Could someone please help with these blood test results

[tmoxon]

Hi could someone please advise whether these blood tests are alright or whether they could indicate that B12 is low.  They are my husbands and I was going to compare them to my own however the range is different so thought I would ask whether anyone on here can help. They are 242 pmol/L  range is 115.00 - 1000.00 pmol/L

Thanks for any help anyone can give 

[Gambit62 Administrator]

There are different units used for tests so the reason for the difference in range may be down to different units.  Different machines also have different ranges so it could be that.

However, your husbands results may be in the 'normal' range for the equipment tested but the reality is that individuals vary so much that being in normal range doesn't mean that everything is okay and the results are still in the grey range where significant numbers of people are deficient when they are assessed clinnically, on the basis of their symptoms ... and it is the clinical assessment that really counts.  This is true for several reasons - leaving aside the meaning of normal which is based on averaging over populations

a) the test looks at all B12 in the blood - not the active forms that can be used at the cell level

b) it provides no indication at all what is going on at the cell level - it is quite possible to have high levels in serum but still be deficient at the cell level.

This alert by UKNEQAS may be of use if you are having tobattle against a GP for treatment

ukneqas-haematinics.org.uk/...

as well as referring back to BCSH guidelines if you are in UK which clearly state that treatment should be based on symptoms not test results

bcshguidelines.com/document...

Pointing GP at these pages on the PAS website - designed for medical practitioners may also help

pernicious-anaemia-society....

Suggest that you try and get together a full list of symptoms as well as the clinical evidence

pernicious-anaemia-society....

Do you know what your husbands folate levels were like.  There is a strong relationship between the two.

[tmoxon in reply to Gambit62]

Hi Gambit62 

Thank you for responding and for all the helpful advice.  I have looked at my husbands Folate and its 11.9, there is no range listed so I don't know whether that is good.  I am just comparing his results with my daughters and my own.  Mine was the same and my daughters was 6.10 

The medical issues he is having are depression, tiredness and total apathy. He has been on antidepressants now for almost 2 months and still has the symptoms and has another appointment at the end of this week.  

I have clicked on the links you have sent and on the PAS mental conditions site, the symptoms are exactly how he feels.   We have filled in the questionnaire and he has scored 48.   

Another GP who both my daughter and myself go to gave us Vitamin B12 injections when our levels were what is considered "normal", we took the nice guidelines to the surgery and the GP did listen to us,  so whether the GP my husband sees will do the same I don't know.  

We eat a good diet with plenty of fresh vegetables and probably more meat than is recommended so we should have high levels. 

Thanks once again for your help

[Gambit62 Administrator in reply to tmoxon]

if you have an absorption problem then the amount of meet you consume isn't going to improve your B12 levels and if you are having shots then the assumption is that you have an absorption problem.

Your husbands folate is probably around the lower half of the normal scale so okay but could do with being a bit higher if he starts on shots.

Is there anyway that you could make an appointment for your husband with the GP you see or are you registered at different surgeries?

[tmoxon in reply to Gambit62]

Hi Gambit62 just to let you know that my husband did get the GP to agree to the injections but it wasn't easy, I think when he returns he will go and see another doctor.  Thank you for your help 

[tmoxon]

Hi Gambit62 thanks again for coming back to me and for the information about the folate, i have some vitamin tablets so will ensure he takes those.  

Yes there wouldn't be any issue in him seeing the same GP that we see they are all in the same surgery.  I will wait to see what the one he is going to see on Friday says, I will let you know