Oral supplements

[shuvs]

Quick recap. I have felt awful since November and had B12 checked at start of March, 166 dropping to 142 a week later. Doc thought probably dietary even though I eat meat at least once a day and had been craving and eating black pudding daily for weeks! After 3 weeks of 100mcgs a day my levels had risen to 302 and I was advised "no further action required". My symptoms had improved slightly but since stopping the Breathlessness returned within 3 days and fatigue by day 5. I have an appointment tomorrow and am concerned I will be fobbed off again. Apparently all other blood results were normal bar my white cell count which I believe is unrelated. Thanks in advance for any guidance

[Secondchance]

Your level may rise with oral supplementation as there is some passive absorption but it won't cure the problem if you have an absorption issue. Are you on any drugs that might interfere eg metformin, antacids?

Did you have intrinsic factor/ gastric parietal antibodies checked?

Read up BCSH guidelines as they suggest treatment under 200 before going back to GP. BMJ article Hunt et al Seot 2014 also suggests treatment depending on symptoms.

What was your white cell count? Mine was low and at last check still hadn't gone up.

Good luck.

[shuvs in reply to Secondchance]

Thanks for the reply. I'm not on any medication that would interfere with b12. Dr won't check intrinsic factor as they feel it's unreliable. White cells were 13.4 so only slightly raised. Thanks again. I'm worried Dr will think I want there to be a problem but more worried that something will be missed. Been there done that with endometriosis waiting 10 years for a diagnosis

[Hidden in reply to shuvs]

Raised white cell count can be a sign of some sort of inflammation or just normal for that person, or smoking etc (mine is often raised).

It all depends if you have other def such as iron and or folate but MCV can be a marker for low B12.

Still if serum B12 is low that means a need for treatment, if not supplementing other tests can be done such as active B12 etc, see:

bcshguidelines.com/document...

Kind regards,

Marre.