Blood chemistry continues to be the gold-standard test within the healthcare system. It provides a window into the patient’s health and encourages better communication between you and your patient. Blood labs can help bridge the gap between conventional treatments and holistic alternatives, providing confidence and assurance for the patient.
Establishing a solid baseline with blood tests is especially helpful. From that baseline, you can then monitor trends and catch deviations that might have otherwise gone unnoticed. This can make a world of difference in your recommendations and your outcomes.
Because of this, the more you understand blood chemistry, the more value you can offer your patient.
But interpreting and evaluating blood labs can feel overwhelming – especially if they’re not an everyday part of your practice.
- You might be wondering how to easily explain blood labs to your patient.
- Maybe you have a patient who is describing some pretty broad symptoms (e.g., headaches or feeling weak).
- Or perhaps you struggle with connecting how blood chemistry and labs can inform your recommendations.
Does this sound and feel familiar? If so, it’s totally understandable! Incorporating blood testing as a routine part of your patient process may feel complicated, but it doesn’t have to be.
Sometimes having an example helps. In the article below, we’ll walk through how you can use three common markers to detect an underlying condition. Let’s dive into vitamin B12, methylmalonic acid (MMA), and folate.
What Are Vitamin B12, MMA, and Folate?
One of the most common blood markers is vitamin B12. But there are two others that you’ll also want to pay attention to – MMA and folate. When you first look at your patient’s labs, how these three relate to one another may not initially seem that intuitive. Let’s take a quick look at each of them and how they work together.
B12 is such an important vitamin – it’s quite possibly the MVP for the body.
- Helps create red blood cells, which carry oxygen throughout the body
- Plays a key role in carbohydrate metabolism
- Is critical for maintaining nerve function
- Helps make DNA within the cells
B12 is absolutely essential.
Because of B12’s importance, the body stores a significant amount of it – several year’s worth.So, when you see a B12 deficiency on a blood test, you can be confident that your patient has been deficient for quite some time.
MMA is produced from the breakdown of fatty acids and amino acids. It reacts with vitamin B12 to produce coenzyme A (CoA), which is crucial to cellular function.
For MMA to be useful, it must react with B12 to produce this enzyme. So, if there’s not enough B12 available, MMA will build-up in the body. This is why you’ll want to look at MMA levels if you’re checking your patient for a possible B12 deficiency.
Folate, also called vitamin B9 or folic acid, is naturally present in certain foods and sometimes added to others. It plays a critical part in developing blood cells as well as converting carbohydrates into energy. Folate is critically important during certain periods of high growth, such as during pregnancy, infancy, and into adolescence.
The body needs both folate and B12 to function normally. Both play key roles in making red blood cells and creating DNA and RNA that help build cells. Because B12 and folate often go together, this is where MMA comes in handy. The MMA level can help distinguish between a B12 and a folate deficiency in your patient. Simply put, MMA levels are normal with a folate deficiency, but they’re elevated with a B12 deficiency.
The Role of Food
Vitamin B12 and folate are considered essential nutrients. This means they must be consumed from food and absorbed by the body – not synthesized within the body like other nutrients may be. So, you’ll want to consider your patient’s diet. Look at what he or she is eating on a daily basis and make proper recommendations to optimize their B12 and folate levels.
Food Sources of Vitamin B12
The body prefers and utilizes B12 much more efficiently from food than through supplements. The majority of vitamin B12 comes from animal sources, so you’ll want to recommend foods like liver, sardines, tuna, beef, eggs, raw milk, etc.
If B12 levels are low, you might want to consider the possibility of malabsorption or other conditions such as hypochlorhydria, small intestinal bacterial overgrowth, or pancreatic insufficiency. You’ll have to examine and rule out extenuating factors based on what you see in your particular patient.
Food Sources of Folate
Decreased folate can be caused by a number of factors – pregnancy, certain medications, or your patient’s diet, to name a few. Your patient could be consuming a high amount of refined carbohydrates, preventing them from getting enough folate in their diet.
Fortunately, foods rich in folate are a bit different than B12-rich foods. There’s a much larger pool of foods for your patients to choose from – ones that can really make a positive impact on getting folate into their bodies. Foods such as organ meat, liver, and egg yolks are abundant in folate. But if those are not good options, there’s also a good amount in avocados, asparagus, cauliflower, broccoli, and brussels sprouts.
Also, folate is especially important during pregnancy, so make sure your recommendations for pregnant mamas include plenty of folate-rich foods.
Bringing It All Together for Your Patient
Because vitamin B12, MMA, and folate are interrelated, evaluating the three in relationship to one another is crucial. One marker’s performance can clarify or give insight into what’s happening with the others. And when looking at the three together, you can get a clearer picture of what’s going on with your patient.
From here, you can continue to narrow down and identify the root causes behind their symptoms. Doing so helps you create the most effective treatment plan for your patient. Because at the end of the day, you want what’s best for your patient and what will help them heal.
I’m Here to Help You
Knowing how to interpret blood labs accurately is a skill – one that takes time to master. If you’d like to deepen your understanding of blood chemistry, I’ve got you covered.
This month, I’m hosting an online Blood Chemistry Seminar. This seminar is entirely virtual and designed to teach you how to evaluate blood markers with ease and clarity. Having the confidence to make the right recommendations will translate to better patient results and greater satisfaction. I’ll be teaching you how to evaluate:
- metabolic panel
- thyroid panel
- lipid panel
- iron panel
- and so much more
And the best part – we’ll work through the material using simple, easy-to-understand language that you can use to help your patients understand what’s going on in their body.
If you’re here reading this, wishing you had been able to participate in the Blood Chemistry Seminar – don’t you worry! The seminar notes are available for purchase here. Make sure you check it out and grab a copy. I can’t wait for you to dive in!
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3. (2020, July 31). Methylmalonic Acid (MMA) Test: MedlinePlus Medical Test. Retrieved September 14, 2020, from https://medlineplus.gov/lab-tests/methylmalonic-acid-mma-test/
4. (2020, June 3). Folate – Health Professional Fact Sheet. Retrieved September 14, 2020, from https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
5. (n.d.). Vitamin B-12 and Folate – Health Encyclopedia – University of …. Retrieved September 16, 2020, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=vitamin_b12_folate
6. (2020, July 31). 4.2: Nutrients – Biology LibreTexts. Retrieved September 16, 2020, from https://bio.libretexts.org/Bookshelves/Human_Biology/Book%3A_Human_Biology_(Wakim_and_Grewal)/04%3A_Nutrition/4.2%3A_Nutrients
7. (2020, February 25). Top 12 Foods That Are High in Vitamin B12 – Healthline. Retrieved September 16, 2020, from https://www.healthline.com/nutrition/vitamin-b12-foods
8. (n.d.). Folate Deficiency: Causes, Symptoms, and Diagnosis. Retrieved September 14, 2020, from https://www.healthline.com/health/folate-deficiency