Author Archives: dgfarmer

NICE briefing

The UK National Institute for Health and Care Excellence (NICE) has issued a briefing on the use of Active-B12. Their review is very positive and suggests that the likely use of Active-B12 would be in place of current tests in people with suspected Vitamin B12 deficiency.



Axis-Shield will attend MEDICA in Dusseldorf, Germany from November 16-19th 2015. If you would like to learn more about Active-B12 or if you would like to discuss distribution of the assay please visit us in Hall 16 Stand G10 or contact us.

Oxford Project to Investigate Memory and Ageing (OPTIMA)

A team from the Oxford Project to investigate Memory and Ageing (OPTIMA) has found that on average, in those taking vitamin supplements, brain shrinkage slowed by 30%.

In some cases it slowed by more than 50%, making their brain atrophy no worse than that of people without cognitive impairment.

Importantly, only the Active-B12 result and NOT the standard Total B12 result was able to predict the cognitive decline.

Scottish Parliament – Pernicious anaemia and vitamin B12 deficiency debate

A petition to the Scottish Government has urged a review and overhaul of the current method of diagnosis and treatment of pernicious anaemia and vitamin B12 deficiency.

The chamber heard that there was no consensus across individual NHS boards on the current testing methods and also that the Axis-Shield Active-B12 test offers a more accurate method of detecting this disease.

UK Lab Quality Service publicises concerns over B12 tests

UK NEQAS, the body which ensures the quality of UK lab results, have publicised their concerns over the traditional B12 tests. In the April 2013 newsletter of the Association of Clinical Biochemists (ACB), they write:

“UK NEQAS Haematinics is keen to publicise their concerns on problems with current B12assays which may be vulnerable to interference resulting in normal values despite severe cobalamin deficiency.

The Committee advises that where there is a discordance between the clinical features of neuropathy such as parasthesiae, loss of joint position sense, or megaloblastic anaemia and a “normal” B12 result, clinicians are advised to request storage of serum for further testing and are advised to treat the patient withB12 replacement therapy.

Further testing may include repeat testing by an alternativeB12 assay, holotranscobalamin assay, serum methylmalonic acid and measurement of intrinsic factor antibody. Treatment with B12 should not be delayed to avoid progression of neurological damage”

View the warning in the ACB newsletter here.

Vitamin B12 and One Carbon Metabolism in Health and Disease

Vitamin B12 and One Carbon Metabolism in Health and Disease
New Delhi, India 8-10th March 2013

“Vitamin B12 is an important micronutrient linking our diet to health. Deficiency of this vitamin leads to high levels of homocysteine, a key intermediate in the one carbon metabolism pathway that has been associated with several complex disorders. Reports from various parts of India have projected that 30-60% of the population irrespective of the age group are deficient in Vitamin B12.

However, despite the wide prevalence of vitamin B12 deficiency there has been a lack of concerted efforts from the clinicians and researches to understand the importance of vitamin B12 in India and conditions arising due to its deficiency, some of which are trans-generational. This meeting would focus attention on this important public health issue for the Indian population.

The meeting will deliberate on the genetic, epigenetic and dietary factors that predispose Indians to vitamin B12 deficiency and hyper-homocysteinemia and provide mechanistic insights on the role of one carbon metabolism in health and disease”


To see the presentation which Axis-Shield made at the conference please click here

Vitamin B12 Symposium 2012

Vitamin B12 Symposium 2012
Nancy, France, September 20th-22nd 2012

This scientific congress reviewed current findings in the field of Vitamin B12. The added utility of Active-B12 was reviewed and discussed in several sessions and was once again shown to be the best single marker of B12 status. Some of the topics are shown below with a summary of the presentations:

The Application of serum holotranscobalamin, supported by methylmalonicacid as a front-line test to assess vitamin B12 status in a mixed patient population.

A. Sobczynska-Malefora, Nutristasis Unit, GSTS Pathology, London, UK

“Assays for holotranscobalamin and MMA can be successfully utilised in tandem to define vitamin B12 status in large mixed patient populations. Initial automated screening by holotranscobalamin identifies an indeterminate cohort who benefit from confirmatory testing by MMA”

Is HoloTC a more valuable biomarker of Vitamin B12 intake and status?

CF Hughes, Northern Ireland Centre for Food and Health, University of Ulster

“These results support the conclusion that holoTC is a more sensitive biomarker of vitamin B12 status than the more traditional biomarker, serum total B12. HoloTC was more strongly correlated than serum total B12 to dietary intakes in both younger and older adults. HoloTC was able to detect small changes in vitamin B12 intake that were not detected by serum total B12”

HoloTC, the active B12

E. Nexo, Dept of Clinical Biochemistry, Aarhus University Hospital, Denmark

“HoloTC or Active-B12 denotes the part of circulating plasma cobalamin available for cells of the body. Current data supports holoTC as a promising biomarker for vitamin B12 status, both when holoTC us used alone or in combination with other biomarkers. Notably holoTC is the biomarker of choice in situations where measurement of total cobalamin is inadequate. During pregnancy total cobalamin declines despite a normal vitamin B12 status while holoTC remains unchanged. In children severely vitamin b12 deficient because of a lack of transcobalamin (total TC), total cobalamin may remain within the reference interval while no holoTC is detected. Finally, newly absorbed vitamin B12 occurs as holoTC, and therefore an increase in holoTC upon oral loading with vitamin B12 can be used to judge the capacity for uptake of the vitamin”

MMA, Hcy and other metabolic markers of vitamin B12 deficiency

W.Herrmann, Dept of Clinical Chemistry, Saarland University, Germany

“Vitamin B12 deficiency is more widespread in the population than has been assumed so far. Measurement of total vitamin B12 has limited diagnostic sensitivity and specificity, especially in the concentration range <400pmol/L…..a lowered serum holoTC concentration (but normal MMA) is the earliest marker of vitamin B12 deficiency and signals that the body does not have sufficient available vitamin B12…Lowered holoTC combined with raised MMA and homocysteine levels are indicative of metabolically manifest vitamin B12 deficiency. The new markers enable the detection of vitamin deficiency notably more often.”