1st Post

Hi everyone This is my first post and the community has been great to read, help please told my blood results again are all normal 53 yr male. V depressed and fatigued, confused and no memory, numb fingers on left hand,restless legs.

Blood results B12 149 serum folate 4.5ug/l RDW 14.7 Haemoglobin 142 serum ferritin 12 how do I inteperate results

Many thanks

11 Replies

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  • Hi Holehead. Hello and welcome.

    It's quite difficult to interpret blood results without having the reference ranges as well (reference ranges are the numbers - sometimes in brackets - immediately after the result). Different labs tend to use different tests / reference ranges so this is important when interpreting blood results.

    So if you can post the results again, with the relevant reference ranges, people will be able to help with the interpretation of your results.

    👍😀

  • What Foggyme said, plus - do you have a value for MCV? That tells us how big your red blood cells are - which can be an indicator of low B12 and/or folate.

  • Hi

    Thanks for your comments I have enclosed the details

    Serum B12 149 ref 150-1000ng/l

    Serum folate 4.5 ref 2-18.8 ug/l

    Serum ferritin 12 ref 12-250ug/l

    RDW 14.7% ref 12-15%

    RBCount 4.6 ref 4.5-6.5

    Haemoglobin 142 ref 130-180g/l

    Serum TSH 2.1mlU/L ref 0.3- 4.5

    All on a downward trend other than RDW which is upward

    Many thanks Mark

  • Hi Holehead.

    The serum B12 result indicates that have B12 deficiency, which your GP should now be treating with B12 injections.

    Your folate is also very low. B12 and folate work together so you need good folate levels so your body can utilise B12 properly. Folate levels should be in top third of the range.

    It is important that your GP does not give you folate supplements unless your B12 deficiency is treated (folate should commence 24 hours after your first B12 injection). If your GP treats the low folate without treating your B12 deficiency, you will be exposed to the potential for irreversible neurological damage. Some GP's don't know this.

    Your serum ferritin is very low and this can make you feel very ill indeed (breathless, weak, tired, difficulty swallowing etc.). Some of these symptoms are also the symptoms of B12 deficiency, so you could be getting a 'double whammy' of symptoms.

    Although the RBC and Haemaglobin are within the reference range, the downward trend, together with the increase in RDW (which indicates that your red blood cells are getting larger - indicative of macrocytic anaemia).

    Macrocytic anaemia can be present in pernicious anaemia and in view of your proven B12 deficiency, your GP should test anti-IF antibodies to see if you have this condition (note - the test is only 50% accurate so you can still have PA, even if you test negative).

    TSH - think this is slightly high, though your GP will say it is normal. But not very knowledgable about this. Try posting your result on the thyroid forum - very knowledgable folks there will be able to a advise on that (and they'll probably tell you to get FT4, FT3 and thyroid antibodies tested too).

    So...back to the B12 deficiency. If you have neurological symptoms, it is important that you are treated with B12 injections immediately, in order to prevent potentially irreversible neurological damage. And you should have the neurological regime, in order to prevent potentially irreversible neurological damage. Your GP may not know this.

    If you do have neuro symptoms, you should get 6 X loading doses of Hydroxocobalamin on alternate days, then 1mg Hydroxocobalamin every other day until no further improvement, the 1mg Hydroxocobalamin every eight weeks. Your GP may not know this.

    If you don't have neuro symptoms, you should have 6 X loading doses on alternate days, then an injection every three months.

    If you have a read of the PAS pinned posts to the right of this page when you log on, they give lots of information about diagnostic testing for PA, the treatment of B12 deficiency, guidelines that GP's should follow, and a checklist (you'll be able to identify neurological symptoms - and you might even find that you have symptoms that you didn't know we're symptoms).

    If your GP is reluctant to treat your B12 deficiency, Print and highlight anything that is relevant to your case and take it along to show your GP. Unfortunately, many GP's are very ill-informed about B12 deficiency and PA so don't be surprised if you end up having a battle on your hands when trying to get treatment.

    If you have trouble getting treatment or you are not sure if your GP is providing the correct treatment, then please put up a new post and people can help and offer advice about this.

    Certainly, your B12 deficiency, low folate and low ferritin should be addressed by your GP.

    Good luck with your GP...please let us know how you get and and, as I said, lots of people here to help, if needed.

    Take care 😀

  • Thank you so much for your detailed information

    Regards Mark

  • Hi foggyme

    I just read your post and i wanted to ask when you said folate supplements , is it the same meaning folic Acid tablets . I wanted to know because I was given them all the way threw my second pregnancy and for three months afterwards to . And my daughter has just had her bloods and b12 tested (she is 15) because she was low on the B12 and folic Acid , they want her tested again but the doctor said she can take the folic acid now it makes no odds . I originally told her to hold off taking them in case it influences the test results

  • Hi Tracey55.

    Yes, folate deficiency is treated with folic acid supplements (sorry if I was not as clear as I could have been 🙃).

    Not easy to say about your daughter taking folic acid before B12 without knowing what her B12 levels were (low or actually deficient).

    If deficient or very low in the reference range all the guidelines state treat with B12 first (24-48 hours before folic acid).

    Neurological damage by treating with folic acid first is rare - but why take the risk.

    Another thing to consider - teating with folic acid only can mask the symptoms of B12 deficiency and allow neurological damage associated with B12 deficiency to occur so...best for your GP to treat both at the same time.

    Your GP may not be aware that B12 deficiency - and the symptoms associated with it - can occur even if B12 levels are in the 'normal' reference range - particularly if at the low end.

    So, in short, your GP should be treating symptoms, not serum B12 levels.

    Also complicated because the symptoms of folate deficiency ha e cross-over symptoms with B12 deficiency 😖.

    If your daughter has neurological symptoms, your GP should not hesitate but treat for B12 deficiency, with injections, immediately.

    If you have a family history of PA or other autoimmune conditions your daughter is more likely (but not certain) to have PA to, so your GP should test IF antibodies (though this test returns 50% false negative results, so a negative result does not rule out PA).

    Hope this helps.

    If you need any further information or help with your GP, put up a new post and folks will be along to help and advise.

    Good luck.

    👍

  • Hi holehead "normal" test results are only normal if you are normal and are based on an average which means that many of us are not normal - if you see what I mean

    So as Foggyme and fbirder say try to get all the details from your tests and if possible include the serum Folate result - if it was done.

    Also, tell us a bit about your lifestyle, diet, all your medications, illnesses etc as this will help others on here to assess what is going on.

  • you need the reference ranges because they vary depending on the precise test method and kit used but looking at the numbers and comparing them to general ranges your Serum B12 looks low, as does you folate - serum ferritin looks low as well ... but really need the reference ranges.

    Suggest that you talk things through with your doctor.

  • Hi

    Thanks for your comments I have enclosed the details

    Serum B12 149 ref 150-1000ng/l

    Serum folate 4.5 ref 2-18.8 ug/l

    Serum ferritin 12 ref 12-250ug/l

    RDW 14.7% ref 12-15%

    RBCount 4.6 ref 4.5-6.5

    Haemoglobin 142 ref 130-180g/l

    Serum TSH 2.1mlU/L ref 0.3- 4.5

    All on a downward trend other than RDW which is upward

    Many thanks Mark

  • Sorry forgot to say the MCV is 93.7 ref 82-100

    Been a vegetarian for 48 years but good diet including plenty eggs pulses and dairy products told I have a polyp near the appendix however this has been going on since Nov 2015 and next appointment with the surgeon not till January 2017 to discuss options

    Self employed with an active job outside non smoker. hope this helps to give a better picture

    Mar

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