Hello nice people,
I'm new here on PAS, I have posted on Thyroid UK before as I have hypothyroidism (Hashimoto's).
I had some private tests done for thyroid levels which included vitamin checks too and they showed the following:
B12 serum 179.7pg/ml (191-663)
Folate serum 9.61ug/L. (4.6-18.7)
Vit D 25 OH 18.1nmol/L. (50-200)
Ferritin 19.28ug/L. (13-150)
CRP high sensitivity- 8.1mg/L (0 - 5)
I supplemented with sublingual b12 200ug/every other day for 2.5 weeks until I went to see my GP. My neuro symptoms were increasing and I thought I might need b12 injections. Members on thyroid uk had advised me also to ask for GPC and IF antibody testing. Well, GP, no surprise, didn't think the private tests were reliable, nor that there was any need for the antibody tests ( my grandmother and aunt have PA and there is also coeliac disease in that line of the family- although I tested negative for that) GP did reluctantly agree to test the b12, Vit d etc again.
And this is where my confusion starts! I'd read that you shouldn't supplement 1-2 weeks before b12 testing (and IFAb) so I waited 3 weeks before booking the blood test at the surgery. In the same week I had private tests done for GPC, IF and active B12 and the results are as follows:
Gastric partial cell Ab - Negative
Intrinsic factor Ab - 8.9 U/ml (normal: <6 )
Active B12 - 73pmol/L (25.1 - 165)
B12 serum - 161pg/mL (180-914)
Serum folate - 5.5ng/mL (3.1-20.0)
Indeterminate B12 result. Please correlate with Hb, MCV and clinical picture.
Long term acid suppression is the commonest cause. I have been prescribed H2 blockers and then ppi 's for the last 16 years following diagnosis for hiatus hernia and acid reflux, and when asked about this the GP didn't think I should stop taking these.
Serum ferritin - 19ug/L (13 - 150) Low normal ferritin must be considered with clinical context and other haematological indices. Ferritin increases in response to inflammation - iron deficiency can then be masked.
Serum 25 OH Vit d3 - <30nmol/L Result: severe vitamin d deficiency.
Haemoglobin estimation: 138g/L (115 - 165)
Total white cell count: 5.30 10*9/L (3.40 - 11.0)
Platelet count: 245 10*9/L (140 - 450)
Haematocrit: 0.433 (0.350 - 0.470)
RBC Count: 4.77 10*12/L (3.90 - 5.60)
MCV: 90.8fl (80.0-102.0)
MCH: 28.9pg (26 - 32)
MCHC: 319g/L (300-360)
Red blood cell distribut width: 14.4% (11 - 16)
Neutrophil count: 2.80 10*9/L (1.70 - 8.00)
Lymphocytes count: 1.80 10*9/L (1.00 - 4.00)
Monocyte count: 0.50 10*9/L (0.20 - 1.50)
Eosinophil count: 0.20 10*9 /L (0.00 - 0.50)
Basophils count: 0.00 10*9/L (0.00 - 0.10)
I'm confused as to how I got a mid range Active B12 result and a low Serum B12 result within a day of each other. Could the IFAb result be a false positive because of the b12 supplements I took three weeks earlier?
I have no idea yet how to interpret the FBC results - do they look ok?
My GP has prescribed Desunin 4000IU daily for 10 weeks then 800IU daily until retest in December for the Vit d deficiency, but nothing regarding the B12 - I still have the neuro symptoms - pins and needles, mental fog, memory loss, episodes of fatigue, dizziness, blurred vision etc
Any help gratefully received 😀