Pernicious Anaemia Society

Elevated B12 serum but might be PA

Just had another serum B12 test, and it came back elevated: 917 (191 - 663). I think that I'm unable to utilize B12, and it's just doing nothing.

I've just had a comprehensive test, in which they check a whole load of levels. But after reading the PAS testing guidelines, it seems I may be deficient.

The PAS mention that a high MCH is a possible marker, and mine came in at: 32.7 (27 - 32.0). Another marker is high cholesterol: 6.4 (0.0 - 5.0), and the PAS guide recommends that the folate serum goes no lower than 10, and mine shows: 6.4 (4.6 - 18.7). I also see people here mention ferritin, and mine is: 81.5 (28 - 365).

My main symptoms are: fatigue, muscle ache, tinnitus, pins and needles in hands/feet, and heart palpitations, plus a whole load of goodies.

Based on this info, should I not bother with further tests, i.e. HoloTC, MMA, tHcy, and just self treat? Plus it may take awhile to get a doctor's referral. I'm really looking to save money, but will go ahead if it convinces my GP to treat me in the long term.

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Have you been supplementing B12 at all? If not then your B12 levels look a bit high for that to actually be the problem. Imagine it isn't impossible but generally the grey stone starts at 500.

If you have been supplementing then that is likely to make the B12 serum test difficult to interpret and you probably need to stop supplementing for at least 3 months to get an interpretable result.

If your folate is on the low side then that is more likely to be a problem as your body needs folate in order to metabolise B12, so might be worth looking into supplementing that.

Unfortunately the symptoms of B12 deficiency have a high crossover with other conditions so best to follow up on other possibilities. You could always try printing out the list of symptoms and ticking off everything that you have and talking through that with your GP so B12 doesn't get ruled out as a possibility.

I believe there is a genetic condition that means some people are unable to process B12 at all but think that would have manifested itself in childhood.


Just wondering, have you had your thyroid bloods checked alongside B12 BreklandRanger ?

B12 Deficiency mimics Hypothyroid symptoms. (Hypothyroidism is an under active thyroid)

High cholesterol blood levels can be a sign of Hypothyroidism, once medicated to optimum levels a Hypothyroid person's high cholesterol blood level normally reduces.

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I've just had a couple done recently.

Test 1 (Dec 2014)

TSH: 1.780 Range: 0.270 - 4.200

Free T4: 17.89 Range: 12 - 22

Free T3: 5.2 Range: 3.1 - 6.8

Thyroid peroxidase antibodies: Negative. Ranges: Negative = <60, Equivocal = 60 - 100, Positive = >100

Test 2 (Jan 2015)

TSH: 2.350 Range: 0.270 - 4.200

Free T4: 22.01 Range: 12 - 22 *Note: just slightly at the high end.


Hi again BrecklandRanger,

Mostly a TSH goes down as a FT4 goes up, wondering why your TSH has gone up along with your FT4 also going up. A TSH going up can be to do with antibodies.

High FT4 'might' be to do with Hyperthyroidism that also connect with tiredness, muscle ache and palpitations, (sorry, but I know more about Hypothyroidism than Hyperthyroidism.)

You have only had the one Thyroid antibody blood test ? ( Antithyroid Peroxidase Antibody)

I do know you are meant to have the two, the other being - Antithyroglobulin Antibody is also needed

to get a proper picture.

Not saying you have a thyroid problem, but it might be an idea to pop your question up on the 'Thyroid Uk' also on Health Unlocked, website. I am joined to a number of Health Unlocked sites as many illnesses in my Family are cross overs, one illness links to another. (ie autoimmune conditions)

Your Ferritin also looks low.

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Glad you mentioned low ferritin.

Re iron def; Wikipedia mentions that a high RDW ( red blood cell distribution width) usually precedes anaemia. My actual RDW was slightly elevated at: 15.5 (11.6 - 14.0)

But I will look into checking out the Antithyroglobulin Antibody.

Something else to consider...


If I were you I would pop all your results as you have done on here up on Thyroid UK HealthUnlocked.

They will give you a quicker (and much better,) read out than I can do.

I do recall needing to get my ferritin (stored iron) levels over 80 (or up to 90 due to my hair shedding.) My level was at 45 then, but cannot remember my ranges for ferritin without checking, best to get others opinions on it.

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