Pernicious Anaemia Society
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Update Doctors

Hi all,

have just been to my doctors and picked up my blood test results, that my new doctors wanted to do before going any further (originally the new doctor said she would arrange for me to have a MRI scan, but think this has been knocked on the head by her supervisor).

At that point I had to make some excuse for my B12 result to likely be through the roof which it is, and told her I was taking very high dosage sublinguals, did not say I was SI (although I think my last SI was around 7-10 days before the Blood tests,

Anyway here goes if anyone can point out anything that they think is abnormal:

Serum C reactive protein - <5 [<5]

Serum Calcium Level - 2.35 mmol/L [2.2 - 2.6] - there is an exclamation mark under this one

Serum adjusted calcium concentration 2.3 mml/L [2.2 - 2.6]

Serum inorganic phosphate level - 1.03 mml?l [0.8 -1.5]

Alkaline phospatase Level - 95U/L [30 -130]

Serum total albumin level - 75g/L [60 - 80]

Serum sodium Level - 141 mmol/L [133 - 146]

serum potassium level - 4.3 [3.5 - 5.3]

Serum Urea level - 5.3 {2.5 - 7.8]#

Serum creatinine level - 62 umol/L [60 - 120]

GFR calculated abbriviated MDRD - >60mL/min/1.73m*2

Serum total bilirubin level - 9 umol/L [0 - 21] - Exclamation mark under this one

Serum alanine aminotransferase level - 23 iu/L [5 -31]

Serum Free T4 level - 21.7 pmol/L [12 -22]

Serum TSH level - 1.33 miu/L [0.35 - 5.5]

Total white blood count - 8.2 10^9/L [4 - 11]

Red Blood cell Count - 4.71 10^12?l [3.8 - 5.8]

Haemoglobin concentration - 13.4g/dL [11.5 -16.5]

Haematocrit - 0.395 [0.37 - 0.47

Mean Cell Volume - 83.9 fl [76 -97] - this has changed a lot since SI as this last blood test was 101.9 (as is this if the number is large where the blood doesnt carry oxygen properly?

Mean Cell haemoglobin level - 28.5 pg [27 - 33]

Mean cell haemoglobin concentration - 33.9 g/dl [30 - 36]

Red blood cell distribution width - 12.6% [9 - 15]

Platelet count - 428 10^9/L [150 - 450]

Mean platelet volume - 10.1 fl [7.5 - 11]

Serum B12 - > 1,900 [180 - 914] - we knew this was going to be high

There were a few other readings but thing they were all okay, anyone have any thoughts on any of the above?


My neuro symptoms have got worse, I have lost my balance and actually fallen twice since yesterday, and last saturday I had a terrifying experience on the tube train in london, - I took my husband to london for his birthday, we got on the tube was packed, and had to stand, I could not see my feet as we were packed in like sardines and I could NOT stand up at all, a very kind lady gave up her seat for me as she must has seen the shear panic in my face, and probably my husbands too.

got an appointment to see the doctor on Friday 25th, am hoping that she will see sense and refer me to a specialist, I don't think she is going to let me have b12 shots, so looks like I will have to continue SI myself without the support of the NHS,

Thank you x

5 Replies

Mean Cell Volume - 83.9 fl [76 -97] - this has changed a lot since SI as this last blood test was 101.9 (as is this if the number is large where the blood doesnt carry oxygen properly?

A high value for MCV means that your red blood cells are larger than normal - macrocytic anaemia. It can be caused by low B12 (or folate). The fact that yours has dropped to the normal range means that whichever was causing the problem - it's not now.


Hi AngelaJG. The serum bilirubin may have an exclamation mark because it is a little on the low side (although not outside the reference range). This is not usually a cause for concern. Bilirubin can be reduced by caffeine, excessive vitamin C or some medications. It can be lowered in some disease processes and your GP may investigate further, though as your other results look okay, may consider this unnecessary.

The serum calcium probably has an asterisk because this is also a little low (though again, not outside the reference range). This can be due to dietary deficiency, decreased vitamin D, magnesium deficiency, renal conditions, under active name but a few. It could cause abdominal cramps, muscle cramps, and tingling fingers. You may not necessarily have these symptoms but if you do, then discuss them with your GP, who may consider prescribing supplements (too much calcium can cause problems, so best to take supplements, if needed, following advice from your GP).

