As you may recall, my soon to be three year old grandson was born with a twisted bowel and had to have emergency surgery at Mayo at two days old. They removed about a foot of his bowel. He has remained small but healthy. Food sometimes seems to "shoot through him". Blueberries can even be smelled in his feces. He just had his annual tests and all was normal except his B12 levels.
Normal was 140-914; his was 1114. I understand how they could be low but wonder if you have any ideas on why they could be high (I see the scary google things). He is not receiving B12 supplements. Is this unusually high and should we be concerned? There was no feedback from the doctor. As an FYI his vitamin D (which is supplemented )was 79. Thanks for any insight. Deb
Tex or Polly - a grandbaby question
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Hi Deb,
That's typically not a good sign (as your Google search has indicated). I'm sure you've already considered the usual causes (and hopefully his doctors have ruled them out), such as liver or kidney issues (including cancer). B-12 is stored in the liver, and certain conditions can cause it to be released. If his liver enzymes are normal, though, I would think that should rule out a liver issue. Does he by any chance have diabetes? It can cause kidney problems that can result in a high B-12 level.
A myeloproliferative disorder is possible, but if his red cell and white cell counts are all normal, that should rule this out.
A retest might be a good idea, because one should never rely on a single test result, if the result might indicate a serious issue.
That said, if he also had a CBC and everything else checks out, I suspect that the problem is defined by the abstract at the following link:
ELEVATED VITAMIN B12 LEVELS IN CHILDREN WITH SHORT BOWEL SYNDROME AND INTESTINAL DYSMOTILITY
Since an ileostomy tends to cause the same symptoms as short bowel syndrome, I can certainly identify with this issue.
Tex
That's typically not a good sign (as your Google search has indicated). I'm sure you've already considered the usual causes (and hopefully his doctors have ruled them out), such as liver or kidney issues (including cancer). B-12 is stored in the liver, and certain conditions can cause it to be released. If his liver enzymes are normal, though, I would think that should rule out a liver issue. Does he by any chance have diabetes? It can cause kidney problems that can result in a high B-12 level.
A myeloproliferative disorder is possible, but if his red cell and white cell counts are all normal, that should rule this out.
A retest might be a good idea, because one should never rely on a single test result, if the result might indicate a serious issue.
That said, if he also had a CBC and everything else checks out, I suspect that the problem is defined by the abstract at the following link:
The red emphasis is mine, of course,Vitamin B12 deficiency in patients with intestinal disease has been attributed to malabsorption, ileal resection, and small bowel bacterial overgrowth (SBBO). To the best of our knowledge, elevated serum vitamin B12 (VB12) levels in children with intestinal disease have not previously been reported. We report the incidence of elevated VB12 levels in this population.
Methods:
Laboratory and demographic data were collected for patients with short bowel syndrome (SBS) and intestinal dysmotility (ID) followed in the clinics at 2 institutions. Those who received tube feedings or a combination of parenteral nutrition (PN) and enteral nutrition (EN) for >3 months and whose VB12 levels were routinely monitored were included.
Results:
A total of 139 subjects were identified and medical records reviewed. 96 instances of elevated VB12 levels (>900 pg/ml) were identified in 46 (33%) of 139 subjects; 20 instances of low VB12 levels (<150>2000 pg/ml (limit of detection). Age range at initial high VB12 level: 3-286 months; mean: 60 months. Primary diagnoses: SBS (33), gastroschisis (4), pseudo-obstruction (5), IBD (3), microvillus inclusion disease/SB transplant (1). 33(72%) had partial or complete ileal resection; 31(67%) had resection of ileocecal valve (ICV). 32(33%) of elevated VB12 levels were found in 15 subjects while receiving no PN and no VB12 enterally beyond that in commercial formulas.
Conclusions:
Most children with SBS and ID receiving adequate nutrition have normal VB12 levels. Elevated VB12 levels were significantly more frequent (p < 0.05) than low levels, even in cases of ileal and ICV resection. These findings are contrary to the belief that VB12 deficiency is common in intestinal disease. Given that the source of VB12 (or its analogues) in humans is only dietary intake or bacterial synthesis in the gut lumen, we speculate that synthesis of VB12 from SBBO and absorption in the SB is responsible for the frequency of elevated VB12 levels in this population.
ELEVATED VITAMIN B12 LEVELS IN CHILDREN WITH SHORT BOWEL SYNDROME AND INTESTINAL DYSMOTILITY
Since an ileostomy tends to cause the same symptoms as short bowel syndrome, I can certainly identify with this issue.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.