Author Archives: dgfarmer

BBC Radio 4 Inside Health

The failings of current tests and treatment for Vitamin B12 deficiency were discussed on Radio 4’s Inside Health program on 4th September 2012.

Professor John Hunter of Cranfield University and Martyn Hooper, Chair of the PerniciousAnaemia Society discussed how current practices are not meeting patient needs due to the poor performance of existing blood tests and the out-of-date guidelines provided to doctors.

Listen to the discussion here

B-vitamins and Choline 2012

This well-attended conference in Leipzig in March 2012 once again highlighted the increasingly important role of testing for Active-B12 (Holotranscobalamin).

Following this conference, an International Expert Panel released the following Consensus Statement.

IFCC Worldlab/Euromedlab Berlin 2011

Axis-Shield exhibited at the IFCC meeting and also held a workshop on Active-B12 with two invited speakers from clinical chemistry and academia.

A workshop was also sponsored by Abbott Diagnostics where a talk was given by a leading expert on Vitamin B12.

The presentations given at both workshops were very well received and all recommended the use of Active-B12 as a first-line test for diagnosing Vitamin B12 deficiency. The presentations from the Axis-Shield workshop are available to view below, along with a summary of all three presentations.

In addition, a poster was presented by a research group which also concluded that Active-B12 is a superior marker to Total B12.


Professor John Scott, Trinity College, Dublin, Ireland:

The diagnostic accuracy of Active B12 using red cell B12 levels to indicate B12 tissue status

  • Active-B12 outperforms Total B12
  • Active-B12 has superior specificity and sensitivity than Total B12

> Euromedlab Berlin 2011 Scott presentation PDF (642KB)

Professor Jan Lindemans, Erasmus Medical Centre, Rotterdam, Netherlands:

Outcomes of a multi-centre study and experience with introducing and running Active B12 in the clinical chemistry lab

  • The Active-B12 assay demonstrates a better sensitivity and specificity in detecting vitamin B12 deficiency than the Total B12 assay in a mixed collection of diagnostic samples
  • For the detection of B12-deficiency, Active-B12 can replace Total B12 as a first-line diagnostic aid; no reason for combination with Total B12.

> Euromedlab Berlin 2011 Lindemans presentation PDF (748KB)

Professor Wolfgang Herrmann, Dept of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Germany:

Clinical implication and methods used to detect early development of Vitamin B12 deficiency

  • HoloTC is…a sensitive and powerful marker of low B12 status
  • Total Vitamin B12 underestimates the prevalence of vitamin b12 deficiency
  • HoloTC is related to brain shrinkage and indicates sensitive cognitive impairment

E. Haschke-Becher, M.Linnebank, B.Fowler, A.Kainz, I.Aigner, P.Niedetzky, WJ.Erwa, O.Stanger

Effectiveness of serum Holotranscobalamin II and/or Vitamin B12 in diagnosis of vitamin B12 deficiency

  • HTC has a high accuracy in identifying non-depletion. Therefore it is an ideal entry marker that allows to stop further testing after identification of non-depletion.
  • HTC has a significantly better positive predictive value in the depletion group than total serum vitamin B12.
  • HTC is a more reliable indicator than total serum vitamin B12 in this healthy population with normal renal function and should be used to screen for vitamin B12 deficiency.
  • HTC might reach an even better sensitivity and specificity than calculated from this study, if it can be established as an early marker for B12 depletion that precedes MMA elevation with high accuracy as described in a recent publication.

> Euromedlab 2011 Haschke-Becker poster (553KB)

Pernicious Anaemia Society, June 2011

Pernicious Anaemia Society: Diagnosing B12 Deficiency – Problems, Consequences and Resolution
June 2011, Porthcawl, Wales

The Pernicious Anaemia Society held a symposium and study day in Porthcawl, Wales in June 2011 to highlight the problems of diagnosing B12 deficiency and the potentially serious implications. A number of informative talks were given from leading experts on Vitamin B12.

The speakers recognised that current testing for B12 status using the Total B12 assay is flawed due to the non-specific nature of the test. Several of the speakers recommended the use of the more specific and sensitive Active-B12 assay for diagnosing B12 deficiency.

Dr Fiona Porter-Smith, GP, Cwm Garw Practice, Bridgend.
The Problems of Diagnosing B12 Deficiency: The Patient Perspective

Professor John Scott, Professor of Molecular Medicine, Trinity College Dublin
The Absorption of Vitamin B12 and it’s Interruptions; revisited

Dr Anne Molloy, Clinical Lead, Vitamin Research Group, Trinity College Dublin
Should HoloTC be the first line diagnostics procedure for assessment of vitamin B12 status? A comparison of the performance of blood indicators of tissue B12 status

Professor Helga Refsum and Professor David Smith, University of Oxford
Low-normal B12 status: assessment, prevalence and association with disease

Dr Siddarth Banka, Regional Genetics Service, University of Manchester
Pernicious Anaemia – Genetic Insights

Professor John Hunter, Professor of Medicine, University of Cranfield
Does the large bowel sometimes have an effect on B12 metabolism?

Dr Joseph Chandy, GP, Shinwell Medical Centre
A Protocol for B12 Diagnosis and Treatment by Primary Care Clinicians

The symposium concluded with a powerful documentary made by the society entitled ‘Living with the Fog’. The film highlights the serious issues in diagnosis and treatment of B12 deficiency and the devastating effects it can have on patients.

For further information please see

8th International Conference on Homocysteine Metabolism Lisbon, June 19-22nd 2011

8th International Conference on Homocysteine Metabolism
Lisbon, Portugal June 19-22nd 2011

Several sessions at the conference focussed on Homocysteine in relation to Vitamin B12. The importance of correctly estimating B12 levels was once again highlighted. Some of the presentations and posters from the conference are shown below. For more information on these presentations, please contact Axis-Shield.

Plasma vitamin B12 and holoTC – between uptake and utilisation
Ebba Nexo (Aarhus, Denmark)
Vitamin B12 intracellular trafficking
Brian Fowler (Basel, Switzerland)
Holotranscobalamin predicts tissue vitamin B12 status (red cell cobalamin) in elderly subjects with significantly greater accuracy than either total serum cobalamin or methylmalonic acid
Anne Molloy (Dublin, Ireland)
Baseline homocysteine is crucially important in trials with B vitamin: the VITACOG trial
David Smith (Oxford, United Kingdom)
Cognitive function in an elderly population: interaction between vitamin B12 status, depression and apolipoprotein E4. the Hordaland homocysteine study
Anna Vogiatzoglou (Reading, United Kingdom)