Vitamin B12 level is high in a diabetic patient. Please help.

Patient's Query

Hello doctor,

I am 60, weight is 44 kg, height is 5.6, diabetes for past 25 years, on low carbohydrate diet for 80 days, taking no medicine for diabetes now. Sugar levels are under control, checking every day. The problem from past 50 days is that there are feet and ankle swelling that disappears in the morning and comes back by night. No pain or weight loss. Kidney function test, liver function test, 2D echo, thyroid test, HbA1C, lipid profile, stool examination, B12 tests were done. Met local doctor, and he said it is nutritional pedal edema or malabsorption. Prescribed below medicine. Oroalbumen powder three times for 30 days. Revidox LB twice a day for five days. Lasilactone 25 mg once in the morning for three days. Along with the above, taking Thyronorm 25 mcg, Vitamin C, multivitamin tablet, Omega 3 fish oil, Ecosprin 75. It has been three days, did not see much improvement. Vitamin B12 was 1271.

My questions are why is Vitamin B12 high? Could this be small intestine bacterial overgrowth? Taking lots of proteins and healthy food, but no use. Could you please help to get the food absorbed.

Answer

Dr. Noushif M

General Surgery Medical Gastroenterology Surgical Gastroenterology

Hi,

Welcome to icliniq.com.

High vitamin B12 can result from multiple causes. Since your liver function test, kidney function test, peripheral blood smear, etc., are normal (attachment removed to protect patient identity), we can rule out these as the cause. Other causes like diabetes (which you have as evidenced by HBA1c), nonvegetarian diet (do not know your status) and vitamin supplementation (which you are on) can also cause mild elevations. Small intestinal bacterial overgrowth results in Vitamin B12 deficiency.

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