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Pernicious Anaemia Society
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I have many of the symptoms of PA but have been told by my GP that blood test results are 'normal'. Not sure where to turn next!


If anyone could offer any advice I would be very grateful. I've been suffering from lethargy, exhaustion, poor memory, zero attention span, pins and needles, Reynaulds and shortness of breath for years now. It's now to the point where I am doing odd things like putting my phone in the fridge, milk in the cupboard, etc, on a regular basis. Initially went to the GP around 10 years ago and ended up with a diagnosis of ADD but none of my symptoms are resolved with my ADD medication - they get me through the day but that's it. Have recently gone back to the GP and queried whether it could be B12/anaemia related. They have categorically ruled this out due to the following blood test results:

Serum iron: 14.4 (9-30.4)

Serum transferrin: 3.2 (2-3.4)

Transferrin saturation index: 17% (15-65%)

Serum ferritin: 15ug/L (15-200)

Serum vitamin B12: 300 (179-1162)

Serum folate: 5.2 (2.8-12.4)

Serum vit D3: 71

Serum TSH: 0.95 (0.3-5)

Serum free TS4: 12.4 (8.8-18.8)

RBC: 4.49 (3.8-5.8)

MCV: 87.5 (76-98)

MCH: 29.7 (26-32)

MCHC: 340 (310-360)

Haematocrit: 39.3% (37-47)

Red Blood cell distribution width: 13.2% (11-14)

Neutrophil: 5.2 (2.5-7.5)

Lymphocyte: 2.5 (1.4-4)

Monocyte: 0.6 (0-0.8)

Eosinophil: 0.1 (0-0.4)

Basophil: 0.0 (0--.2)

Erythrocyte sedimentation rate: 2mm/h (3-12)

My GP has basically told me that she doesn't know what to test for next! Can anyone offer any advice? I'm at my wits end and seem to be getting more and more tired by the month.

Thank you so much in advance!

p.s. not sure if this is relevant but a blood test in November last year had my iron at 18.7, TSH at 1.17 and FT4 at 14 so these have all dropped in the last 9 months or so.

2 Replies

You could ask to be referred for the active b12 test at st Thomas' hospital in London, it costs £18. Are you near London? MMA is £96 and homocysteine £40 if you want those as well. Or your doc could trial you on treatment? The new BCSH guidelines may help, see Algorithm 1:


More good info here:



Thank you, that's very helpful.

The doctor has agreed to send me for a further blood test to check for intrinsic factor. I'm near London so will mention the tests at St Thomas' when I go to pick up the results. They won't trial treatment for B12 without more evidence, but at least they now agree with me that my ferritin levels are low enough to warrant medication!


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