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Pernicious Anaemia Society
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Hi I am a 45 year old female who runs her own business which can be very stressful at times.. I am feeling constantly tired and have been for some time now, very lethargic and crabbit, I could sleep constantly, my bones feel tender and sore... I am getting thrush alot as well although this is a recent thing..

I have been to the doctor and had all relevant tests done. Initially for about a year I was on iron tablets and now I have just been put on folic acid tablets, I don't really feel that they have helped.. I eat a good varied diet, don't drink and don't smoke, I don't exercise as much now because of the tiredness..

Is there anyone who has the same or similar problems and have you found anything which helps any information would be appreciated..

Many thanks

10 Replies

have you been tested for b12 deficiency?

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What are the relevant tests you have had done ? Do you have the results with ranges ? You are entitled to have copies of your blood tests - which enables you to monitor your progress and post here with questions. Sometimes - well often actually - a GP will say everything is normal - when they mean in range. However for optimal health it is where you are in the range that is important.

So did you have the following tested - Ferritin - Folate - Iron - B12 - VitD ? Ferritin needs to be around mid-range - also Folate - B12 is good around 1000 and VitD also needs to be at the top of the range. These tests usually have to be requested as they are not included in a FBC.

If your Folate is low and the GP gave you a treatment - then I am thinking your B12 is very low too - as they work together in the body.

Did they test your Thyroid ? These are the tests that are required - TSH - FT4 - FT3 - and Thyroid anti-bodies Anti-TPO and Anti-Tg. Often they just test the TSH which tells you so very little about what is really going on with the thyroid.

Both the Thyroid and B12 are notoriously mis-diagnosed and under-treated causing so much pain and suffering.

I am not a Medic - just a Hashimotos girl with other auto-immune conditions and a B12 issue :-)


I have thrush too for a long time off and on, mostly on. Since I started Symprove (a probiotic) it has gone. I think that unpasteurised sauerkraut has the same effect.


have you had Vit D tests. I have recently been told I am low, as have several friends (I think they must have had instructions to start looking at it) If you look at the symptoms of D deficiency it refers to bones quite a lot, and sensitivity to moderate pressure.

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PA is a condition that causes an inabilty to absorb B12 from your diet. One (potential) consequence of a B12 deficiency is anaemia - generally macrocytosis in which the red blood cells are deformed and less efficient at carrying oxygen - however this is just one symptom and not one that everyone with PA, or a B12 absorption problem will have any form of anaemia - ie the anaemia in PA is a bit of a misnomer.

You need to find out exactly what 'all the relevant tests' means - and get the results. It would be useful to know what your GP has done in terms of trying to diagnose the cause of your anaemia. Obvious that at some point your folate levels have shown up as low so you have had been given folic acid to take. However, it is important to know what was going on with your B12 levels - and by that I mean it is important to know exactly what your B12 levels were and what symptoms you have that may point to a B12 deficiency as people vary a lot in the way they react to B12 and it is quite possible for one person to be deficient with levels that another would be perfectly okay with.

This is a link to the symptoms of a B12 deficiency so you can see if that rings bells.


If it does then you need to go back to your doctor and may have a struggle getting them to treat you for B12 deficiency but they should not be treating you just for a folate deficiency if there is a chance that you have a B12 deficiency as well.



Thankyou so much for your reply, after reading all the information about pernicious anaemia I have a lot of the symptoms, I went back to my doctors this evening and he said my blood showed that I did not have this or a B12 deficiency, what it did show was I was borderline with an under active thyroid... I have to go to the hospital and speak with haematology doctor on Thursday as they are specialists in this, and get his opinion also.

My doctor has referred me to a respitory doctor to be seen by him as he is concerned about my breathlessness... I will await a letter from him for an appointment.

I am so frustrated by all of this, I am a healthy 45 year old who doesn't drink or smoke and was very active up until recently, I just feel too tired to exercise or do anything any more..

The doctor also asked about my work was it maybe stress related or was I depressed...

I do have stress with my job, but I've been running my own business for 17 years now, so not any more stress than usual...

And as for depression, I do get a little down for feeling as tired but other than that in fine...

Many thanks thou for your reply

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Next time you see the doctor I would ask for a copy of the blood tests if I was you. It is quite possible to be B12 deficient with results well into so-called 'normal range' but most GPs aren't aware of this.

Unfortunately thyroid and B12 absorption problems is a common combination but far two often the focus is on the thyroid and B12 is forgotten about because there isn't any sign of macrocytosis.

I've had B12 problems for 40+ years but never had any macrocytosis.

One possibility with B12 is breathlessness caused by effects on the nervous system (effects on the autonomic system - scrambled signals so the brain thinks that cells aren't getting enough oxygen) rather than any anaemia which would be the problem doctors would be expecting (blood not carrying oxygen).


Hi, I was referred to the Haemotokogy dept at the hospital, I was their yesterday.. She said that my B12 blood count was high and she didn't think that was the problem, she has thou given me iron tablets to take and B12 supplements which she said won't do me any harm to take.. She has now referred me to another clinic she thinks I have chronic fatigue..

What's your thoughts?

And ill keep you posted on how I get on..



Like what Gambit62 says, you really do need the exact numbers (along with the units and ranges) for your blood results. What is 'normal' can be low enough to produce symptoms.

The B12 tablets won't do any harm but, if you have an absorption problem, they wouldn't do any good either.

CFS is really just a catchphrase for 'we've no idea what's wrong with you - here's a label, now go away'.

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with @fbirder on CFS being a label rather than a diagnosis - its a catchall for a load of symptoms that could have a number of different causes - but hope that the specialist referal does get you to what is causing the actual problem. Thyroid is one of the possibilities but I really would ask for exactly what the results are for the B12 and everything else.

Like B12 thyroid responses do vary from person to person but the variation tends to be less than with B12 so borderline for the average person could be problem for you as an individual.

B12 deficiency isn't just about the numbers in you blood its about what is happening at the cell level and it is quite possible to have high numbers in blood - and yet for there to be very little available at the cell level - this becomes more likely with really high numbers - and is called functional B12 deficiency ... there are a couple of conditions that can cause high B12 levels and kick off a functional deficiency but I would have expected the haematologist to have looked into these possibilities. It would be useful to know exactly what the doctor was talking about when they said 'high'.

Do you know what strength of B12 you were given and what form - probably cyano and quite a low dose?


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