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Test Referenced | Entry Type | Mayo ID | Description | Reporting Description | Method | Collection Container | Temperature | Stability | [NAME] | Unit of Measure | [NAME] | Minimum Volume | Reject Due To | Reference Values | Days/Times Performed | Analytic Time | Maximum Lab Time | CPT Units | CPT Code | LOINC® Code | LOINC® Attributes | Always Performed | Orderable Separately | Performing Location
FB12V | Test | FB12V | [NAME] Deficiency Panel | [NAME] Deficiency Panel | Gas Chromatography/Mass Spectrometry (GC/MS) | Green-Top Tube (Sodium Heparin): GrnNaHp OR Plain, Red-Top Tube: Red OR |  |  | 1 | mL | Submit only 1 of the following specimens:   Preferred Serum Draw blood in a plain, red-top tube(s). Serum should be separated from cells within 1 hour from time of collection or kept on ice prior to separation. Pour off 1.0 mL serum into a plastic vial, freeze and ship frozen. Note: 	1. Indicate serum on request form. 	2. Label specimen appropriately (serum).   Alternate Plasma Draw blood in a heparin (green-top) tube(s).  [NAME] should be separated from cells within 1 hour from time of collection or kept on ice prior to separation. Pour off 1 mL plasma into a plastic vial, freeze and ship frozen.  Note:  	1. Indicate plasma on request form. 	2. Label specimen appropriately (plasma). | 0.2 mL | Specimens other than	Serum, plasma Anticoagulants other than	Heparin Hemolysis	NA Thawing	Warm reject; Cold OK Lipemia	NA Icteric	NA | INTERPRETATION:                     NORMAL     B12 DEFICIENCY     FOLATE DEFICIENCY Metabolite    %HIGH                %HIGH                                %HIGH            RANGE VALUES   RANGE   VALUES      RANGE    VALUES Methylmalonic Acid:                       73-271   <3            271-200,000  >95             73-271    <3 2-Methylcitric Acid:                       60-228   <3             228-15,000   >80              60-228    <3 Homocysteine:                       5.1-13.9 <3                 14-500       >95             14-250    >95 Cystathionine:                        44-342  <3             342-4000      >80         342-18,000 >80      NOTE 1)Serum Methylmalonic Acid and Homocysteine are the primary metabolic tests for diagnosing and distinguishing between B12 and folate deficiency. They can be used in conjunction with the serum B12 which is usually low or low normal (<350 pg/mL) in B12 deficiency and the serum folate which is usually low or low normal (<5 ng/mL) in folate deficiency. 2-Methylcitric Acid and Cystathionine provide confirmatory evidence for such deficiencies. Homocysteine and especially Cystathionine may also be high in B6 deficiency.      NOTE 2) Elevated levels of serum metabolites will correct to normal after treatment with the appropriate vitamin but will not correct after treatment with the wrong vitamin, even in pharmacologic amounts.      NOTE 3) Any of the four metabolites can be elevated due to renal insufficiency or intravascular volume depletion. This occurs most commonly in the case of 2-Methylcitric Acid and Cystathionine. Elevated metabolite levels do not correct with B12, folate or [NAME] treatment unless vitamin deficiency coexists.   NOTE 4) Serum metabolite levels can be rechecked 5 to 15 days after vitamin therapy.      NOTE 5) Normal ranges 6 hours post oral [NAME] load (100 mg L-Methionine/kg body wt.) are as follows: Homocysteine 16.5-45.7 umoles/Liter and Cystathionine 424-2500 nmoles/Liter. Methylmalonic Acid and 2-Methylcitric Acid do not change after a [NAME] load.      Test Performed by: Metabolite Laboratories, Inc.                              Department of Hematology                              University of Colorado Denver                              12700 E. 19th Ave., Room 9122/9125                              Building P-15, Research [NAME]Aurora, CO 80045 | Monday and Wednesday | 2 days | 8 days |  | Profile |  |  |  |  | Metabolite Laboratories, Inc. Department of Hematology Univ of C
FB12V | [NAME] | VARIES | Varies |  |  |  | Frozen
FB12V | Result | Z0152 | Methylmalonic Acid | Methylmalonic Acid | Numeric |  |  |  |  | nmol/L |  |  |  |  |  |  |  |  |  | In Process
FB12V | Result | Z0153 | 2-Methylcitric Acid | 2-Methylcitric Acid | Numeric |  |  |  |  | nmol/L |  |  |  |  |  |  |  |  |  | In Process
FB12V | Result | Z0154 | Homocysteine | Homocysteine | Numeric |  |  |  |  | umol/L |  |  |  |  |  |  |  |  |  | In Process
FB12V | Result | Z0155 | Cystathionine | Cystathionine | Numeric |  |  |  |  | nmol/L |  |  |  |  |  |  |  |  |  | In Process
FB12V | Billing Component | FB12V |  | Organic acid, single, quantitative |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 83921
FB12V | Billing Component | FB12V |  | Amino Acids, QN,each spec |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 | 82136