Low folate and B12

[ElleK]

Hi I have come from the Thyroid UK Forum I have been told I need to speak to doctor about folate and B12 results what do I need to ask for re pernicious anaemia please?

Thank you

Folate - 2.7 (4.6 - 18.5)

Vitamin B12 - 185 (180 - 900)

[Gambit62 Administrator]

were these private tests or are they results from GP?

Your GP will probably want to do a full blood count to look for macrocytosis - although this is a classic symptom of B12 and folate deficiencies it isn't among the first symptoms to arise for about 30% of those with B12 absorption problems. Further - if you have an iron based anaemia then that will tend towards microcytosis - the opposite effect - though a high distribution width of red cells would be expected.

Put together a list of symptoms

pernicious-anaemia-society....

note: evaluation of symptoms may be muddied because of overlap with thyroid but best to note everything

Your GP may regard the B12 test as borderline and needing clarification - MMA and homocysteine levels (secondary indicators - as can be raised by other things) can help to clarify if there is a deficiency at the cell level. Possible that may not regard it as a problem at all because it is normal range - so need to make sure they are aware that the B12 serum test isn't a definitive guide to deficiency and they need to look at symptoms as well.

Note: alert from UKNEQAS

pernicious-anaemia-society....

IFA is the test for PA - but it is prone to false negatives about 50% of the time so a negative result doesn't rule out PA.

PA is also only one cause of a B12 deficiency - others include gastric surgery affecting the ileum, low stomach acidity (frequently mistaken for high stomach acidity as symptoms are pretty much the same), h pylori infections and a whole raft of drug interactions.

Please avoid supplementing until you have gone as far as you can with GP as it makes interpretation of results on B12 more difficult.

Ideally you need to be treated for B12 24-48 hours before the folate deficiency is addressed.

Please read through the pinned posts for other information