My test results help please - Pernicious Anaemi...

Pernicious Anaemia Society
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My test results help please

How do these look please x

Mean cell volume 93.6 fL [80 - 100]

Mean cell haemoglobin level 31.1 pg [27 - 32]

Red blood cell count 4.7 10^12/L [3.8 - 4.8]

Haematocrit 0.44 [0.36 - 0.46]

Mean cell haemoglobin concentration 33.2 g/dL [32 - 36]

Nucleated red blood cell count 0 10^9/L

Haemoglobin concentration 14.6 g/dL [12 - 15]

Total white blood count 8.6 10^9/L [4 - 11]

Platelet count - observation 258 10^9/L

Serum iron tests Plasma total bilirubin level 8 umol/l [0 - 20]

Plasma calcium level 2.19 mmol/L

Plasma adjusted calcium concentration 2.24 mmol/L [2.2 - 2.6]

eGFR using creatinine (CKD-EPI) per 1.73 square metres > 90 mL/min

Plasma albumin level 36 g/L [35 - 50]

Liver function tests

Plasma total protein level 71 g/L [60 - 80]

Plasma alkaline phosphatase level 68 iu/L [30 - 130]

Plasma C-reactive protein level 2 mg/L [0 - 7.5]

plasma creatinine level 64 umol/L [53 - 97]

Transferrin saturation index 37 % [16 - 45]

Plasma ferritin level 22 ng/mL [11 - 307]

Serum iron level 23 umol/l [5 - 30]

Serum transferrin level 2.77 g/L [1.9 - 2.8]

Plasma folate level 4.1 ng/mL [3.8 - 25]

Plasma sodium level 137 mmol/L [133 - 146]

Plasma potassium level 3.8 mmol/L [3.5 - 5.3]

Serum vitamin B12 level 252 ng/L

10 Replies

Hi Ldhall,

I'm not any kind of medical expert but it looks to me like your ferritin levels are low. Mine was 30 & I felt very fatigued and so on the advice of my doctor, took iron supplements. It is now 76 & I feel much better. Your folate looks low as well as your B12.

Do you have any symptoms of B12 deficiency? You can go to the PAS website and look at the symptoms. Fatigue, sore tongue, tinnitus, unbalanced gait, dizziness, breathlessness are just a few of the symptoms.

Have you discussed these test results with your GP?

Since your B12 is in the grey area and not technically deficient, (although I did not see the parameters for B12 in your test results) your GP might not consider you B12 deficient.

However, going on what I've learned on this forum and books such as Sally Pacholok's "Could it be B12?" , if you are having neurological symptoms and fatigue, you really should be getting B12 injections or sound kind of supplementation.

It depends on what is causing the deficiency as to the type of supplemental B12 would work for you. Are you vegan or vegetarian? Take Metformin or PPI's?

If you could write a little more about your situation, there are lots of very well informed folk who can give you more information. Keep us posted!

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Okay I was really bad last year, anxiety d crying for no reason, neck pain, chest pain, couldn't exercise, breathless, diahreah everyday for months, Dr said anxiety, I couldn't explain I was anxious but could say why, I had neck pain, shoulder pain, back pain, legs if walking fast would feel like mlower legs would burst and had to walk in tiny steps and slow, still drs did nothing, gave me beta blockers for palpitations, I tested b12 it was 220, no help, I started drinking protein shake as I had lost weight, didnt realize it had folic acid and b12 in it, next test was 287, but palatations had nearly gone, and shoulders started to feel a bit better, stopped the drink and next test was 252, started to feel tired again, got iron from Dr but that was a fight, I have tinnitus now not to bad but annoying, get more headaches too, thanks for your replies x

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Hi ldhall,

No wonder you feel so bad!

When my B12 was 290, I had breathlessness, (low iron causes this also) fatigue, dizziness, tingly arms& hands, burning toes and a bunch of other symptoms. I've had tinnitus for years but B12 is miraculously helping. Your B12 level is in the grey area, as many people's are on this forum. Any level lower than 500 may/ can cause neurological symptoms like you have/had. The lower levels the doctors go by, usually under 200 is when people become anemic from low B12. But even at those lower numbers not everyone becomes anemic.

It sounds as if supplementation really works for you! Which is great. A great way to take B12 is sublingually. You can get doses of 1000 up to 5000mcgs. Taking B12 plus taking folic acid should make you feel better and you can't overdose on B12, so no worries about taking too much. What ever your body doesn't need will get urinated out. Glad you have the iron, take vitamin C with it for better absorption.

I really can't stress how much the B12 can help you feel better! :-)

Best of luck and let us know how you are getting along!

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Thank you, but the problem I have, which I am sure everyone has experienced, end I say my symptoms to Dr he and several others say not related to b12d, or you can't have symptoms at your level, banging my Head against a very hard wall lol, my partner wants us to have another baby, but I am worried with my levels as they are, getting older so would want to try sooner rather than later. Will see if he will retest again, also I was a veggie for about 2 years then I started feeling unwell, I eat meat now have son for the last year, so question is should my level be higher now that I eat meat, or sound like malabsorption, I have ulcerative colitis for 11 years but not had symptoms for years now, x

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I have IBS which causes absorption problems. But as I posted earlier to someone else, I'm not sure if the b12 deficiency came first which can cause stomach problems or vice versa. It takes a long time to become deficient in B12, usually it is recycled in the body. But I think a person needs 2.4mcgs. a day which they usually get from food.

So it would seem logical that 11 years of ulcerative colitis plus being vegetarian could cause malabsortion/depletion and it has just taken this long for you to become deficient in B12.

I know once you start getting low on B12, then the symptoms seem to snowball.

You are in the grey zone with your B12 level and so many GPs won't treat until it drops lower, which is really stupid and not healthy for the patient. If you are in the U.K. There is lots of info and guidelines that you could copy and print and show to your doctor. Check out fbirder's posts, he has gathered a lot of that information to help people with doctors who won't listen.

You could suggest to your GP a trial period of B12 injections, other people have done that with good results.

It also would be good to get tested for Pernicious Anemia. The intrinsic factor test and test for gastric parietal antibodies. I think I have that right. Someone can correct me if it's called something else.

You are not alone, there are so many people that post here with your grey zone problem!

If you are in the U.K., then just post again and ask how to get the doctor to listen and treat you.

I am in the US. And it is a bit different here.

Don't give up!

Many people supplement our self inject B12. But before you take oral it sublingual supplements, I would ask the doctor to test you for Pernicious Anemia.

Hoping that you get the help you need! :-) xx

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just realized that sleepybunny has a great reply below with lots of links and where you can find the most up to date guidelines.

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I agree with ndodge - an iron supplement may do some good. As would some folic acid (400 ug a day).


Got iron, 2 tabs a day, I bought some folic acid myself x

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I've assumed you are in the UK.

A lot of the symptoms you describe can be found on lists of B12 deficiency symptoms.

B12 Deficiency Symptoms


See PAS Symptoms checklist in link above.

B12 books

"Could It Be b12" by Sally Pacholok and JJ. Stuart

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper. This book is up to date with current UK guidelines.

UK B12 documents

Recent documents make it clear that people who are symptomatic for B12 deficiency should be treated even if their B12 levels are within normal range.



2) See summary points in this link

3) Google "BCSH Cobalamin and Folate Guidelines

Other LInks

I am not a medic just a patient who has struggled to get a diagnosis.


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