Vitamin B12 Blood Test: What Levels are Normal, Low and High?

Many people have approached me lately asking similar questions about vitamin B12 blood test range, results, etc. I decided to conclude all the how, why and what of the process in one place.

Vitamin B12 Blood Test? You Wish ;)
Sometimes a vitamin B12 blood test is taken from your hand and not your elbow. (From the back of your hand actually, not as shown in the picture).

How Is Vitamin B12 Blood Test Performed?

The health care provider will wrap an elastic band around your arm to make the vein ‘full of blood’ and then draw it from the vein of your elbow, most of the time. He will then put an antiseptic over the place to clean it. The blood is collected in a vial that is attached to the needle. He then covers the site to stop your bleeding. Simpe, isn’t it? Low vitamin B12 levels be damned.

How Painful Is It?

Well, I can only speak from my experience. I was very afraid of these tests when I was a kid but right now all I feel is a little sting. That’s it. Most of the people I know kind of feel the same so I guess I can safely say that it’s not really painful. As always though, your miles may vary.

Vitamin B12 Blood Levels Range and Test Results

Normal values of vitamin B12 in blood are between 200 to 900 picograms per milileter. Talk to your lab and request the specific values since every lab values ‘normal range’ differently.

However, these values aren’t exactly correct because many people have been diagnosed with B12 deficiency even when their B12 levels were within the normal range. That means that the lower limit for normal B12 levels is rather too low and even if your test results show a normal value, you could be suffering from a B12 deficiency. Below are the preferred B12 values along with their interpretations:

Normal B12 status: >550 pg/ml
Deficient in B12: <550 pg/ml
Adequate to maintain a healthy nervous system and to prevent disease in elderly individuals: 1000 pg/ml

(Note: These are the preferred values and have been suggested by Pacholok & Stuart in their book ‘Could it be B12?’)

Take action immediately, it is far easier to treat a deficiency in its early beginning than later.

High levels of vitamin b12 in blood are very, very rare. This vitamin stores up in the liver, kidneys and muscles and any excess is usually drawn out in your urine. However, liver diseases (cirrhosis and hepatitis), and Myeloproliferative disorders (such as myelocytic leukemia or polycythemia vera) might increase your B12 levels, so do not overlook it.

What If I’m Found to Have a B12 Deficiency?

If you are found to be deficient, the average doctor will most probably begin a series of vitamin B12 shots. In the case of absorption issues, this is a smart choice. Otherwise, there are plenty of other treatments that may prove as effective. If you found yourself with low B12 levels, you may also be interested to read our list of foods high in B12.

Written with the help of Dr. Aqsa Ghazanfar, author of “The B12 Deficiency Survival Handbook“.


    • Dr. Aqsa Ghazanfar says

      Hi there Nydia!

      Your B12 levels are normal. They should ideally be between 550 and 1000 and a level above or around 1000 is even better. If you have any condition due to which you might have been deficient in this vitamin, regular supplementation (injections, pills, etc) will be required depending on the cause and severity of the underlying disease.

  1. Antoinette says

    My B12 level was tested on 11/12/2012. It was greater than 1000 pg/ml. Labs reference range is 193-983. What treatment or labs are needed. I have essential HBP, no Diabetes. only med Larsartan HCTZ. Thanks!

  2. Dr. Aqsa Ghazanfar says

    Hi Antoinette!
    Your B12 levels are optimal, congratulations! You don’t need any treatment at all. Just continue taking the medicines that were given to you by your doctor and everything will be just fine. If there’s anything else I can help you out with let, me know!

    • Bindu says

      Megan – I stumbled upon your blog via Michele Anderson’s wesitbe. On a professional level, I am a clinician/social worker so I found demyelination very interesting in how it potentially relates to Autism/PDD. I had never heard of demyelination before and started doing some research. On a personal level, I have a list of symptoms that I have struggled with but have been better controlled over the past 2 yrs since I started eating GF and limiting my dairy intake. I remember how difficult it was for me to take that on; I can’t even imagine the challenges you faced in overhauling your entire lifestyle. I recently read your entry about candida. I was amazed by the symptoms when I looked it up on the internet. The next day I made an appointment with my GI dr. Thank you so much for sharing your story and the details of your journey (although I STILL wonder how you find the time to post!). You truly have helped so many people. Thank you!! Teagan: You are so courageous, strong, and brave. Reading the posts from you momma as she tells your story brings up so many feelings. It must have been so scary for you when you could not talk. I’m so glad you are feeling healthy and you have your words again. You have been through so much as a little guy and you have faced many challenges; this will surly prepare you for the challenges you will encounter in the future. Godspeed.

  3. Christina says

    My B12 level is 1842 (marked hi on my lab results) Should I stop taking B12 supplements? I take 2500mcg each morning of the sublingual B12 before heading to the gym. I suffer from low iron levels and I am worried that if I stop taking the B12 I will be even more tired. Although I am on bloodbuilders and in the last 6 months I have brought my iron levels from a 24 to 61. Is my B12 too high?

  4. Dr. Aqsa Ghazanfar says

    Hi Christina!
    Your B12 levels are indeed high, but B12 isn’t toxic when present in such large quantities. However, you don’t really need that much of it so you should definitely decrease the dosage and/or frequency. More importantly, you shouldn’t rely on B12 for energy when the root cause of low energy (i.e. low iron levels) is still present in our body. Your iron levels are within the normal range but they’re still towards the lower side of the range (which is 50-170 ug/dl for adult women). You’re not exactly deficient in Iron but continue taking your iron supplements, etc till your levels have increased – that will make you feel much better because low iron levels cause anemia (which manifests as lethargy, weakness, etc). Also, people who are not deficient in B12 do not gain energy by using it. Your B12 stores are more than full and continuing B12 supplementation won’t boost your energy, it will only maintain your metabolism and energy levels within the normal range (which means excess B12 doesn’t mean an excess of energy!). Hope this helps!

