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Vitamins

Holotranscobalamin

Holotranscobalamin measures the earliest sign of B12 depletion. For active individuals, catching B12 deficiency early may help maintain red blood cell production, oxygen transport, and optimal recovery from intense training.

Doctor's Assessment Included

When is this value abnormal?

Decision limits per result, in pmol/l
Result Value (pmol/l)
Low < 20
Borderline 20–40
Sufficient ≥ 40

Afkapwaarden verschillen per laboratorium (Saltro 20/40 pmol/l; elders 25/45 of internationaal 35/50). Deze banden volgen Saltro. Actief B12 is ongeschikt als controle tijdens suppletie.

Source: Saltro

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

What It Measures

This test measures holotranscobalamin (holoTC), the complex of vitamin B12 bound to transcobalamin II. This represents roughly 10-30% of circulating B12 but is considered the only form available for cellular uptake and metabolic use.

Why It Matters

Active individuals with early B12 depletion may notice reduced endurance, slower recovery, and decreased energy before a full deficiency develops. Holotranscobalamin could provide an early warning, allowing you to address the issue before it impacts performance.

When to Test

Testing may be recommended when total B12 results are borderline, if you have risk factors for B12 deficiency, or when your healthcare provider wants a more sensitive assessment of your B12 status. It can help clarify ambiguous total B12 results.

Symptoms

Low Levels

Some people with low holotranscobalamin may experience early signs of B12 deficiency including subtle fatigue, mild cognitive difficulties, and slight mood changes. These symptoms may appear before more obvious signs of deficiency develop.

High Levels

Elevated holotranscobalamin levels are generally not associated with specific symptoms. However, very high levels may occasionally be seen in certain medical conditions and should be discussed with your healthcare provider for proper interpretation.

Lifestyle Tips

Supporting healthy B12 levels through diet may include consuming animal products such as meat, fish, eggs, and dairy. Those on plant-based diets should consider discussing B12 supplementation with their healthcare provider to maintain adequate stores.

Frequently Asked Questions

How is holotranscobalamin different from active B12?
Holotranscobalamin and active B12 measure the same thing — the biologically active form of vitamin B12 bound to transcobalamin II. They are essentially the same test, sometimes referred to by different names in different clinical settings.
When would my doctor order this test instead of total B12?
This test is often ordered when total B12 results are borderline or inconclusive, or when a more sensitive early detection of B12 depletion is desired. It may provide clearer information about your body's functional B12 availability.
Can holotranscobalamin detect deficiency earlier than other tests?
Holotranscobalamin is considered one of the earliest markers to change when B12 stores begin to deplete. It may detect insufficiency before total B12 levels fall below reference ranges, potentially allowing for earlier intervention.

Tests with related values

These panels measure values from the same category as this marker.

Health Checkups

InsideTracker

A 36-biomarker performance and longevity panel inspired by InsideTracker Ultimate — covering heart, hormones, metabolism, inflammation, recovery and iron status.

SHBG (Sex Hormone Binding Globulin) TSH (Thyroid Stimulating Hormone) ALT (Alanine Aminotransferase) LDL Cholesterol GGT (Gamma-Glutamyl Transferase) Cortisol DHEA-S Estradiol (E2) Free Testosterone Total Testosterone Folate (Folic Acid) Vitamin B12 Calcium Ferritin Iron (Serum) Magnesium Magnesium (Intracellular) Potassium Progesterone Sodium Transferrin CRP (C-Reactive Protein) Glucose (Fasting) HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) HDL Cholesterol Total Cholesterol Albumin AST (Aspartate Aminotransferase) Vitamin D (25-OH) Insulin (Fasting) Leukocyte Differential Creatine Kinase (CK) Transferrin Saturation Triglycerides Basic Blood Count
€399,-
Complete Health

360 Health

Broad health panel: hormones, thyroid, vitamins, lipids, liver, kidney, and blood count.

HbA1c (Glycated Hemoglobin) TSH (Thyroid Stimulating Hormone) Triglycerides Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Free T4 (Thyroxine) LDL Cholesterol Liver Function Test (LFT) SHBG (Sex Hormone Binding Globulin) Vitamin B12 Vitamin D (25-OH) Total Testosterone Free T3 (Triiodothyronine) Ferritin HDL Cholesterol Albumin Total Cholesterol Basic Blood Count
€346,-

Whoop

A 44-biomarker comprehensive health panel inspired by WHOOP Advanced Labs — a deep look at metabolism, cardiovascular risk, hormones, liver, kidney and inflammation.

SHBG (Sex Hormone Binding Globulin) TSH (Thyroid Stimulating Hormone) ALT (Alanine Aminotransferase) LDL Cholesterol Cortisol DHEA-S Estradiol (E2) Free Testosterone FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) Total Testosterone Bicarbonate Calcium Chloride Ferritin Iron (Serum) Magnesium Potassium Sodium Transferrin CRP (C-Reactive Protein) Homocysteine Glucose (Fasting) HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) HDL Cholesterol Omega-3 Index Total Cholesterol Albumin HOMA-IR ALP (Alkaline Phosphatase) AST (Aspartate Aminotransferase) Bilirubin (Total) Total Protein Urea (BUN) Creatinine Vitamin D (25-OH) eGFR (Estimated Glomerular Filtration Rate) Insulin (Fasting) Leukocyte Differential Transferrin Saturation Lipoprotein(a) Triglycerides Basic Blood Count
€499,-

Holotranscobalamin

€49,-