Need help please. Do I have PA?

[shambles]

The lowest my B12 ever showed was 408 (211-911) back in September 2012 but I had been using supplements, just form Tesco, as I was not clued in on the PA issue. I have since moved on to use Thorne B complex and use 1000 sublingual B12. I stopped all B's for 4 months for an active B12 test but it came back high in range. I've just paid for a homocysteine and IF.

I have Graves’/Hashi’s, thyroid removed.

.

TSH 0.02 (0.55-4.78)

FT4 22 (9-23)

FT3 5(3.50-6.5)

Homocysteine 12 (10-15) AT RISK

IF 1.4 (0-10) Just paid for both of these tests last week for myself.

B12 777 (211-911) with supplementing

Active B12 119 (25-165) done in Jan 2012 after 4 months of not supplementing.

Folate 10.3 >3.40

Ferritin 89 (20-291)

IRON 23.2 umol/L 6.6 - 26.0

T.I.B.C * 81 umol/L 41 - 77

TRANSFERRIN SATURATION 29 % 20 - 55

Vit D 101 >50 replete

HbA1c 35 (20-41)

RBC

Haemoglobin 123 (115-165)

MCV 92 (77-99)

MCH 32.5 (27-32) HIGH

Haematocrit 0.349 (0.37-0.47) LOW

RBC 3.79 (4.20-5.40) LOW

MCHC 35.2 (30-37)

WBC

WBC 3.9 (4-11) LOW

Neutrophil 2 (2-7.5)

Lymphocyte 1.5 (1.5-4.5)

Monocyte 0.3 (0.2-1.12)

Eosinophil `0.1 (0.10-0.60)

Basophil 0.0 (0.0-0.20)

I have gene mutations for B12, B6, folate. Both the MTHFR C677T and MTHFR A1298C. FUT2 rs602662 is the gene that had a decreased ability to absorb B12. FUT2 is the gene for reduced amount of B6.

Based on these result could someone tell me if I should take it to the GP?

I should mention that my endo said to had odd shaped blood cells but said no more. Is any of this PA?

Sorry for the long post :0(

[Laura5]

Think I would ask for referral to a haematologist to find out more about the odd shaped blood cells.

[shambles in reply to Laura5]

Thanks Laura5.

Pretty difficult with my results and thyroid to see what is occurring.

[Polaris]

Re. Odd shaped blood cells:

"B12 deficiency mimics many other diseases, so your doctor can't know if you're low in B12 simply by analysing your symptoms. Also your doctor can't determine if you're deficient or not simply by ordering a blood count or smear (a test for anaemia, enlarged red blood cells and abnormal white blood cells (neutrophils) seen in some clear cut cases of B12 deficiency)". - from 'Could it be B12?".

"What High MCH Levels Mean

MCH levels in blood tests are considered high if they are 35 or higher. A normal hemoglobin level is considered to be in the range between 26 and 33 picograms per red blood cell.

High MCH levels can indicate macrocytic anemia, which can be caused by insufficient vitamin B12. Insufficient folic acid can be another cause of macrocytic anaemia."

[shambles]

Thanks Polaris

The lab that did the homocysteine test said I should tart taking B vitamins immediately but I don't want to do that, I want a diagonsis if possible.

I am doing a B vitamin blood test panel tomorrow which I had ordered prior to the results of the homocysteine test.

[Sleepybunny]

"I want a diagonsis if possible."

My personal view is that it is wise to get a diagnosis if possible before supplementing. I am in the UK and only started to self treat as an absolute last resort when all attempts to get treated by NHS failed.

I am now faced with the fact that it is extremely unlikely I will ever get a diagnosis because my b12 levels are high due to supplementation.

I think it's possible that your Active B12 result and homocysteine could still have been influenced by your previous supplementation. I read on one website for the manufacturer of Active B12 tests that they recommmended Active B12 should be done before supplementing.

patient.info/doctor/macrocy...

"odd shaped blood cells"

I have read that B12 deficiency can cause hyper-segmented neutrophils. Have you ever had a "Blood smear" aka "blood film", This test is available privately.

b12deficiency.info/signs-an...

labtestsonline.org.uk/under...

ncbi.nlm.nih.gov/pubmed/250...

I thought it was interesting that many of your white blood cell results were either low or at the bottom of the range but I don't know if this is significant in any way.

[shambles]

Thanks for the detailed reply Sleepbunny.

I think I need to stop all supplementing again for a further four months. I was so hard the last time but yes I'm with you on getting a diagnosis.

I only stopped supplements for the homocysteine test a week or two before the test and have since read it should have been longer. Why oh why are you not told that before you pay and take the test? My thoughts on that are that surely my homcysteine level should have been lower if affected by supplementing or have I got that wrong?

I may very well have a folate and B6 issue only and not B12. I will see what the B vitamin test I am doing tomorrow brings

[Sleepybunny in reply to shambles]

"Why oh why are you not told that before you pay"

Totally agree with you on that point.

I wasted hundreds of pounds that I could ill afford on a private haematologist appt. The haemo wanted to do homocysteine, MMA and Active B12. I queried whether these tests would be affected by my high level of supplementation and got a vague reply so I went ahead and afterwards found out that the results would almost certainly be compromised by my supplements.

I felt incredibly angry and upset because I now have a set of results on record that in effect say my homcysteine, MMA and Active B12 levels are extremely good, no problems and definitely no B12 deficiency. There is no way I will ever prove a deficiency now unless I come off supplements for months even years which I think would not be safe for me.

[shambles]

I have decided to contact the company I got the test from.

I am interested in knowing their policy on supplementing prior to the test. When I received the results they said I should start taking B complex and B12. On reflection the whole thing seems wrong. Surely it would be better served to go to the GP and get tested for PA or anaemia which ever it may be. Also this suggests they think you haven't been supplementing prior. However, there was no suggestion or mention of not supplementing prior.

I might even ask for a refund. :0)