B12/Folate

Serum (gold top tube)

Specimen should be protected from light by transfering centrifuged serum or plasma to a brown pourover container, or transport specimen in a brown paper sack or aluminum foil. Centrifuge specimen after collection or transport to lab for centrifugation. This test includes a serum folate and does not include rbc folate or folate performed on whole blood.

Serum (gold top) tube or Lithium Heparin Plasma (green top) tube

Daily upon receipt

Vitamin B12: 239 - 931 pg/mL Folate: 2.76 - >20.0 ng/mL

Vitamin B12: Reduced concentrations of vitamin B12 may indicate the presence of vitamin dependent anemia. Elevated concentrations of vitamin B12 have been associated with pregnancy, the use of oral contraceptives and multivitamins and in myeloproliferative diseases, such as chronic granulocytic leukemia and myelomonocytic leukemia. An elevated concentration of vitamin B12 is not known to cause clinical problems. Measurement of vitamin B12 is intended to identify and monitor vitamin B12 deficiency. This can arise from the following: (1) defect in the secretion of Intrinsic Factor, resulting in inadequate absorption from food (pernicious anemia); (2) gastrectomy and malabsorption due to surgical resection; and (3) a variety of bacterial or inflammatory diseases affecting the small intestine. Serum Folate: Folates are a subset of vitamins related to pteroylglutamic acid (PGA) that function as co-enzymes in metabolic reactions involving the transfer of single carbon units. Folate and vitamin B12 are necessary for DNA synthesis, and consequently normal red blood cell maturation. Folate deficiency can lead to macrocytic (megaloblastic) anemia. Folate is obtained from dietary sources including fruits, green and leafy vegetables, yeast and organ meats. Folate is absorbed from the small intestine and stored in the liver. Low folate intake, malabsorption as a result of gastrointestinal diseases, pregnancy and the use of drugs such as phenytoin, oral contraceptives and excessive concentrations of alcohol are causes of folate deficiency. Low serum folate concentrations are an early indication of folate depletion and precede depletion in the tissues. Adequate folate concentrations during pregnancy are also important in the prevention of neural tube defects (NTD) in infants. Folate supplementation prior to conception and in the first weeks of pregnancy reduces the incidence of NTD affected births.