  5. Dr. Aqsa Ghazanfar says

    Hi BeeBee!
    Your B12 levels are extremely need to start supplementation A.S.A.P. However, you also need to find out the cause of such low B12 levels (in case you’re not a vegetarian who doesn’t supplement their diet with B12). Your doctor will know which tests to perform (and if to perform any, for that matter). If there’s anything else you want to know, I’ll be more than glad to help !

  6. dlbuko says

    my b12 on 10-14-13 was 498. my tsh was 5.5 increased dose from 100 mcg to 112 mcg I took it from 10-1-13 to 10-31-13 I felt awful the whole time My renal doctor rechecked it on 10-25-13 and tsh was 1.56 and free t4 was 1.28 she thought my dose was too high I decreased dose 16 days ago in the meantime I have been online and med help thyroid community thought my b was too low . My concern is I have chronic kidney disease and have concerns about increasing it

  7. Erma says

    My B12 level is 1192. I have been supplementing with 2 Viviscal hair vitamins in the a.m. and p.m. for two months. This vitamin contains 120mg of Biotin and 12 mg of Niacin. I also take vitamin fortified Medifast diet bars and drinks and shakes. Is it possible that since, I had lab work at 11:00 am that extra Biotin and Niacin push my B12 level beyond the recommend levels?

  8. James says

    My son aged 35 has a B12 level of 1107 is this critical. He also has a low iron and is on supplements. Should he be concerned?

  9. anita says

    i am a banker .my job profile requires sitting upto 8 to 10 hours daily . my blood test report of b-12 is >2000 ,is it normal ? i m diabetic & my hb remains between 9 to 10 .please let me know what i should do for medication .

  10. Dr Ramakrishna N. Reddy dr(hc) USA says

    Recent tests revealed the present level of vitamin B12 is 1024 pg/ml . Your opinion.
    I am a cancer ostomy survivor for last 23 years & 80 years old male.

  11. RANDY says


  12. Howard Myers says

    How do you relate the B12 units pg/ml to over the counter units of mc/g ? Somebody please separate the apples from the oranges.

  13. Bonnie Traugh says

    Ive been receiving B12 injections for 3yrs. I get 1000/every 2 months. I just had my level checked and its >2000. Should I be concerned? Should I discontinue my injections?
    Thank you for your help.

  14. Wendy says

    Having a few thyroid issues being hypo and all. But…he checked my b12 and my folate? What’s the relation to check for both?
    The folate was 0.9 and the B12 was 333. Usually the b12 injections giveme energy but today is my first one in a long time (several months) and im exhausted!!hard to keep eyes opena since.
    Any ideas on the levels?
    CRP 0.9 c-reactive protien. Produced by liver, it rises when inflammation is throughout the body, it’s always in 15 yrs been flagged as high. Now it’s not?
    Folate Lvl 11.8
    Vitamin B12 Lvl 333 pp
    Sed Rate 16
    Any thoughts???
    Thank you in advance!

  15. Wendy says

    They found a fees solid nodules in my thyroid one being 1cm and then when I went for another test they couldn’t find them. Said they were gone even since my thyroid is midline they still couldn’t find it. Interesting and m curious….


    Last monthI checked my B12 level. It was 224 at VEPRA DIAGNOSTIC Centre Bengaluru. I have problems of depression ,heavyness in head,Costipation etc. tThe normal range is ,
    Normal 180-914,Intermediate 145-180 and Deficient My doctor has checked my Thyrod profile and has started medication to increase.
    He suggested that my Vitamin b12 should be about 600 or more and has suggested B12 injection and oral Tablets
    I need your advise. I am 73 years old

  17. Sarah says

    I am 22 , I have been hypothyroid since I was younger and since march I was able to get off the levothyroxine due to everything being normal and I am joining the U.S ARMY so no meds can be taken, weight loss, energy and healthy. That lasted for about 6 months until about august , then I started gaining weight fast (23lbs), fatigue, tired etc so I went back to my Dr on Oct 1 thinking my thyroid went bad, got my blood drawn but the levels were fine. Then my Dr told me that I have slight elevation in my liver, I don’t drink, smoke, do drugs.. He tested for hep A,B,C which came positive for A and B due to vaccination, C was negative. I saw another Dr 2 weeks later to get the results for the hep labs because I was tired of waiting (my Dr was sick) and he said the same thing but he wanted to retest. Same slightly elevated liver, thyroid is perfect and I had him test me for deficiencies and they only do vitamin D and b12,,, I don’t know why but anyways, my B12 was 1000 and my Vitamin D is low. I have to get a ultrasound on Monday to check my liver and I read that high b12 and low vitamin d could be liver, kidney etc disease.. I have never had this and I am freaking out, I started taking Vitamin D3 so hopefully that is why my liver is elevated. Yeah I gained all that weight but I lost it already. I eat clean(new vegetarian), drink gallons of water daily, exercise so I have no clue what’s wrong, if there is .. I dont have and liver problem symtoms, i have energy, no pain or problems. If any one has had this same problem , please share. Add me on FB at SARAH WEIR

Leave a Reply

Your email address will not be published. Required fields are marked *