My Neurologist had me do the NutrEval test where your urine is tested for vitamin and minerals, etc. My B12 has been as high as 1900 when doing a blood test at my regular doctor. The report came back for the NutrEval and it shows a B12 of 12. So obviously I’m not absorbing it, but is this number even possible? I have read many of Mrs. D’s posts and that is what prompted me to ask for more tests. I don’t see the Neurologist for another week. My question is first if this number is possible and secondly, if a person isn’t absorbing vitamin b12, will they absorb a supplement or do they need injections?

i dont know if that number is possible or not. i would have it retested before i would accept a 12. labs have made errors with my blood tests before. .... if you take 5000 mcg of methylcobalamin b12 a day, that should be as good as getting shots. if your nunmbers are really that low, i would get the shots and then continue on taking it orally when the shots stop.

Reference ranges for blood serum will most likely not be the same for urine tests.
It's important to know the lab's reference ranges. Many labs doing the urine test provide a pretty good report on the results. Did you get a copy of the results/report?

Were you taking any supplements when your blood was tested. If so, that could show a falsely elevated blood serum level.

Maybe even a typo or a different measurement...

Are the units in which the two Vitamin B12 measurements are expressed the same?

If they differ by a factor of 100 they could be comparable. It is like expressing a distance measurement in metres or centimetres - 1 metre is the same as 100 centimetres.

In the report, my vitamin D is 56 which is pretty consistent with what my blood work always shows, so it wouldn’t appear they are using a different measurement unit. It just seems odd that I have blood tests of 1900 without supplements and then the urine test comes back at 12. The report concluded that I’m of course deficient, but only mentions the number once. It would seem to me like it must be a mistake.

B12 testing via urine. It's interesting to see they don't look for B12 but MMA/creatine concentrations.

Vitamin B12 Deficiency Urine Test | Dr. Schweikart

Thanks for the link Marlene. I’m embarrassed to say I WAS reading the report wrong. The optimal number for this test is 40 and I’m at 12. Still low with a super high blood serum reading with no supplements, but not as far off as I thought! Vitamin B2 is actually much lower as well. Hopefully we can find out why and correct these things with supplements and or injections. I’ve had PN that has continued to get worse over the past five years and never supplemented because I thought as did my doctor that my serum levels are very high every time I have blood work done. Mrs. D told me when I first came here that didn’t seem normal and she was right as usual.

In case this helps...

I discovered by genetic testing that I'm a carrier of the Biotinidase Deficiency variant. This causes me to have very low "normal" values of the enzyme. As best I understand it, the enzyme is responsible for allowing your body to make use of biotin (B7) in food sources. I'm not supposed to affected with just low levels, but since taking biotin supplements, a metabolic problem I was experiencing has disappeared completely. Biotin is involved in the metabolic process involved.

I also took the Nutra Eval test at one point, and it didn't show any problems with my biotin levels. Without high enough levels of this enzyme, though, I think it was indeed impeding my ability to make use of it, and supplements have absolutely helped me.

Thank you everyone. I’ll be interested to see what my doctor’s plans are since according to the Eval report I’m deficient in several vitamins. Again, these are vitamins that I should be getting plenty of from my diet and my blood serum levels are extremely high with no supplements. There must be a reason they are not absorbing, but I’m not sure if there are further tests to determine that or if I will just leave with a list of supplements that won’t absorb either. Hopefully he will have a plan, but since this test is new to medical doctors here, it may be harder to talk to him about methylation, MTHFR and absorption issues. Even the B vitamins bother my stomach, so taking a truckload of things is not going to be possible.