Pernicious Anaemia Society
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Please someone help?

I have posted my blood results before but know one has replied and could really do with some help.

I am suffering hairloss and generally feel awful.

My results have come back ..

MCV - 97 reference 80-100

MCH - 32.6 reference 27-32

Total white cell count - 3.9 reference 4.00 - 11.00

Vit b12 - 411 ng

Folate - 9.2

Is there anything in these results abnormal?? X

8 Replies


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.





I've assumed you're in the UK.

MCV - 97 reference 80-100

MCH - 32.6 reference 27-32

Your MCH appears to be above normal reference range and your MCV is close to the upper limit of range.

High MCH and MCV can be indicators of macrocytosis which can be associated with B12 deficiency.

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.




Google "BCSH Cobalamin and Folate Guidelines".

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.


01656 769467

Website run by a B12 defic sufferer

Have you looked at lists of b12 deficiency/PA symptoms?


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.


"Could it be B12" by sally pacholok and JJ. Stuart

"What You Should Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of the PAS and has written other books on PA and B12 deficiency.

Sometimes B12 deficiency can be found with other conditions. Have you had thyroid tests? Coeliac tests?


I am not a medic just a patient who has had great difficulty getting a diagnosis and wants others to have the info to make their own decisions.

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And you are brilliant!!!

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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


Also I might add my b12 was 499 ng a year ago and has dropped to 411ng. Is this normal?


"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.

I'd urge you to give the PAS a ring.


01656 769467

There is someone in the PAS office between 8 and 2pm most weekdays but not Sundays. I have rung them on more than one occasion.

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Thankyou I will call them. I've started to supplement myself the last few days. So I guess

Il need

To ride this out and see if things get better. Thanks for all the support x


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