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  • 25 year old female patient with worsening fatigue and abnormal vitamin level.
  • PCP wanted guidance and confirmation on next steps for patient who was advised to take B12 supplement.
  • Specialist provided educational guidance on appropriate levels and additional resources for improvement of symptoms.

eConsult Transcript

PCP submission

Hi I have a healthy 25 y/o F pt who c/o fatigue, I did some labs and a covering doctor sent lab results to pt on behalf of me. Pt’s vit B12 level was 295 (normal: 200-1100) and pt was advised to take vitamin B supplement.

Specialist response

Hi, thanks for the consult. Since her B12 was on the lower end, I think a supplement would be appropriate. The RDA for Vit b12 for her would be 2.4 mcg/day. I would recommend starting with 500 mcg because her B12 was on the lower end but not out of range. If on a recheck her level has not increased to where you would like it to be, you could then consider increasing the dose. In one study, supplementing with 500 mcg of Vit b12 normalized b12 levels for 90% of participants so this dose would also likely be adequate for your patient.

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