Pernicious Anaemia Society
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Help with blood results

Can anyone help with these blood results and tell me which other supplements i may need. (These were taken on 1st april). Having more done tomorrow but folate and b12 won't be included. Just to add these ones were done 6 weeks after my jab as the nurse didn't actually bother doing the b12 & folate before my jab as was initially requested.

Haemoglobin (115 - 160g/L) 128

Red Cell Count (3.8 - 5.8) 4.90

Haematocrit (0.37 - 0,47) 0.386

Mean Cell Volume (78-98 f1) 79

Mean Cell Hb (27.0 - 32.0 pg) 26.1

White Cell Count (4.0 - 11.0) 10.5 (previous 11.1 on 25/2/16)

Neutrophil Count (2.0 - 7.5) 6.83

Lymphocite Count (1.5 - 4.0) 2.81

Monocyte Count (0.2 - 0.8) 0.51

Eosinophil Count (0.04 - 0.4) 0.24

Basophil Count (0.01 - 0.1) 0.06

Platelet Count (150 - 400) 402

ESR (3 - 15 mm/hr) 49

Creatinine ( 50 - 98 umol/L) 64

Sodium (135 - 145) 137

Potassium ( 3.6 - 5.0) 4.4

Bilirubin (3 - 21) 5

ALT (10 - 50) 12

Alk.Phos ( 40 - 125) 86

GGT (5 - 35) 40 H

Albumin ( 36 - 47) 32L

HbA1c (IFCC) (20 - 42) 69 (this was done 21/12/15)

Vitamin B12 (180 - 2000) 875 (this is about 6 weeks after my injection)

Ferritin (15 - 200) 45 (I take 5mg folic acid 6 days out of 7)

In brackets are the reference ranges. Doc didnt think it was worth testing my vit D level.  I take metformin for type 2 insulin dependant diabetes and methotrexate for the rheumatoid arthritis as well as various other meds including omeprazole lyrica and tramadol.  

3 Replies

Well, you are on a lot of meds that are known to interfere with the absorption of B12 so not surprising that you were deficient.

The B12 might look okay but for I think you are probably going to find that you run out of oomph well before you get to your maintenance shot.  And it would be good to know what your folate is doing as that can get depleted if your body is processing a lot of B12.

B12 results don't mean a alot once supplementation starts unless they continue to be low which is a sure sign that you need maintenance shots more frequently.

The serum test tells you how much total B12 you have in your blood but not how much you have of the forms that are used by cells ... or how the process of transferring to cells is actually going.

Do you know what your symptoms are and have you been keeping a diary.  Going to be a bit difficult as there is an awful lot of overlap with symptoms of diabetes and medics will have a tendency a) to be unaware of symptoms of B12 and b) assume everythin is down to the diabetes - eg if you have neuropathy.

You can find a checklist of symptoms here



Your ferritin looks ok at 45 but I would want some more iron tests. Your ESR is raised slightly which points to inflammation and inflammation is known to raise ferritin.  Your MCH is low and your MCV is right at the bottom of the normal range which both point to iron deficiency. Folic acid doesn't help to fix an iron deficiency. If you are taking omeprazole this will be lowering the acidity level in your stomach which will make it more difficult to absorb iron.

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Thanks for the replies, I had a feeling there might be some iron issues.  I was diagnosed PA about 20 years ago and have nerve damage confirmed in my hands and feet, I also have tinnitus which right now I am fighting my gp to try and get increased injections of b12 in the meantime I am trying supplementing with patches. 

The esr issue I'm told by the doc that it's due to the rheumatoid arthritis. I've tried to address the issue of the meds but the doc just won't listen. I am hopefully back on the rheumatology list and will bring a lot of the issues up with the rheumatologist when I see them, I've also been referred to audiology for the tinnitus.



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