead extraction is recommended in cases of lead infections, fractures, or other mechanical problems that prevent safe and effective ICD shock therapies. Although extraction remains an infrequent necessity among implantation patients, it is associated with significant risks, including death.





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