[Appropriate use of laboratory tests – vitamin B12 testing]
Gonthier K, Neveu B, Robitaille H
Record ID 32018015609
French
Original Title:
Utilisation judicieuse des analyses biomédicales ‒ Dosage de la vitamine B12
Authors' objectives:
Vitamin B12 testing raises several issues concerning its relevance, particularly because
there is no known clinical benefit that supports screening for vitamin B12 deficiency in
asymptomatic individuals. In Québec, this biochemical test is frequently used. The
objective of this work is to develop a guidance sheet to support appropriate use, in order
to reduce the volume of procedures with low added value within Québec’s healthcare
system.
Authors' results and conclusions:
RESULTS: Vitamin B12 testing is not indicated:
• for routine screening for vitamin B12 deficiency in adults, adolescents, and
children who are asymptomatic or at low or moderate risk;
• in persons receiving vitamin B12 supplementation. Vitamin B12 testing may be indicated for persons with:
• unexplained anemia or macrocytosis;
• unexplained neurological signs (e.g., paresthesia, ataxia, neurocognitive
disorder), particularly in populations at increased risk such as older adults,
persons with an alcohol use disorder, vegetarians (or vegans), or malnourished
persons. Repeating vitamin B12 testing may be considered, according to clinical judgment, when
signs or symptoms raise suspicion of vitamin B12 deficiency in certain populations CONCLUSION: The guidance sheet that was developed aims to engage, guide, and support healthcare
professionals in promoting the appropriate use of vitamin B12 testing. It may thus
contribute to reduce the annual number of test requests and associated costs and
workload, while also generating a positive environmental impact.
Authors' methods:
A review of the literature on the indications and recommendations related to vitamin B12
testing was conducted using INESSS’s rapid review methodology. Healthcare
professionals provided experiential and contextual knowledge specific to Québec.
Details
Project Status:
Completed
Year Published:
2026
URL for published report:
https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Biologie_medicale/AnBio_Vitamine_B12_GN_INESSS.pdf
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Vitamin B 12 Deficiency
- Medical Overuse
- Hematologic Tests
- Unnecessary Procedures
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.