Well, well, well! Just as I was thinking of how to try and get the research community interested in investigating the problems with the current test to determine the B12 status of patients along come two significant developments that directly address this problem.
First up is a paper just published that uses not just one test to determine a patient’s B12 status but a combination of four tests: serum B12 (which is the one currently used in 99% of cases), the ‘active’ B12 test (holotranscobalamin), Homocysteine and Methylmalonic Acid. All four tests are useful in determining just how much B12 a person will have but no single one appears to be perfect which is why the four tests are combined.
The paper involves some very complex mathematics and this is because the authors have been able to show that if one or two of the tests are not conducted their outcome can be estimated using the results of the other tests.
Combined indicator of vitamin B 12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points: Sergey N. Fedosov, Alex Brito, Joshua W. Miller, Ralph Green and Lindsay H. Allen; Clin Chem Lab Med 2015; DOI 10.1515/cclm-2014-0818
The second development concerns a team of researchers from outside the UK who are meeting with academics from Oxford University. I’m unable to give details of this new project but it does involve a new way of monitoring patients’ B12 status. I have been invited to attend the meeting which, of course, I will be doing.