The reference ranges for the first two tests, red blood cell (RBC) Indices, show them to be within normal limits. However, you should also have Hemoglobin (Hmb) and Hematocrit (Hct) results along with these.
The white cell count is on verge of low, but just barely, and without the white cell count breakdown (differential) and the Hmb/Hct, any significance cannot be known.
You don't list the reference range (normal values) of B12 and Folate. Normals are not the same in all labs/countries, so these numbers aren't interpretable by themselves.
The best thing to do would be to ask your physician for copies of the results and what they mean to your health. If that hasn't been working for you then you'll need to post again with the information I've mentioned. There should also be more RBC indices included along with MCV and MCH.
My experience is that unless MCV and MCH are well above range then it's difficult to get GPs/consultants to consider the possibility of B12 deficiency.
I was highly symptomatic for B12 deficiency for years with MCV within normal range. MCH periodically above range but doctors showed no interest. When I started to self treat (because I could not get treatment from NHS) my MCV reduced.
I keep records of my blood tests so I can track changes in MCV and MCH over the years.
Has your ferritin level been checked?
Low iron can make red blood cells smaller (microcytosis) which can lead to a low MCV/MCH. Low B12 and/or low folate can make red blood cells larger which can lead to a high MCV/MCH. If a patient has both conditions then red blood cells can appear to be "normal" size and a GP may miss both conditions.
Have you ever had an IFA (Intrinsic Factor antibody ) test which can help diagnose PA (Pernicious Anaemia). This test is not always reliable and it is still possible to have PA if IFA test come back negative.
My experience is that it is possible to be highly symptomatic for B12 deficiency with B12 results similar to yours.
Recent documents make it clear that patients who are symptomatic for B12 deficiency should be treated even if their B12 results are normal range. GPs may not have seen these documents/articles.
This is a long document that came out in 2014. I was told that the NHS should be following its recommenadtions. The PAS have a summary of it in librarys ection on website. Some GPs are unaware of this document.
Has your GP seen these documents? I gave copies of these to my GP.
Other useful links/articles/books
I found it helpful to talk to the PAS (Pernicious Anaemia Society). They are sympathetic and will get back to you if you leave a message.
Symptoms list in library section. I gave a copy of this to GP with all my symptoms ticked.
I always emphasise any neuro symptoms I have as people with B12 defic and neuro symptoms are supposed to be treated more intensively.
Info in BNF (British National formulary) Chpater 9 Section 1.2. All GPs have access to a copy of the BNF. BNF is copyrighted so can't reproduce info here. This link contains similar info. Scroll down to Management section.
Thankyou so much for all of this information. I truly appreciate it and this is such a hard struggle for me. I'm suffering terribly with hair loss and I feel very low and tired of it all. Sometimes I just want to give up! It's a very depressing time in my
Life at the moment and I feel so
Hopeless that life is going to get any better. Sorry for being so depressing!! I have actually just received 1000mcg of b12 methyl form and 400mcg of folate methyl form. Do you think these are OK to start supplementing? My b6 levels were through the roof high!! Which is why I can't take a b
Complex. Thankyou so much again x
P.s what were your symptoms? Oh yeh and my ferritin is 47 but I took high dose prescription iron for 7 weeks and my hair fell out more! X
"I feel so hopeless that life is going to get any better"
I empathise with this as I have spells where I feel very low.
Depression and other mental health issues can be found in people with B12 deficiency. I am not as badly affected as some are. I can walk, work a few hours and do some craft. For me it is lack of support, unhelpful doctors and the sheer variety of symptoms that I find hard to cope with.
"Do you think these are OK to start supplementing?"
My personal opinion is that each person has to make their own decision on this.
I only started to supplement myself after years of trying to get treatment from NHS. I would still prefer to be treated by NHS. I use methylcobalamin and methylfolate.
Has your GP looked into why your B6 levels are so high?
My symptoms are too numerous to list, Some of my neuro symptoms have improved since I started to treat myself.
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