Both of these tests are routine blood screening tests and cannot, in themselves, point to any specific medical condition. As they are within the reference range, and as your other results appear to be okay, your GP may not be concerned but it's best to ask about them so you can be reassured.

Serum creatinine is low but this, on its own, is not usually considered a problem. It can be caused by a lack or low protein in the diet, reduced calorie intake, absorption problems... As with the other results, not diagnostic on its own and has to be read over and against other blood results so would only be significant if there were real problems with your other results.

Thyroid results (serum TSH and serum FT4 - look okay but don't know a great deal about thyroids. Might be a good idea to,post them on the Health Unlocked Thyroid Forum. Folks there are very knowledgable and will be able to advise. And I wouldn't be surprised if they asked for results for FT3, TPO antibodies and Tg antibodies. Suspect your GP didn't do these and they may suggest you to try and get these done. But best to let them advise on that.

Your other results look okay (I note and agree with fbirders comments about the MCV) .

And you're right about the serum B12 - high due to supplementation.

If,you want to look up blood tests on the Internet, try this site - heaps of useful information there.

Hope this helps and good luck with your GP. Post again if you need any further help 😀

1 like

Thanks fbirder and foggym

I am guessing with the mcv when I started si I did a month of loading doses everyday of 5ml methyl and then went to every other day with alt methyl 1ml and hydrox then weekly so would suggest that there was b12 def in relation to mcv if it has now come down within the normal range.

The main thing is to get my doctors to refer me for testing of neuro symptoms to rule out anything sinister I don't even walk normally anymore I am 53 and walk like I am on old woman well actually my father in law walks better than I do and he is in his 80s.

I had stoped si but started again last week was hoping that the new doctor would listen but think it will be an uphill struggle and I know I feel so much better in myself with more energy less shortness of breath can walk for significantly longer sore tounge had gone less tired


thanks both of you xxx


Hi AngelaCJ. Just thought you might like to know more about the frightening experience you had on the train.

One of the unconscious mechanisms that occurs in the body is called proprioception. This relates to the sense of position and movement of the limbs and allows us to know where the limbs are without looking at them - we know where the body is in space.

In some neurological conditions, this sense is disrupted and when the eyes are closed (or in the dark) the body fails to recognise where the limbs are. So the reason you could not stand up was that your body failed to 'know' that you had feet / legs - and hence the falling over.

This is a neurological symptom that can be associated to B12 deficiency (or to other neurological conditions) and should certainly be pointed out to your GP, if you have not already done so.

I'm really surprised that your new GP hasn't heard of IF. Basic anatomy and physiology. Good grief, what on earth do they teach doctors nowadays!

It's good that her initial thought was to send your for an MRI (even though overruled). This means that she will be more likely to refer you to a neurologist, once your initial blood results have been reviewed.

And you should most certainly be referred to a neurologist. It could be difficult to convince your GP that you have B12 deficiency now that your levels have been raised due to self injection. But this is a moot point - you have neurological symptoms (from whatever cause) and these should be investigated by a neurologist (MRI scan of head and spine), at the least.

It might be worth printing of the PDF from the PAS website library 'sub-acute combined degeneration of the spinal cord' and asking your GP to read this while you are there (information on the Internet if you're not a member of the PAaS). I'm not suggesting you have this and am not trying to frighten you. Most GP's seem to be totally unaware of the neurological havoc B12 deficiency can wreak on the body so showing her that information might sharpen her mind and encourage her to take your neurological symptoms seriously.

It's really good that your B12 is starting to make a difference. Neurological damage can take longer to repair, especially if you have been B12 deficient for some time (which I think you have), so worth persevering with the neurological regime of injections (every other day until no further improvement). Just very very bad that you have had to self-treat rather than be treated by a competent GP 😖.

Anyway...seem to have got a long way from falling over on the train 😀...

Good luck with your GP and please let us know how it goes. Lots of people here to pop in and help, if needed 👍


Thanks again foggyme

will keep you updated x


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