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Background:  A novel approach to determine vitamin B 12  status is to combine four blood markers: total B 12  (B 12 ), holotranscobalamin (holoTC), methylmalonic acid (MMA) and total homocysteine (tHcy). This combined indicator of B 12  status is expressed as cB 12 =log 10 [(holoTC·B 12 )/(MMA·Hcy)]–(age factor). Here we calculate cB 12  in datasets with missing biomarkers, examine the influence of folate status, and revise diagnostic cut-points.

Combined indicator of vitamin B 12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points