Blood test results - Very high folate... - Pernicious Anaemi...

Pernicious Anaemia Society

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Blood test results - Very high folate, low B12, what does this mean?


Hi everyone,

I'm suffering from severe fatigue, depression, insomnia and foggy brain for quite some time. My blood test results came back for my ferritin, B12 and folic acid. can someone help me interpret?

B12 328 pg/ml (200 - 1100)

Folic Acid >24 ng/ml (3 - 14)

Ferritin 57 ng/ml (20 - 300)

I really had to push to get this blood test done by my GP and I am seeing him again early next week. Any help would greatly be appreciated


12 Replies

The B12 looks O Mine was 140 when diagnosed with PA and I didn't have any neurological symptoms. Not sure about the other results but the B12 is important

I have read that it is possible to have severe B12 deficiency with levels that are in the normal range. Some medics are unaware of this.

Have you looked at lists of B12 deficiency/PA (Pernicious Anaemia symptoms?

This website has lots of info.

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

01656 769467

The PAS are helpful to talk to, if you leave a message they will get back to you.

Extensive symptoms list in book "COuld It Be b12" by Sally pacholok and JJ. Stuart.

Recent UK documents make it clear that patients who are symptomatic for b12 deficiency shoudl be treated even if their results are normal range to prevent neurological damage.


Google "£BCSH Cobalamin and Folate Guidelines"

There are other blood tests that can be useful to establish a B12 deficiency and PA eg MMA, homocysteine, Active B12, blood smear. have you had an IFA test?

Have you had a FBC (Full Blood Count)? I look at my MCH and MCV on the FbC. High MCH and MCV can indicate the possibility of a macrocytis anaemia.

Good luck. there may be more info on some of my other posts.

Hi Joey. People with low B12 and high folate tend to have more cognitive problems than those without high folate,mmHere are some links and info which might persuade your GP to treat without delay:

Extracts from the book, 'Could it be B12?' By Sally Pacholok & Dr J. Stuart :

"deficiencies begin to appear in the cerebral spinal fluid below 550 pg/ml." "For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Failure to treat adequately and without delay risks permanent neurological damage.

Extract from BCSH guidelines:

"The BNF advises that patients presenting with neurological symptoms should receive 1000 ug i.m. on alternate days until there is no further improvement". :

“In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord."

Cmim/BMJ research document.

" Summary:

* Vitamin B12 deficiency is a common but serious condition

* Clinical presentation may not be obvious thus leading to complex issues around diagnosis and treatment.

* There is no ideal test to define deficiency and therefore the clinical condition of the patient is of utmost importance."

* There is evidence that new techniques, such as measurement of holotranscobalamin and methylmalonic acid levels seem useful in more accurately defining deficiency.

* If clinical features suggest deficiency, then it is important to treat patients to avoid neurological impairment even if there may be discordance between test results and clinical features.

**It is important to recognise that clinical features of deficiency can manifest without anaemia and also without low serum vitamin B12 levels. In these cases, treatment should still be given without delay."

Sorry, I don't know why replies sometimes go wrong and the paragraphs are missing - cannot edit either!

helvella in reply to Polaris

I think the answer might be that what appear to be paragraphs as you paste the text are actually multiple spaces (or some other characters).

In general HTML (the language of web pages) treats anything between one and infinite spaces as the same thing - a single space - when the page is displayed.

Do you have Microsoft Word? If so, paste the text into Word and click on the ¶ (called Pilcrow) in the ribbon across the top (when on the Home tab). That will show where you have paragraphs, newlines, spaces, etc. (Something similar is available in several word processors.)

I do not know why you are unable to edit your own posts. Not being an admin here, I cannot help by editing for you.

Polaris in reply to helvella

Thank you Helvella for your help.

I'm using an IPad though and don't have Word.

It does seem to be when I copy and paste text into my reply but I've always done this and it's only happening just lately. I can't even put in the paragraphs when I edit it and the same is happening if I try to send it in a private message.

fbirder in reply to Polaris

I've been having problems today creating a new post. I can write replies, with proper formatting (even on my iPad) and edit them.

But when I try to write a new post I get told that I don't have the correct permissions ?????

Are you using the iPad app, or accessing via Safari?

Polaris in reply to fbirder

I'm using an IPad.

I think it's something to do with copying and pasting text into the reply, as it doesn't do it when just typing reply without pasting.

Have tried three times now - each time, the paragraphs are fine until I paste them on to 'Reply' ?!

Are you pasting a link into the reply ?

Polaris in reply to helvella

Thanks so much for your message Helvella - Just copied and edited and but it's still coming out without paragraphs?!

Have deleted it.

helvella in reply to Polaris

Odd - what version of IOS are you on?

I suggest you report this to - give them as much detail as possible.

You are not the only one - if you search hard enough you will find otherd having similar problems with IOS.

Polaris in reply to helvella

Thank you - I will do. iOS 9

Hi, my numbers are almost exactly the same as yours- did you get any further in your diagnosis?

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