Vitamin Test (B12, Folate, D, E & Q10)

Which markers are analysed

• Folate (vitamin B9)
• Cobalamin (vitamin B12)
• Vitamin D3 (25OH)
• Vitamin E (alpha-tocopherol)
• Coenzyme Q10

How does the test work?

The test is a blood test that is collected at home via a prick in the finger and then you squeeze out blood that you drip into a tube. The test must be taken on an empty stomach in the morning. The sample is then sent to the lab for analysis and you will receive your answer digitally as soon as the lab has analyzed your sample. Shipping to the lab is included in the price.

What is folate/folic acid?

Folate or folic acid (a synthetic form of folate) also known as vitamin B9 is an important factor for growth and is a prerequisite for the formation of red blood cells and for normal cell division.

Why analyse folate/folic acid?

Folate/folic acid is analysed to determine a possible folate deficiency. The most common causes of folate deficiency are as follows:

• Celiac disease – dominant cause, often with concomitant B12 and iron deficiency
• Pregnancy – increased need
• Hemolytic anemia – increased need
• Kidney failure

What is vitamin B12?

Vitamin B12, also known as cobalamin, is 1 of 8 B vitamins. All B vitamins help the body convert the food we eat into energy. B vitamins are also needed for healthy skin, hair, eyes and normal liver function. They also help the nervous system to function normally.

Why do we need vitamin B12?

Vitamin B12 is a particularly important vitamin for maintaining healthy nerve cells and it helps with the production of DNA and RNA. Vitamin B12 works closely with vitamin B9, also called folate or folic acid (a synthetic form of folate), to create red blood cells and maintain a normal blood count.

The link between vitamin B12 and folate

Vitamin B12 and folate work together to produce S-adenosylmethionine (SAMe). SAMe is the body’s universal methyl donor and plays a role in the immune system, maintains cell membranes and helps produce and break down chemicals in the brain, such as dopamine, serotonin and melatonin. Being deficient in either vitamin B12 and/or folate can reduce levels of SAMe in the body.

Vitamin B12, B6 and B9 (folate) also work together to maintain homocysteine within the normal range. High levels of homocysteine are associated with cardiovascular disease. But science has not been able to fully determine whether homocysteine is a cause of cardiovascular disease or just a marker that indicates someone may have cardiovascular disease. More research is needed to determine this.

What symptoms can B12 deficiency cause?

It is unusual for young people to be deficient in vitamin B12, but it is not uncommon for older people to be deficient. This may be because they have less stomach acid that the body needs to absorb B12. Low levels of B12 can cause a range of symptoms including:

• Fatigue
• Respiratory distress
• Diarrhoea
• Nervousness
• Numbness
• Tingling sensations in fingers and toes
• Severe deficiency of B12 causes nerve damage

Which risk groups exist for B12 deficiency?

The people most at risk for B12 deficiency include:

• Vegans and vegetarians who do not eat dairy or eggs, as vitamin B12 is only found in animal products, except in trace amounts in unwashed vegetables and other vegetables that cannot be relied upon as sufficient sources
• People with problems absorbing nutrients due to inflammatory bowel disease (IBD), pancreatic disease, weight loss surgery, or certain medications
• People with eating disorders
• People with HIV
• People with diabetes

Folate/folic acid can mask B12 deficiency

Folate/folic acid (vitamin B9), especially when taken in high doses, can mask the symptoms of vitamin B12 deficiency. The danger with this is that without symptoms, you can walk around with a B12 deficiency and not know about it, and can thus risk developing more serious consequences, e.g. nerve damage that is irreversible.

What is vitamin D?

Contrary to what the name suggests, vitamin D is actually a steroid hormone. Vitamin D has a major impact on our health because it affects hundreds of genes in most of the body’s cells. Vitamin D affects the body’s ability to absorb phosphorus and calcium, which are necessary substances for a normal bone structure and normal teeth. Vitamin D also plays an important role in the normal functioning of the immune system.

When we stay outdoors in the summer, we build up a layer of vitamin D that the body then consumes during the dark part of the year. The body then stores vitamin D for about three months (personal variation occurs) so it is not until three months after the sunny months of summer that we feel low vitamin D levels.

Why analyse vitamin D?

Vitamin D is an important component of the body’s metabolism and lack of vitamin D plays a role in many diseases. The risk of infectious diseases as well as winter and spring depressions, multiple sclerosis, cancer, diabetes, cardiovascular disease, osteoporosis, general aches and obesity can increase with vitamin D deficiency.

How is vitamin D formed?

When we are out in the sun and exposed to UV radiation, the body produces vitamin D via cholesterol in the skin, which is then sent to the liver and kidneys where it is converted into an active form.

In the summer, you don’t have to be outside for long periods of time for your body to form enough vitamin D. For a light-skinned person, about 15-20 minutes of sun exposure in a t-shirt is enough. Dark-skinned and elderly people have a poorer ability to form vitamin D via the sun, which means that they may need to stay in the sun for a longer time to form enough vitamin D.

In winter, the sun in most of Europe is too weak for the production of vitamin D to be stimulated. For that reason, most people need vitamin D supplements during the autumn and winter months.

How do you get vitamin D deficiency?

Vitamin D deficiency mainly occurs due to reduced conversion of vitamin D in the skin, and it is common for the values to be below or at the bottom of the reference range during the winter months because the sun’s rays are then not strong enough for the body to be able to form vitamin D. Vitamin D deficiency can also be caused by reduced parathyroid function (hypoparathyroidism), but this is an uncommon disease.

What level of vitamin D should one have?

The body’s level of vitamin D naturally varies throughout the year. During the winter months, UV radiation is too weak for the body to produce vitamin D. Vitamin D is stored in the body, so if you have had enough sunlight during the summer months, your body will use the vitamin D that is available. If you have stored less from the summer, the risk of your vitamin D level dropping to a deficient level already in the autumn increases. If you have more stored, you can last longer.

• <25 nmol/L deficiency
• 25-50 nmol/L insufficiency
• >50 nmol/L sufficiency
• >100-125 nmol/L optimal level
• >150 nmol/L increases the risk of kidney stones
• >250 nmol/L potentially toxic

Can you overdose on vitamin D?

Very high levels (above 250 nmol/L) of vitamin D are toxic and can lead to high levels of calcium in the blood, calcium deposits in the kidneys and kidney failure. It is not possible to overdose on vitamin D through diet alone, but if you take supplements that contain large amounts of vitamin D, you can overdose overtime.

What does a high vitamin D value mean?

High vitamin D levels are seen in hyperparathyroidism (uncommon), in large intakes of vitamin D (mainly via dietary supplements), sarcoid and other granulomatous diseases with increased calcium concentration and in some cases in pregnancy. This can lead to hypercalcemia and metastatic soft tissue calcification. The half-life of vitamin D is considered to be 2-3 weeks, while the terminal half-life is considerably longer.

What is Vitamin E?

Vitamin E is a fat-soluble vitamin that occurs in several different forms, of which alpha-tocopherol is the most common form. Vitamin E’s primary role in the body is to act as an antioxidant to protect the cells of the body from free radicals that cause oxidative stress. Vitamin E also plays a role in the immune system and can prevent blood clots.

Why analyse vitamin E?

Vitamin E plays an important role as an antioxidant in the body and also contributes to a normal immune system.

What is Q10?

CoQ10 is a coenzyme and an antioxidant that is produced naturally in the body and contributes to the cells’ energy metabolism. The body’s Q10 levels decrease with increasing age, and people over 50 generally have lower Q10 levels.

Why analyse Q10?

Q10 plays an important role in cellular energy metabolism and high/normal levels are associated with healthy aging.