Pernicious Anaemia Society
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Blood tests back

The Dr sent me to see how my levels were doing as I was complaining my coughing/breathleness had returned. I had six loading injections late December and have been taking Active B supplements containing 1ooo mcg (although ran out about 4 days before blood taken.

B12 was 630 - is this where should be after injections?

TSH 2.9 (0.4-5.5)

T4 14.1

Notes on file were all normal.

Comments please.

I asked for the last 2 as can't shift weight/had gall bladder removed etc. so been wondering about thyroid.

11 Replies

The B12 level does seem to be heading south, though given that it is a couple of months since your loading shots that is to be expected, but it is an indicator that you aren't managing to retain B12 from the shots particularly well - are you on maintenance shots or have you just been given tupplements? Given that the deficiency probably occured because of an absorption problem just taking tablets isn't necessarily going to help (although about 1% of our B12 is absorbed passively outside the ileum so flooding the gut with B12 can have some effect) ... if they are sublinguals then that means that the B12 should be absorbed through membraines in the mouth so bit different from just tablets.

I'm afraid I can't comment on the other results - don't have thyroid or other problems - but sure someone else can comment.

Are you supplementing B9 (folic acid) as well? And did you have results for B9? You need B9 to absorb and use B12 properly so if levels get low that can affect your ability to use the B12 you are receiving in shots/through supplementation.



Gambit has given you good advice, so I will only add that I also can not comment on thyroid test results, but perhaps your iron is low? Did you have a result for ferritin ( = iron storage) I find I get breathless when low in iron. I am breathless at the moment, have what seems a permanent cough, but I smoke so it most probably is that. There are a lot of coughing bugs going round at the moment. Did you get copies of blood tests? Can you see if your white cell count is up, and what your MCV is? MCV will go down in size if iron def, white cell count up if you have some infection etc. Other inflammatory markers are ESR and CRP.

Kind regards,



My b12 was 550 a month after my loading injections if this helps? I haven't been taking any other b12 supplements so I think your level is about right. You t4 is a little on the low side


Many people only feel well with a lower or suppressed TSH (my own BP, heart and cholesterol problems all but disappeared and I had better resistance to infections on receiving adequate thyroxine). 'Understanding Thyroid Disorders', written by Dr Toft, gives good advice and, as it is published in association with the BMJ, your GP might be more willing to listen and increase your dose. Here is an extract:

"Judging the correct dose of thyroxine.

Typical results would be a ft4 of of 24pmol/l or TT4 of 140 nmol/l, and a TSH of 0.2 mU/l. In some patients, a sense of wellbeing is achieved only when fT4 or TT4 is raised, for example, 30pmol/l or 170pmol/l, and TSH low or undetectable. In this circumstance, it is essential that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidism."

As you probably already know, the problem is getting GP to test for anything other than TSH.

Autoimmune thyroid problems, B12 and D deficiencies are usually interlinked with symptoms sometimes overlapping and they impact on all the systems of the body, especially the thyroid so you might find this an interesting link:

Hope this helps and hope you start to feel better.


PS. People react individually to B12 supplements: sprays, patches and tablets. I've tried most and am finding Jarrows 5000 mcg. dissolved under tongue really effective - good reviews on Amazon.


Thanks for all your comments. I have a phone consultation booked with Dr tomorrow, I imagine it will go something like Thyroid tests normal and B12 fine so NFA. The Jarrow sounds good. Wondering if worth getting thyroid full tests done privately. I'm not on any treatment other than the B12 (and HRT). It would be good to a) stop coughing and b) walk up stairs without feeling they were a mountain. Hey ho. Good to have a place to chunter on!


Blood test results:July folate - 5.9 (5.4-24) not measured since

White blood count 6.7 10*9L (4-10)

MCV 90fl (83-101)

Ferritin 241 ug/L 241(10-291) - had redone Dec and had come down to 233.

Vit D insufficient.

IF negative

B12 serum 198 July and 205 Oct (210-910)

Holo TC 36 (25-108)

MMA 443 (0-280)

Homocysteine 13.1 (0-15)

Celiac test negative.

The active B complex includes 1mg methylcobalmin and 800mcg methyltetrahydrofolate as well as other B's. I think that's all ur questions answered.


Your folate is to low, it most probably has sunk even more once you started B12 treatment re :"July folate - 5.9 (5.4-24) not measured since". Not every one benefits from methyltetrahydrofolate, it does not suit every one. But not having enough folate is not going to help you, I'd suggest you have serum folate tested and if low having prescription strength folic acid prescribed.


Thanks Marre. 😃


Well, I've had the Dr's call. Thyroid results are in middle of range so considered normal. The lab would refuse to do fT3 and she doesnt have any reason to do fuller tests like the reverse ones. They would take note of any tests done privately.

Discussions have been had with all Drs in practice about more frequent B12 with result that as drug licensed for no more than 2-3 month frequency they don't feel able to administer more at moment but agree that I still having symptoms. They are going to write to a haematologist for advice and speak to me in about 2 weeks.

Agreed for me to have folate test. Wish I'd asked for ferritin too...

Nice Dr, obviously constricted in what she can do.


Re:"Nice Dr, obviously constricted in what she can do.", Yes I came across that, they do want to help, but are limited to guidelines etc. Off the record they will say things, but are unable to recommend anything that is not recommended in guidelines. I buy my own B12 and add to what I'm given on prescription, as long as my blood tests stay normal then what I do is fine my GP said..but he can not be responsible for what I do at home..Good you are having folate tested, just as for ferritin as well when you are having the blood test, a haematologist can be very helpful! Hope it goes well for you! Marre.


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