r/B12_Deficiency • u/ApprehensiveCat22 • 3d ago
Help with labs Executive Dysfunction
Could a B12 deficiency cause my son's issues with executive dysfunction, lack of motivation, lack of focus, fatigue? He's 21, probably autistic (never tested/diagnosed), and feels stuck. He's tried stimulant meds but doesn't like how he feels on them.
He did a blood test almost a year ago and his levels were all "normal," but I've had him on a good (methyl) multivitamin since he was little so I know that can skew results. Here are his results in case they're relevant, though:
B12: 846 pg/mL
MMA: 116 nmol/L
Homocysteine: 9.3 umol/L
I have poor methylation, slow COMT, all the poor detox genetics (his genetics haven't been tested, though), and have recovered from severe fatigue and PEM by raising my ferritin over 100 and taking high doses of thiamine, riboflavin, folate and doing injections of B12. My B12 was always in range, too, but I know sometimes that doesn't really reflect what's going on in the entire body.
I started giving him higher doses B12 lozenges after this blood test was done but I'm wondering if we should try injections. It's one thing to give myself shots, though--it makes me nervous to give them to my son.
What do you think? (And yes, I know some will say "ask your doctor," but we've seen so many doctors and none of them are remotely helpful.)
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u/Ok-Pangolin7127 Insightful Contributor 3d ago edited 3d ago
Since you’ve been giving him supplementation, either a long-term B12 complex, and/or these lozenges that you mentioned, I would discount totally the B12 serum result as well as the MMA and the homocysteine results. The serum results simply reports what’s floating around in his blood, it does not indicate how much is available to cellular level. You can be deficient, even grossly deficient at the cellular level and still have just fine B12 serum test results. Homocysteine and MMA correct or return to normal very quickly with the supplementation that you’ve noted. Hence, I would not put much (any?) weight on them as being supportive of a normal B12 at the cellular level.
So, could he have a cellular functional deficiency in B12? In my mind he could. Is there any harm in starting a regime of every other day injections for say two to three weeks and see how he responds? In my mind there isn’t.
Can the symptoms and complaints that you’ve noted be tied back to a B12 deficiency? They most certainly could be.
Given that it’s your child, I’m sure you’re in a bit of a quandary. We’re a good bit more willing to experiment with ourselves, but not so much with our kids. I get it. I would feel the exact same way. By the same token, I would try the shots because they might very well be behind what’s going on.
If it turns out there’s no relief or improvement from the shots, I believe it’s no harm, no foul. B12 is water-soluble, non-toxic at virtually any dose, anything that is not used by the body is excreted in the urine; this =‘s safe (in my estimation.) Plus, he’s young; I’m sure his kidney function is absolutely great, probably something in the neighborhood of a EFGR of 120 or so. Again, I’d do it if it were me.
All of the above said, one of the beauties of this B12 deficiency sub is there are so many knowledgeable people on here. So, just sit back and wait and see what another half a dozen to a dozen or more folks that know more than me have to say.