I can’t tell you how many times I’ve heard, “I’m just tired because life is busy.”
Sure, life is busy—but when someone drags through the day, forgets simple things, or feels pins-and-needles in their hands, my nurse brain goes straight to vitamin B12. I learned that lesson years ago with a patient who was eating “healthy,” but her B12 came back in the basement. One shot and a few weeks later? Whole new person.
The B12 blood test is a simple draw that measures cobalamin—the nutrient your red blood cells and nerves depend on. Without enough, you can’t make healthy blood cells or keep your brain running smoothly.
Think of B12 as your body’s spark plug. No spark, no energy.
Normal: about 200 – 900
Borderline: 200 – 300 (I’ll usually order a methylmalonic acid test if we’re in this gray zone.)
Deficient: below 200
Labs can set slightly different cut-offs, so always double-check with your provider.
Here’s the kicker: you can eat well and still come up short.
Digestive quirks – Crohn’s, celiac, even long-term heartburn meds can block absorption.
Age – Our stomach acid drops after 50, which makes it tougher to pull B12 from food.
Medications – Metformin is a quiet B12 thief; I see it all the time in folks with type 2 diabetes.
I’ve watched marathon runners with pristine diets test low because their gut just wasn’t absorbing enough.
Fatigue is the obvious one, but I also ask about:
Numbness or tingling in fingers and toes
Brain fog or that “walking through mud” feeling
Mood dips or irritability
Pale skin or shortness of breath
Catch it early and these often reverse. Wait too long and nerve damage can stick around—nobody wants that.
Here’s what’s worked for my patients (and me, honestly):
Food first – Salmon, clams, eggs, and dairy are B12 all-stars. Vegans can look for fortified nutritional yeast or plant milks.
Supplements – Sublingual B12 melts under your tongue; great for folks with gut absorption issues.
Injections – If levels are really low, a series of shots can bring you back fast.
Pro tip: pair B12 with a good night’s sleep. Your cells repair best when you’re out cold.
Quick in-person blood draw, results usually within a couple of days. No doctors order required and only $35.
Offers a B12 panel plus methylmalonic acid if you want the full picture.
At-home finger-prick kit that mails straight to your door. Super handy if clinics aren’t your thing.
Affiliate Disclaimer: Some of the links above are affiliate links, meaning I may earn a small commission if you purchase through them—at no extra cost to you. I only share lab options I genuinely trust and would recommend to my own patients, friends, and family.
Your B12 number is a clue, not the whole mystery. Pair it with folate, homocysteine, and a CBC for a better read on energy and nerve health.
✨ Book a 60-minute consult with me if you want help building a food-plus-supplement plan that actually sticks.
National Institutes of Health – Vitamin B12 Fact Sheet
Mayo Clinic – Vitamin B12 Test
MedlinePlus – Vitamin B12 Level
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Understanding Zinc: Why This Micronutrient Matters More Than You Think I can’t count how many times I’ve had someone tell me, “But I eat healthy
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