Apologies for the long post...
I am a 35 year old female, and about a year and a half ago I had iron-deficient anaemia. I was treated with iron supplements and my iron levels are now ok. However, I have felt utterly exhausted over the past 6 months (no matter how much I sleep) and have been suffering with poor memory, confusion, lack of concentration, regular ‘brain fogs’, headaches, dizziness, palpitations, shortness of breath and general feeling of nausea. I assumed the anaemia returned (or I was just loosing my mind!) so asked my GP for a blood test.
The results came back, and my iron levels were fine, but my B12 levels were low:
Transferrin saturation index: 24% (range 16-50%)
Serum iron level: 16.5 (range 11-30)
Serum ferritin: 19 (range 10-200)
Haemaglobin estimate: 125 (range 120-150)
B12: 127 (range 180-900)
I read the information on the NHS website and patient.info and felt an enormous relief that there seemed to be an explanation for how I was feeling, as my symptoms seemed to match those of B12 deficiency. I also read many case studies where levels of around 127 were considered very low, and patients experienced similar symptoms to me.
I saw my GP last month to discuss my test results. I was told that they were all normal. When I questioned the B12 result, she said my B12 levels were slightly low, but that “we are all a bit deficient in some vitamin or other”. When I asked if it could be the low B12 that was causing my symptoms, I was told no, and that I probably had post viral fatigue syndrome. When I said “But I haven’t been ill!” I was then told that I must be depressed (I'm not). She said there wasn’t any point in further testing for pernicious anaemia, because my blood test shows I’m not anaemic. The GP recommended I take multivitamins (which I already do, and have done for years). I was fairly desperate, so asked her outright if I could have B12 injections and she reluctantly agreed.
I finished the 6 loading doses last week. I felt no different for the first few days, but towards the end of the two week period started to feel like I had some energy again and didn't experience any brain fogs. However, in the last 10 days since my last loading injection, I am back to feeling exhausted, confused and very 'foggy'. I'm supposed to wait 3 months before the next injection.
Does anyone have any advice? Specifically:
- Should I see a different GP to discuss this problem? 127 is surely lower than it should be, and surely could be the cause of my symptoms (particularly as they did start to ease when having the injections)? I don't want to appear a hypochondriac, or like I'm telling the doctors what to do!
- The GP agreed to the 6 loading doses, but should I ask for more? The NICE guidance for pernicious anaemia suggests that where neurological symptoms are present, you should continue with the injections every other day until symptoms stop improving, with possible referral to haematologist or neurologist . Do the confusion, brain fogs, memory loss and headaches count as neurological symptoms? Do these rules apply even if a person isn't anaemic?
- Why would my B12 levels be low? Is this pernicious anaemia (even though I'm not apparently anaemic)? I do have psoriasis which is another auto-immune condition, but am otherwise healthy, eat a good balanced diet, with plenty of meat so why wouldn't I be absorbing B12?
Sorry again for the long post, any advice would be welcome.