Need help

[Happyand60]

Can anyone help me to understand my blood results. Serum ferritin level 14.4ug/L (30.0-400.0 serum vitamin b12 level 314ngL (190.0-910.0) and serum folate 5.6ngL (3.3-99999.0). Been to doctors with pins and needles in arms. Pain in my legs and a feeling of tiredness . I just need help in to get me up and going again... Thanks

[expatkerry]

Hi there, your results are similar to mine, I had a ferritine level of 12 and B12 267, these results read with a fibroscopy of my stomach which revealed atrophic gastritis and the fact that I was producing antibodies confirmed that my symptoms (neuropathy, parasthesia, fatigue etc) were due to Pernicious anemia. I think your doctor needs to refer you to a specialist to do more tests. Best of luck

[Happyand60 in reply to expatkerry]

Thanks for your reply. Don't think doctor is interested in B12 as he dismissed it as soon as I was trying to ask about it..

[Sleepybunny]

Although your B12 level is in range, many people experience symptoms of B12 deficiency at that sort of level. Have you looked at any B12 defic/PA symptoms lists?

b12deficiency.info/signs-an...

pernicious-anaemia-society.... PA Symptoms list in here.

The PAS are very helpful and sympathetic. If you leave a message they will get back to you. The library section on the website has a lot of useful info.

pernicious-anaemia-society.... 01656 769467

Useful websites

b12deficiency.info/

b12d.org

martynhooper.com/

Books

Could It Be B12 by Sally Pacholok and JJ. Stuart

Pernicious Anaemia;The Forgotten Disease by Martyn Hooper

Living with Pernicious Anaemia by Martyn Hooper

What you need to know about Pernicious Anaemia and B12 Deficiency by Martyn Hooper

Recent UK articles and documents (see below) make it clear that patients symptomatic for B12 deficiency should be treated even if tehir B12 levels are in range.

Useful articles/documents

ukneqas-haematinics.org.uk/...

bmj.com/content/349/bmj.g5226

Google "BCSH Cobalamin and Folate Guidelines"

Pins and needles, pain and tiredness are all found in B12 deficiency but also in other conditions. Has your GP checked your thyroid? Have you ever had a test for Coeliac disease?

Pins and needles is usually considered to be a neurological symptom.People with B12 deficiency and neuro symptoms should receive more intensive treatment. Your GP can find out details of treatment in the BNF (British National Formulary) Chapter 9 Section 1.2. The BNF is copyrighted so can't reproduce here but this link has similar details.

patient.info/doctor/pernici...

scroll down to Management

The treatment is also mentioned in the BCSH Cobalamin guidelines.

Have you had an IFA (Intrinsic Factor Antibody)test? This can help diagnose PA (Pernicious Anaemia) but the test is not always reliable. It is possible to have PA even if IFA test is negative. Some people have a form of PA where they don't produce antibodies. This is called Antibody Negative Pernicious Anaemia and is mentioned in the BCSH Cobalamin guidelines.

I gave my GP a copy of the BCSH Cobalamin Guidelines. I found page 29 particularly useful . It's a diagnosis flowchart.

There are other tests such as MMA, Homocysteine and Active B12 that can help diagnose a B12 deficiency. The results of these tests can be compromised if a patient is already supplementing with B12. They are available privately if GP won't order them.

b12deficiency.info/b12-test...

Another test that can be useful but is not often done on NHS to diagnose B12 deficiency is a "blood smear" aka blood film. It can show if blood cells are unusual shapes. B12 deficiency can cause shape changes in some blood cells.

Have you had a FBC (Full Blood Count)? There can be useful clues on the FBC. I always look at my MCV and MCH. high CV and high MCH can indicate the possibility of macrocytosis. Macrocytosis is sometimes found in B12 deficiency (but not always).

I see that your ferritin level is below range. Low iron makes red blood cells smaller. Low B12 and/or low folate makes red blood cells larger. If a patient has both conditions, their MCV may appear normal and their GP might miss both problems.

patient.info/doctor/macrocy...

patient.info/doctor/full-bl...

patient.info/health/full-bl...

Sadly there are some GPs/consultants who are not aware of the new guidelines that emphasise the importance of looking at symptoms not just test results.

Good luck.

[Happyand60 in reply to Sleepybunny]

Thank you for your help. I've been to get some better for you B12 spray today ..hopefully this will help as my doctor says I don't need any as my bloods are OK. I just need to have my body working some what better than it is now. Thanks again for your help ..