First sheet of my dads test results (the right way round!)

[skyrocket]

Here is his results again

[clivealive Forum Support]

As it says your Dad's B12 is borderline low

Sorry, I cannot now remember what his symptoms were and is Folate included on the test report?

[skyrocket in reply to clivealive]

His symptoms are confusion, memory problems, trouble getting his words out unjumbled, tiredness, tinnitus, diarrhea, and weight loss. I have uploaded the second sheet of results as well and i think Folate is on that one

[skyrocket in reply to clivealive]

The second sheet of results with Folate is on a separate post I put up about 45 mins ago.

My mum was supplementing him with a B12 spray even though I told her not to when they were having the blood test....

[clivealive Forum Support]

I think Folate is 15.6ug/L and the range something above >6.5 but it's difficult to read as it's in the fold. It is flagged as Normal but I don't know whether it is low or not. Perhaps fbirder could advise?

[Gambit62 Administrator]

the symptoms you mention could, unfortunately, be caused by a number of things. That does include a B12 deficiency.

Your father's levels are in the grey range where most people will be okay but a significant number of people aren't.

Your father's results don't show any macrocytosis - although this isn't one of the first symptoms to appear for about 30% of those with a B12 absorption problem neurological symptoms start first. However, GPs have a tendency to assume that B12 isn't an issue if there isn't any sign of macrocytosis

His ferritin is a bit on the low side and which could indicate that he has a problem absorbing iron from his food as well as B12 - this could be significant because it would lead to smaller red blood cells and could counteract any macrocytosis.

Tests that you could ask for that might clarify B12 status are:

- MMA and homocysteine tests (but the results may have been affected by supplementation)

- IFA to check for PA as a cause of a deficiency though given age and the fact that the test is prone to false negatives about 50% of the time it could possibly just be a deadend.

Question: Has your mother noticed any improvement in your father as a result of using the spray? if yes then that would be evidence that there is an underlying B12 deficiency - and you could try talking through the impact of the spray with your GP

However, I think the most useful thing you could do, given your personal circumstances, is to join the PAS and contact them for support

pernicious-anaemia-society....

martynhooper.com/2016/09/23...

[skyrocket in reply to Gambit62]

Thank you for your replies.

He is now on 3 tablets of Jarrow 5000mcg sublingual a day (so 15000 mcg) which I believe is still a relatively small amount if one is deficient.

He has been on this doseage for about 3 weeks. Maybe a bit too early to tell?

Before he was on the BetterYou B12 spray of 1000 mcg which is definitely not a high dose.

[fbirder in reply to skyrocket]

He is now on 3 tablets of Jarrow 5000mcg sublingual a day (so 15000 mcg) which I believe is still a relatively small amount if one is deficient.

That depends on the cause of the deficiency. If it's caused by diet - not enough meat, fish eggs, dairy - then it's a huge amount (about 100000% of the recommended daily amount).

If, on the other hand, it's caused by an absorption problem then it's still not a small amount. Absorption of B12 via the sublingual route is a fairly grey area. Quite a lot of it isn't absorbed but is swallowed. But it should still be plenty to keep levels high in most people.

Still not as good as proper treatment with injections (where you know exactly how much is getting into the body).

[skyrocket]

I have joined the PA and will phone them or try and get my mum to do it.

How long does B12 stay in ones system ie how long should he stop taking it before a test?

And how long does it take to feel better once taking it? He had a pretty bad diet in that he doesn't eat much meat and no fish or eggs.

[Gambit62 Administrator in reply to skyrocket]

metabolism of B12 is a very individual thing but in general testing for B12 serum etc its recommended to stop supplementing for 3-6 months. The test for IFA you need to stop for about a week but given your father's age I'm not sure it is worth pursing IFA as there may well be a different absorption problem going on in his case.

If it was diet then the amounts your father is taking will have replaced any loss many times over by now.

Generally people may take months or it could be weeks before some symptoms start to improve after they are getting enough B12 for them.

Has your mother noticed any effect from the B12 supplementation to date?

I think you also need to be prepared - difficult though it is - for the possibility that it really is nothing to do with B12 and possibly is dementia - though push for proper scans to confirm that.