50 yr old male B12 Vitamin Serum 155ng/L range 130.00-800.00ng/L
Serum Folate 12.2 ug/L Range 4.00-20.00ugL I have visited my GP and mentioned my B12 Serum Test Result Concerns,
My GP explained that my result is normal as my (MCV) Mean Corpuscular Volume is 91fL
which is right in the Middle of the Range 80.00-100.00fL.Which would likely be elevated in B12 diagnosis.Would anyone on the forum agree with this as it is quite confusing.
GP has agreed that i should check B12 Serum once a year due to my Mothers Pernicious Anemia.
When i took the online B12 deficiency symptom test i scored 9+ at Pernicious Anemia Society website
from a link kindly provided by forum member.
I asked GP about Methylcobalamin sublingual Tablets for a family member to take between injections
and the GP said they were unaware of any benefits taking these or any supplements of B12 in between Injections of 3 months,as there are no clinical trials on this in the UK
And also said you can't get Methylcobalamin sublingual in the UK and asked where i had seem them.
I mentioned only Overseas sales that i had seen.
Regards
Advice1
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Advice1
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Hi only 30% people don't get anaemia with B12 deficiency and most GPs don't know this but it is well recognised in research. There is an inverse correlation between anaemia and neurological symptoms so people with bad anaemic are supposed to get less neuron symptoms and vice versa. No-one understands this.
I had low B12 which GP was not going to treat because I wasn't anaemic but I had a lot of neuron symptoms which the majority resolved in 8 weeks of every other day treatment with hydroxocobalamin 1mg im
I would recommend getting an active B12 checked at St Thomas if you have not taken any supplements yourself.
Interesting reply Secondchance, would you mind to give me more details on which department at St. Thomas's to go through to get an active B12 test, I know my boyfriend has an issue with B12 but need to have the evidence?
Serum vitamin B12 is the most commonly used method of establishing B12 deficiency. In general, levels <111 pmol/mL reliably indicate deficiency. Neurological deficiency or anaemia is usually evident in patients with levels <89 pmol/mL. False positives (low levels in the absence of deficiency) can occur with pregnancy, folate deficiency, myeloma,[7] and excessive vitamin C intake.
i'm 114 pmol/mL which like you say is low but why doesnt the GP see this?
Even more unfortunately most of them either aren't aware of this or are incapable of admitting this so they are perfectly capable of spouting as much rubbish as the rest of us.
Even more unfortunately their position means that people tend to trust them and think that what they must be saying must be 100% correct.
I remember years ago a GP telling me flat out that there wasn't a test for carpal tunnel syndrome - which I had been recommended to ask for and given a leaflet about by occupational health at work. However, I'm at the not trusting doctors end of the spectrum anyway so ....
Of course you can get methly b12 as sublingual tablets in the UK - it is a vitamin and it isn't regulated in the UK as a medication would be. The only reason why injectible B12 is regulated is because the prescription only rules in the UK apply to all injectible substances.
Personally I'm a bit sceptical about some of the information on patient.co.uk, eg the statement on B12 something on the lines that 'a very few people have problems with the frequency of injections and experience symptoms returning before maintenance shots' as that so does not chime with my own experiences and in general where I find people who don't question the regime they all know when their shots are due because the symptoms start to return ... and don't get me started on the questionnaire on depression (not sure if that is patient.co.uk to be fair.
The NICE guidance on B12 is hopelessly confused and confusing for GPs - really doesn't do anything to dispel the confusion over B12D and anaemia and probably even makes it worse. Unfortunately they don't have the time to go into other ancilliary guidance such as BCSH ... and lets face it even a few haemotologists don't seem to be fully aware or understand it.
The best doctor I ever saw - and one of the few that I would trust - a neurologist specialising in migraine - had the strength and integrity of character to be able to admit that he didn't know everything and nobody did and most of the time it was a question of we do it because it seems to work. Okay so it is an approach that has its dangers but it's honest and it's open and that is soooooo what is missing in these days of being driven by checklists, 5 minute appointments, dealing piecemeal with symptoms rather than dealing holistically with the patient and looking for underlying causes - treating labels as if they are conditions - because that is what GERD is, that is what depression is ....
Sorry I've gone through today on much less B12 than I normally have and starting to get a bit ratty as a result.
Have some sympathies with GPs in terms of not being able to know everything but do rather lose that when you see how unwilling they are to actually work with patients to address concerns or actually listen and take notice when they provide them with information.
Hi Gambit62 sorry to hear your not too good today I do hope you feel better soon.
Thanks for your contribution which i really did find very useful especially as you mentioned Carpal Tunnel which i was tested and was found to have in my left arm.
Which i will make a note of.You have raised some valuable points and my GP did mention about being careful what you read on the internet about B12 Deficiency!
You have to fight for the right to be heard for treatment and if it has to be private treatment with an Active B12 test i will just do it like you say we trust the GP
But out of all the Doctors over the years my mothers was diagnosed very late
through no fault of her own, which is terrible.
Thank-you very much for generous your help Gambit62
"My GP explained that my result is normal as my (MCV) Mean Corpuscular Volume is 91fL"
If you have a co-existent low level of iron ( I can't see a ferrritin result) this could explain why your MCV is "normal". Low iron makes blood cells smaller, low B12 makes them bigger therefore if you have low levels of iron and B12 your MCV results can appear normal.
Have you read the following documents/books. You may find them useful.
MCV (unless definitively low or high) needs to be considered in relation to other factors/results. Low B12 tends to cause high MCV; low iron tends to cause low MCV. Concurrent low B12 and low iron can result in a very middle-range MCV. In that case you would expect a high Red Cell Distribution Width (RDW).
Hi Helvella ,Thats interesting about RDW (RBC) thanks for your explanation
so as i'm in the Mid Range MCV 91fl (Range 80.00-100.00fL) from the results i posted for the Blood Count in my recent post RBC are slightly on the low side and not High.It appears from what you say that i have a Normal Result ,but possibly just naturally have a low B12 result of 114pmolL (155 ng/L)
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Implications of elevated HoloTC (active B12) and HoloTC > 20% of serum B12?
Low 'normal' B12 and high folate - B12 deficient?
B12 Deficiency 
Active B12 Test
