Reference values for serum levels of vitamin B12 and folic acid in a population-based sample of adults between 35 and 80 years of age

Objectives: To examine folic acid and vitamin B-12 status in a group of 1000 persons sampled from the community of Umearing, Sweden, and aged 35, 40, 45, 50, 55, 60, 65, 70, 75 or 80 years. Reference data for folate and age-stratified reference data for vitamin B-12 are presented, together with an examination of potential confounders. Measurements: All subjects participated in extensive health examinations and interviews, and laboratory blood testing was performed. Results: A series of exclusion criteria were applied, and data from 961 subjects were analysed. Vitamin B-12 levels were found to decrease with increasing age, whereas folate levels remained constant across the age span studied. None of the vitamins was found to vary with sex, education, smoking or alcohol consumption, body mass index, prescription-free vitamin supplements, level of haemoglobin, or mean cell volume of erythrocytes. Further, none of these factors was associated with the age-related decrease of vitamin B-12 level. Conclusions: The offered reference ranges should be used only in order to rule out deficiency. For B-12 levels, the age of the subject should be considered such that, for elderly people in particular, values above the medians should be considered as indicative of normal vitamin status.