Help with results low folate high crp.

[In-limbo]

Hello. I have many symptoms with overlap with thyroid and b12. This past year I have visited the dr dozens of times they think I'm a hypochondriac so I did these test through medichecks. I'm suffering a lot with air hunger right now and tiredness. I also have loose stool most days and have had since I had gallbladder removed a year ago. I was diagnosed with h pylori in April and had treatment. I'm at a loss now what to do next?

[Gambit62 Administrator]

In the above your folate levels are low - the symptoms of folate deficiency are very similar to those of B12 deficiency because the two are used together.

unpacking the B12 from thyroid is going to be difficult and the result above for B12 is in the grey range but that doesn't mean that its where you are deficient.

The CRP result indicates that you have some inflamation somewhere - which could be an indication of an auto-immune disease - which could relate to B12 or to thyroid.

Suggest that you look into MMA test as that could help to clarify if you are B12 deficient at the cell level. Homocysteine can also be a marker for B12 deficiency but it will also be raised by low folate so probably not useful in this instance.

You could also try testing for Intrinsic Factor and possibly Gastric Parietal Cell antibodies but both of these test have a tendency to give false results so aren't necessarily conclusive. These are looking for evidence that you have Pernicious Anaemia which is the most common cause of B12 absorption problems.

However, the gallbladder removal could have affected the ileum where B12 absorption occurs so that's quite a probable cause in this instance. This might be something to draw to the attention of your doctor to get them to listen properly to the B12 concerns

Do you have any earlier tests for B12 that show that your levels have dropped or is this the first time serum B12 has been measured?

[In-limbo in reply to Gambit62]

Thank you so much for your help. I don't have a print out but I can tell you that my b12 levels have been 196 2 years ago then 300 a few months later then 214 in April now this. I took b12 spray for about 8 weeks but haven't used any for 3-4 months as I wanted to see if my levels would drop.

I will make appt with my new GP (had to change surgery as I'm getting now where with previous surgery) hence the private testing.

I suspect I have some kind of autoimmune disease as my temp is usually between 37.5-38 and I have a sunburn type rash on my chest that been there for months. My crp has never been below 5.

I have itchy sensitive scalp random itching on body. Cystic acne breakout last 2 months on my jaw and back. Intermittent blurred vision (optician couldn't find anything wrong) headaches

Whooshing noise in my ear

Chest tightness

Air hunger

Palpitations

Carpal tunnel in my hand usually dead when I wake.

Reflux

Frequent need to urinate

Diarrhoea/indigested food in stool

Awful memory can't even remember 5 items on list

Brain fog

Cannot find words

Major irritability

Bloated stomach

Sugar and carb cravings

Fullness and pain in liver area

I'm sure there's more but I can't think of them now.

[Leothelion in reply to In-limbo]

Looking at your symptoms, mine were the same and my B12 was 233 I've had the injections it has help most of those symptoms, and as soon as I need the next one some of them return.

Originally my GP said to keep taking supplements but they were not helping much, so I saw a private Neuro and he got my dr to give me injections.

[In-limbo in reply to Leothelion]

I am debating paying for a private consult. I just want a dr to actually listen to ALL my symptoms and diagnose me so I can get treatment.

Having air hunger and chest tightness today. I just want to function. I have some b12 methyl spray in the cupboard should I start taking that again or do I need to sort out the folate deficiency first?

[Polaris]

Hi Inlimbo. Your levels are still low (deficiencies begin to appear in the cerebral spinal fluid below 550) and, with neurological symptoms you've described, GP should treating you with B12 injections as per BNF/BCSH guidelines in the pinned posts on the right hand side of site:

"The BNF advises that patients presenting with neurological symptoms should receive 1000 ug i.m. on alternate days until there is no further improvement."

Few GPs understand B12 deficiency or the fact that you have several high risks, not least gall bladder removal/H.pylori/thyroid disease, all of which will make it difficult to absorb B12 from diet alone. So it could be a good idea to write to GP or go back armed with your list of symptoms and information, in case needed. It might also be as well to take someone close to you for support, to ensure these results and symptoms are now taken more seriously - you probably already know that the longer they're left untreated, the longer it will take to recover and greater the risk of permanent damage.

To start with, here are some helpful sites you may not have seen:

ncbi.nlm.nih.gov/m/pubmed/1...

"CONCLUSION: Apart from other risk factors, pernicious anemia itself increases the frequency of gallbladder stones."

b12deficiency.info/b12-writ...

cmim.org/pdf2014/funcion.ph...

The above latest UK research document has a useful summary and important information re. blood tests - bottom of page 4 under 'how is response to treatment assessed'.

............

Hashimoto's and PA, both autoimmune diseases, have overlapping symptoms and many researchers believe the source is 'leaky gut', so following a gluten free diet usually helps. This and sauerkraut (better than any other probiotic I'd tried) banished all my own longstanding gastritis, gall bladder,H/pylori, IBS, reflux, etc.

I notice folate is also low but may be better to wait until B12 has reached a higher level before supplementing this as, without sufficient B12, folic acid gets trapped, builds up in the blood and can make neurological symptoms worse.

I hope you aren't unnecessarily alarmed by all of the above because you will also see from the pinned posts that, if early and adequately treated, many people do recover.

I really hope all starts to improve for you.

[In-limbo in reply to Polaris]

Many thanks for your help you have already answered some questions that I hadn't already asked!

As above I noted that I had some b12 methyl spray here should I start using that again? As bar going privately I don't think I will get injections as I asked back in April when my b12 was 214 I quoted the Bsch guidelines but was refused as here in Somerset you have to be below 120 to get injections!! (So basically dying!) the worst symptoms for me is the air hunger and chest tightness it comes in bouts so it can be gone for weeks then come and stay for weeks! I've had this for 2 years now on and off I've had ecg X ray an echo a year ago all fine! So I'm guessing my heart and lungs are ok so it must be due to low b12?

[Polaris in reply to In-limbo]

It's quite horrifying that you are being left to deal with this alone, as you are quite right, breathing difficulties are another strong symptom of deficiency.

I was also wondering how recently you'd had your gall bladder removed, as the effect of the anaesthetic could have inactivated what little B12 you had? I've found that sometimes you have to go back to GP again to be taken seriously, and then you can perhaps insist that MMA and IF tests carried out......

If you've ruled out the possibility of going back to GP, or self injecting, (the best solutions), the spray might help a bit as well as Jarrows Methylcobalamin 5000 mcg - or both - a matter of finding what works for you.

I really feel for you and know it's so very difficult but, as Sally Pachlok says, , "being assertive can save your life" and, taking someone close to you for moral support can make it more difficult for GP to ignore !

wish I could help more but, if you decide to SI, lots of good advice on the site on how to go about it.....

[In-limbo in reply to Polaris]

My gallbladder was removed in October 2015 so quite recently. My symptoms have definitely been worse since then.

I must make appt with new GP surgery as haven't been yet only recently changed however I won't get my hopes up! I've used the spray today has made my head feel full if you know what I mean? Odd feeling!

[Lyric1980]

I know this post was from a long way back but I think you should look in to Bile acid malabsorption if you haven't already! It's quite common in people after Gall bladder surgery.I was diagnosed with it back in 2015.

BAM causes many deficiencies and is responsible for frequent loose stool and plenty of other symptoms. I hope you see this as it's such a long time ago!!!