Pernicious Anaemia Society

Any help on b12

Any help on b12

Hi have posted before but these were my results from February, I am going to doctors on Tuesday again because just don't feel right my doctor said these results were ok, twelve months ago b12 was100 had loading doses then every 12 weeks, next one due in 2 weeks, has never gone just over 500 in this time in February was 337 had injection just after this, don't know what is know but don't feel right, I am bothered about blood counts and different things cause to me it is leading to anemia but no one does anything , any help please

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I agree with you that your RBC and Hematocrit are trending toward anemia.

Your erythrocyte sedimentation rate test is showing inflammation. (More info on that test can be found here: labtestsonline.org/understa... )

I looked at all three pictures and what I'm not seeing in the tests that were done is a serum iron result. They've checked ferritin, but not serum iron or total iron binding capacity (TIBC). You might have an issue similar to what I'm dealing with; Anemia of Chronic Disease (ACD) - also known as Anemia of Inflammation. But, to find out for sure, you would need to have the missing tests run.

ACD differs from iron deficiency anemia. In ACD, the body's ability to transport iron with a protein called transferrin from stored iron (ferritin) to the red blood cells (serum) is decreased. It's an immune system response and it generally means that there is some additional illness in the body that needs to be addressed.

In iron deficiency anemia the iron panel results would generally be like this:

Serum Iron: low

Transferrin: high

TIBC: high

Iron Saturation Percent: low

Ferritin: low

In contrast, the iron panel results for ACD would be more like this:

Serum Iron: low

Transferrin: low

TIBC: low

Iron Saturation Percent: low

Ferritin: normal or high

If you do have ACD, the important thing to know is that taking oral iron will not correct the iron imbalance. The recommended treatment is to find the underlying cause and address it. Iron infusions are sometimes used, but your results would probably need to be a bit more obviously anemic before you'd be able to convince a doctor to do that.

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