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🧪 What is Active Vitamin B12?

Active Vitamin B12, also known as Holotranscobalamin (holoTC), is the biologically active fraction of Vitamin B12 bound to transcobalamin, which is available for cellular uptake. It reflects the vitamin B12 available for tissue use and is considered an early and sensitive marker of B12 status.

❓ Why is the Test Done?

To:

Detect early Vitamin B12 deficiency before serum total B12 levels decline
Diagnose deficiency in patients with borderline or normal total B12 but clinical symptoms
Evaluate patients with neurological symptoms suggestive of B12 deficiency
Monitor treatment efficacy in B12 supplementation

📊 Normal Range

Active Vitamin B12 Level	Reference Range
25 – 128 pmol/L	May vary slightly by laboratory

📈 Interpretation of Results

Level	Clinical Significance
Low active B12	Indicates Vitamin B12 deficiency or early depletion
Normal active B12	Adequate vitamin B12 status
High active B12	Rare; may be due to supplementation or other causes

🧠 Associated Conditions

Condition	Details
Vitamin B12 deficiency	Causes anemia, neuropathy, cognitive impairment
Pernicious anemia	Autoimmune cause of B12 deficiency
Malabsorption syndromes	Crohn’s disease, celiac disease, gastrectomy

🔄 Related / Follow-Up Tests

Serum total Vitamin B12
Methylmalonic acid (MMA)
Homocysteine levels
Intrinsic factor antibody
Complete blood count (CBC)

✅ Fasting Required?

Test	Fasting Required
Active Vitamin B12 (holoTC)	❌ No

📝 Summary Table

Parameter	Details
What	Measures biologically active Vitamin B12 (holotranscobalamin)
Why	Early detection of B12 deficiency
Normal Range	25–128 pmol/L
Low Levels	Indicates B12 deficiency or early depletion
Associated Conditions	Pernicious anemia, malabsorption, dietary deficiency
Follow-up Tests	Total B12, MMA, homocysteine, intrinsic factor antibody
Fasting Required	❌ No

Vitamin B12 - Active

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