Orthopaedic Dr Amir Sanghavi recently claimed that a B12 tablet gives false positive results compared to a B12 injection. “B12 injection is advised because B12 tablets give a normal blood report. Patients are misguided by the blood reports. But the effect is not there. B12 tablets remain in the body for 24-48 hours, increasing the risk of false-positive reports. Go as per the clinical effect of B12 rather than the biochemical effect of B12,” Dr Sanghavi said during a conversation with author Raksha Bharadia.
Dr Rituja Ugalmugle, consultant, internal medicine, Wockhardt Hospitals, Mumbai Central, said it is “not necessarily” true. “Routine B12 tests measure total B12, which includes both active and inactive forms. A large portion of what shows up on your report may not be usable by your cells. This is why some people have ‘normal’ levels on paper but still experience a deficiency. Symptoms like fatigue, tingling, low mood, brain fog, or hair loss may continue because their cells aren’t getting enough active B12,” said Dr Ugalmugle.
This mismatch is more common in:
– vegetarians and vegans
– those with poor gut health or malabsorption
– people on long-term acidity medicines (PPIs, H2 blockers)
– individuals taking metformin
– adults over 40, where absorption naturally declines
If the routine test can miss a deficiency, which tests detect the real B12 status?
More sensitive markers include:
– Methylmalonic acid (MMA)
– Homocysteine
These...
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