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Old 03-21-2008, 02:33 AM #1
Paul Golding
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Paul Golding
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Hello mrsd,

As you said:

Quote:
most doctors' eyes would glaze over and turn off if you requested this cutting edge testing.
I agree with what you say but I think that you might have misunderstood the intention of my post. I was not promoting the active B12 test; I was responding to a specific question about this new assay. The question arose from my response to Jackie, in her thread "B12 deficiency- still having problems!". In my post, I said:

Quote:
You could use the new “active B12” (holotranscobalamin) test, after two weeks without any treatment, as this is claimed to more accurately indicate the level of B12 available to the cells. I am currently investigating the effectiveness of this test, and will soon publish my results. The “active B12” still does not tell you about how well your cells are able to actually utilize the B12 delivered to them.

The best way to test for actual effectiveness of treatment is to measure the two metabolites of B12, methylmalonic acid (MMA) and total homocysteine (tHcy). These tests are normally used for diagnosis of vitamin B12 deficiency, by comparing the results before treatment with those after treatment. In your case, as you already have a diagnosis and have been receiving treatment, you would only be using the “after” results.

Both MMA and tHcy are sensitive indicators of any deficiency of B12 available to cells for production of chemicals required by the body. They are toxins that are left over when there is insufficient vitamin B12, so will increase when there is a B12 deficiency, indicating a true cellular deficiency. MMA is specific to B12 deficiency, whereas tHcy is also sensitive to folate deficiency. Neither test is perfect, with some false positive and false negative results, but are the best available and are very useful if correctly interpreted. I suggest using both for maximum certainty.
As I have not yet completed my own investigation of the active B12 test, I cannot yet confirm that it is as effective as the kit supplier claims it to be.

The active B12 (holotranscobalamin) test is intended to ultimately replace the total serum B12 assay. Unlike the MMA test, this new active B12 test uses an automated immunoassay, so is inexpensive. The cost here, in Australia, is between $25 and $45 per sample, so should be similar in USA. It is covered by Medicare in Australia, if serum B12 is not tested at the same time.

I have been able to locate two labs in USA who list the active B12 test in their online catalogue. There are likely to be many more actually doing the test but have not yet listed it. There are at least four labs in Australia offering the test now, so there are certain to be many more in USA where Abbott Laboratories, the kit supplier, is located.

Here are the links to the labs:

Specialty Laboratories

American Clinical Services

You said:
Quote:
but doctors in this country are resistant, poorly informed and also form value judgements against the patient, in the form of mean diagnoses in the chart... hypochondriac, malingerer etc
Yes, they are the same here as well. I was labelled as a malingerer and hypochondriac for 40 years, until my ventricular tachycardia was finally discovered in 2004, at the age of 51 years. The full story is on the About Me page of my web site; I suggest that you read it if you want to know what is driving me.

I was similarly labelled when I discovered my B12 deficiency in 2005. This is why I am on a mission to get the message across about vitamin B12 deficiency.

Fortunately, I now have an excellent GP who has a strong interest in nutritional medicine, and who very supportive, as is my psychiatrist. I also now have the cooperation of three labs, which do the testing directly for me.

So, regardless of the level of resistance, I intend to force change in the way that B12 deficiency is diagnosed.

Paul
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