Pernicious Anaemia Society

Blood test results-advice please

Hi im still feeling exhausted, seeing occasional 'spots' in eyes only for a few seconds and not floaters as had eyes checked and feel nausious sometimes and anxiety. Had 6 loading doses over 6 weeks which finished 5 weeks ago. I requested a full blood check and these are my results ( I have PA due to crohns)

B1W = 1004pg/mL

Serum ferritin 40ng/ml

Serum folate 17.2ng/ml

Red blood cell count above range 5.26

Haematocrit above range 0.48

No further action is required according to the print off but im going to see gp tommorrow to discuss. Why do i have a high RBC? Is it early days to feel better?


9 Replies

Hi Springbabyboo. Just spotted your post on way to bed 💤💤

Are you able to give the reference ranges...a bit difficult to interpret accurately without them...if you can leave the reference ranges and folks will be better able to advise 👍

Thoughts: ferritin could do with being a bit higher (80 - 100 a good place to be), high RBC and haemocrit can be due to something as simple as dehydration... or to low levels of oxygen in the blood...but other causes too...needs to be looked at in context of full medical history.

It can take some time to feel better once treatment has started...difficult to say how long because it varies for each individual. Anxiety and nausea can be symptoms of B12 deficiency...floaters not unusual in healthy people so shouldn't be a problem if optician says okay (not sure if an actual symptoms of B12 deficency - but I get them too and I am a deficient so...hmm).

Has your GP put you on a regular regime of B12 injections? And keep in mind that if you have neurological symptoms you should have every other day injections after the initial loading doses (until no further improvement). Your GP may not know that.

Also - your B12 level will be high because you have had the loading doses. Your GP should not use this as a reason to stop your B12 injections - some do, and it's wrong. Come back if you need more advice about that.

And last - did your blood results include an MCH, MCHC, MCV and RCDW - good to see those results too if you have them.


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Hi Foggyme thanks for the reply, the range for ferritin is 13-150ng/ml my result is 40ng/'ml. The folate range is 3.9-26.8 mine is 17.2ng/ml.

The red blood cell count range is 3.8-4.8 my result 5.26. The mean cell volume range 80-100 my result 91fl. Haematocrit range 0.35-0.45 my result 0.48.

Red blood cell distribution width range 10-15 my result 12.9.

Mean cell haemoglobin range 27-34. My result 28.7

Haemoglobin concentration range 115-160 my result 151g/l

Erythrocyte sed rate seems low to me. The range is 1.0-19.0 my result is 2mm/h.

I had lots of other results, calcium, magnesium etc which all seem ok.

I now have my app with gp so will see what they say. I am however on a 3 monthly b12 regime which is due to start at the end of feb.

Thank you


Hi Springbabbyboo. Thanks for these.

No changes to what I said in the reply above.

Erethrocyte sedimentation rate (ESR): this is marker of general inflammation in the body so having a low result is good. Means it's unlikely that you have any active inflammatory processes going on.

Good luck with your GP...and recovery...come back if you need more help.


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Thanks, well I feel like im now down as an over anxious worries as i was offered anti depressents. It was acknowledged that my muscle twitches are neurological but the gp didnt know anyone on more that 3 monthly injections and im to wait and see how i get on then i may get referred (if i push) to a neurologist but becuase my b12 levels are high i dont need any more. Im not going to give up. They want me to contact my gastro consult to see if they recommend more injections. I hope they are more clued up then my gp. If the gastro says no then im stuck. Thanks for all the input. I am thinking of purchasing a b12 nasel spray to tide me over. Although according to my gp not everything is down to B12!

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Hi Springbabyboo. So sorry that your GP is such and idiot! And many apologies for not spotting your reply sooner.

Your B12 levels are high because you have had injections...and high B12 levels, once injections have taken place, should be not be used as a reason to stop treatment. As you know.

And if your GP doesn't know anybody who is on more than three monthly's because he's been dispensing the wrong treatment!

You have neurological symptoms...and all the guidelines say that treatment should take place immediately, with B12 injections...even if serum B12 levels are low, normal...or excessively high. Silly man!'s a load of links to documents that may help,you to convince your GP to treat you...or prepare you for your consultation with a neurologist...who he should refer you to now...because you have unexplained neurological symptoms (at least according to,your GP).

Here's the documents (look particularly at the UKNEQAS Alert... (BSH Diagnostic Protocols) (BSH Guidelines: Treatment of B12 Deficiency and Folate Disorder (UKNEQAS B12 Treatment Alert) (Problems with Serum B12 Test) (Testing B12 During Treatment) (Misconceptions About B12 Deficiency – Good to know before seeing GP) (B12 Treatment Safety / Long Term Treatment for neurological symptoms)

Might look like quite a lot to wade through but they're actually quite easy to read...and very interesting.

Also...look up 'subacute combined degeneration of the spinal cord' on the Internet. I'm not suggesting that you have this. Rather, it's a way to sharpen your GP's mind - I bet he's never heard of it - and it. iChat just shake him into giving you the treatment he should be giving you. Print the document and take it to your GP - insist that he reads it whilst you're there. Then ask him if he is prepared to take responsibility for not prescribing B12 injections, should you develop this condition.

You might have to be brave...but it will be worth it if you get the treatment you should be having.

Last thought - are you able to change GP's?

Last last though - put up a new post if you need anymore help - once a post gets a little older, it slips down the posting page and the only people who see it are people in the original string. Good tip, 'cause you'll get more replies that way.

Good luck...let us know how it goes 👍

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Thank you so much for all this support. I will print it off and take to my GP. Ive a new app on feb 1 with a diff one...i found out the one i saw was an 'associate' gp which actually may explain their ignorance. Fortunately im stubborn. I will updare with a new post afterwards. Thanks again!


Good for you Springbabyboo...good luck 👍


Has your thyroid been tested? If so what were the figures?


Hi Ruthi, yes Thyroid tests were fine, serum THS result 1.47 range 0.27-4.2 and my serum free T4 result 18.7 range 12.0-22.0.


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