Vitamin B12 Deficiency

The first thing to do is to post the results with the units (ng/L etc.) and the 'normal' range. Different labs use different assays which will give different results. While 200 pM/L may be within range on one assay 200 ng/L may be at the bottom on another.

Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to printed copies of your own results. Some surgeries make nominal charge for printing out.

Alternatively you can now ask for online access to your own medical records. Though not all surgeries can do this yet, or may not have blood test results available yet online.

Ring your surgery, asking for a printed copy to be available for you to collect. It may take a day or two - the receptionist has to get it agreed by GP.

"By what I can gather, anything below 200 in B12 is low"

Page 29 of the "BCSH Cobalamin and Folate Guidelines" mentions treating people whose B12 level is below 200ng. This page is a diagnosis flowchart that shows teh process doctors should follow with some one they suspect is B12 deficient. Some GPs are unaware of this document that came out in 2014.

Page 8 of the same document gives details of recommended UK B12 treatment for those with and without neuro symptoms.

The BCSH Cobalamin documents and a recent BMJ B12 article make it clear that people who are symptomatic for b12 deficiency should be treated even if their b12 blood levels are normal range.

bmj.com/content/349/bmj.g5226

Have you read Martyn Hooper's latest book? It's up to date with current UK guidelines.

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency"

B12 Symptoms Lists

I gave a copy of PAS list to my GPs with all my symptoms ticked.

b12deficiency.info/signs-an...

pernicious-anaemia-society....

With B12 it is the symptoms that really count - rather than the actual numbers. Low amounts in blood will obviously mean less getting through to cells but there is a lot of variation in how B12 works for individuals and the normal ranges are just statistical averages. Individuals vary and with B12 they vary a lot - so what is okay for one can be significantly deficient for another.

Having thyroid, RA and lupus is going to make evaluating symptoms quite difficult as there is going to be a degree of overlap ...

This is link to symptoms of B12 deficiency

pernicious-anaemia-society....

so, look at what could be relevant.

look through the pinned posts as well, and at the guidelines for diagnosis and treatment that are included in them.

As your GP thinks no action is required on those - what seem to me - very inadequate test results - I am wondering if your thyroid is being optimally treated. Do you have Hashimotos ? As RA and Lupus are auto-immune it made me think you may have Hashimotos too.

Do you have any recent blood test results with ranges for the thyroid ? Your TSH needs to be 1 or under and the FT4 and FT3 at least 70% of the range. Also the Anti-bodies are Anti-TPO and Anti-Tg. Ferritin could do with being around 80/90. It could be helpful to have your VitD tested too.

Auto-immune conditions seem to hunt in packs - I have Hashimotos and Crohns and a B12 issue caused by surgery.

You have a great deal on your plate and I do not mean to add to things. I am sure you will feel loads better when your B12 is also optimal.

I also wondered if you had ever been tested for Coeliac Disease. Sadly once someone has one auto-immune condition it increases their chances of developing another.

Coeliac disease can affect the gut and can therefore lead to absorption problems with some nutrients eg B12

coeliac.org.uk/coeliac-dise...

"I am going to start a B12 supplement and ask to be re-tested after a suitable amount of time."

Just want to mention that I resorted to self treatment after many years of trying to get NHS to treat me. I had many symptoms that were typical of B12 deficiency.

Self treating made it virtually impossible to get a diagnosis of B12 deficiency from NHS as my b12 levels became high and I was told that there was nothing wrong with my B12.

In my opinion if a person is B12 deficient, the NHS should be willing to treat them. It is possible to be severely deficient even with b12 blood levels that are normal range.

bmj.com/content/349/bmj.g5226

See 5th summary point in link above.

b12deficiency.info/b12-test...

b12deficiency.info/what-to-...

This link is about how B12 deficiency can be misdiagnosed as various other medcial conditions.

b12deficiency.info/misdiagn...

Typically .....If a test comes back "in range", even if it is right at the bottom, then GP would not consider it a medical issue, just a nutritional one, which is not in their remit to treat or advise on.

With regard to coeliac, you can have coeliac with absolutely no symptoms at all, called silent coeliac. Is probably more common ( and obviously more undiagnosed) than typical coeliac

But also recent research and lots of info out on web now about how most, if not all, with autoimmune issues should seriously consider being gluten free.

chriskresser.com/the-gluten...

amymyersmd.com/2015/09/3-im...

As Marz says, when taking vitamin D supplements, the increased Vit D level, increases the calcium uptake & calcium circulating in your system. It is rare that you would also need extra calcium, unless GP has tested it and found it low. Calcium levels should be tightly controlled. Usually recommended we take K2 to help send the extra calcium to the bones, instead of clogging up arteries.

Suggest you get both vitamin D & calcium levels checked.

If taking B12, then you may need to also take vitamin B complex to "keep the B's happy together"