Pernicious Anaemia Society
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Advice on blood tests please


As a result of private blood tests showing I was b12 deficient L119(<140), low serum folate L8.91(10.4-42.4) and high ferritin 269.3(30-150)., my doctor ordered a raft of NHS blood tests. The clinical info stats 'deficiency of Ferritin, vitB12, Folate with loose motions, TT.

The tests that I hope you can help me and I apologize if they are not appropriate to this forum.

Haemoglobin A1c level 43mmol/mol (20.0-41.0)

Serum B12 246 ng/L (211.0-911.0)

Serum folate 4.0 (5.4-25.0)

Plasma viscosity 1.74 (1.5-1.72)

I rang for the test results and was told the tests were borderline and to make a "non-urgent" appt, which I have don.

I would be grateful for any help/advice anyone can give me that helps me to understand these results.

7 Replies

B12 is low, but in range (had you taken any supplements?).

Folate low. The doc will advise you to take folic acid. Tell him you're not too happy doing so without fixing the low B12 first as it can be harmful. Print this out to show him -

HbA1c is high. This indicates a pre-diabetic condition - If you're slightly overweight the doc will suggest losing some before you need medication.

High plasma viscosity can be an indicator of inflammation.


Thanks fbirder. The advice re getting B12 fixed before folate is very helpful. I haven't taken any B12 supplements but I am doing a 12 week probiotic course (Symprove) to help with my cheinic diarrhoea.


sorry - bit confused by the ferritin - private test are extremely high if quoted correct - but the NHS came back showing low ferritin?


Hi Gambit52. The private test for ferritin was 269.2 (20-150) whilst NHS was 226 (10.0-322.0). The range for the NHS is much larger than private.

The ferritin in both tests are comparable it seems that it's the ranges that skew the result.


That's really helpful JamesStibe. I have an appt with doc next week and will push for the B12 supplement as I feel shattered from waking up to going to bed. Also showed these results to my endo who said she didn't think my GO would prescribe anything fir my B12 result. The test, which I didn't post on this site, highlighted antibodies within my thyroid function, which everyone on a partner site has said is hashimotos (an auto immune disease), my endo has said no it's thyroiditis. Also diagnosed with IBS 2 years ago but I'm not 100% sure it is.

I feel hopeful that the doctor I am seeing will see past the results and prescribe supplements. If not I shall self medicate.


REPLT TO Ali8655 .

Hashimoto's is another name for autoimmune thyroiditis. Dr Hashimoto first diagnosed the condition.

Thyroiditis describes the same condition which is inflammation of the thyroid: when antibodies attack the thyroid or thyroid peroxidase, an enzyme which changes the storage levo thyroxine hormone (T4)to the active hormone known as tri-iodo thyronine, (T3) for short. If the conversion enyzmes are destroyed by the antibodies, then the person has high (inactive)T4 in their blood and low, activeT3.

The pituitary gland , located inside the brain, calls for more thyroid hormone, by producing more thyroid stimulating hormone from the pituitary. (TSH). High levels of TSH are inflammatory for the poor thyroid which tries hard to make active hormone T3 but cannot because it is being destroyed by antibodies. The higher the level of TSH, the lower is the actual thyroid function, so TSH is used as a marker for thyroid problems. This is true for untreated thyroid patients, but once there is treatment, the TSH marker function is not adequate to determine treatment. This causes a nightmare for thyroid patients who are told they are healthy because their TSH is low, but they are suffering bad hypothyroid symptoms.

low T3 causes a huge number of hypothyroid symptoms, since together with B12 it is used in a huge number of metabolic processes. So it affects every cell in the body. Very often, thyroid patients self-medicate with T3, because they cannot get their GP or Endo to help. Blood tests for Ft3; FT4 indicate if there is such a need or deficiency.

If there is a deficiency in either T3 or B12 or worse, both (common with Hashimoto's)then life is very miserable. Pain, fatigue; shortness of breath; low heart-function; water retention..neuropathy, fibromyalgia....carpal tunnel; plantar fasciitis (painful, inflammation of sole of foot) you name it.

I have learned so much from this PA site about B12 and the difficulties patients experience in getting a diagnosis or treatment. I suffer both autoimmune thyroiditis (Hashi's)and B12 d. I have convinced endo re the thyroid (took me years) but no luck with getting B12 injections on NHS. out of desperation I self inject B12 high dose. because I was slow realising I was b12 deficient, I now have advice carry on fighting for a diagnosis, but if the symptoms become unbearable...self inject/self medicate. You will be in good company. If not for thyroid and PA websites...I would not be alive and I have a huge debt of gratitude to all those who contribute and share such knowledge and advice on website, which our sad medical profession is too arrogant to understand. Good luck


I'm currently in 100mcg levothyroxine. They only tested my TSH 1.7 (0.1-4.0) and my free T4 15.3 (10.0-20.0). Private blood test showed free T3 to be 4.21 (3.1-6.8).

I'm going to push for B12 supplements when I see the doctor on Mon, hopefully that will make me feel more like I'm in the land of the living. Fingers crossed.


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