Pernicious Anaemia Society

Some test results

Can't post my test results, so here they are updated

Range in brackets

Total white cell count 7.8 10*9/L (3.60-10.5)

Red blood count. 4.87. 10 * 12/L ( 3.85 - 5.20 )

Mean corpuscle vol 80.3 fl (80 - 101 )

Mean corpusc Haemoglobin 24.4 pg ( 27 - 34 ) !!

Mean corpusc. Haemoglobin concentration 304g/L (315 - 360 ) !!

Red blood cell distribution width 15.3 (11.5 - 14.7 ) !!

Platelet count 365 10*9/L (160-370)

Mean platelet volume 7.4 fl (5.90-9.90)

Neutrophil count 4.94 10*9/L (1.50-7.70)

Lymphocyte count 2.21 10*9/L (1.10-4.00)

Monocyte count 0.35 10*9/L (0.10-0.90)

Eosinophil count 0.2 10*9/L (0.02-0.50)

Basophil count 0.04 10*9/L (0.00-0.20)

Large unstained cells 0.11 10*9/L (0.0-0.5)

Folate. 7.1 ug/L ( 3 - 19 )

B12 292 ng/L. ( 170 - 730 )

TSH 0.57 (0.3-5.00)

Please let me know what you think about these results as my doc says I'm ok! Even though the haemoglobin results were flagged as being low.

Thanks to you all.

11 Replies

Cali25. Can you post your low haemoglobin results - and any others you have, together with the reference ranges. Picture can be incomplete without all the results and it will help people to better advise if they have as full a picture as possible.



Foggyme - Cali25 has now listed with ranges

Definite signs of iron based anaemia.

Folate is towards the lower end of the range and B12 is in grey range.

Is your GP treating you at all for the iron based anaemia?

It may be indicative, in comparision with lower B12 and folate - of an absorption problem.

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Thanks Gambit62 appreciate your help. The GP is not treating me for anything at the moment, I saw a different GP after the other was so rude, see my original post. He is at least willing to do some other bloods, may have to pay for private tests. I'm concerned as my mother & grandfather had PA, have lots of symptoms that overlap with hypothyroid & type 2 diabetes. GP's just put everything down to diabetes even though well controlled.


yes, common story - did you share the article that I gave on your other post in relation to metformin and B12 absorption with the GP?

Unravelling symptoms to get to the bottom of what is going on is going to be very difficult

This is an article about iron deficiency and diabetes

In relation to B12 deficiency would suggest that you try looking at MMA and/or homocysteine as a way of clarifying on the serum B12.

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Yes I did and I also showed him the info on NHS site on B12 test measuring both active & inactive giving the total can be inaccurate. Interesting article my blood glucose levels had risen this last time that might be the answer.


Hi Cali125. Good grief...your GP is wrong. I agree with Gambit62

Your MCV is right at the bottom of the range, your MCH and MCHC are well below the reference range and you RBC is raised. All these are indicative of iron deficency anaemia.

Iron deficency anaemia changes the shape of the red blood cells, making them smaller. This potential mask a macrocytic (large red blood cell) anaemia of the type sometimes (but not always ) found in B12 / folate deficiency and PA.

You record your neutrophil count as. 4.94 10*9/L (160-370). Please could you just check that the reference range is accurate. If it is, then you neutrophil count is very very low. Sometimes this has no know cause but it can also be caused by....B12 and folate deficency. This will need addressing swiftly by your GP since you will be at very high risk of bacterial infection with a level this low - assuming, of course, that the reference range is correct. And the treatment for this is the treatment for B12 / folate deficiency: B12 injection followed 24 hours later by oral folate supplements.

If your reported neutrophil results are correct, your GP should most certainly not have missed this. Your other blood results indicate that folate and B12 deficency is the most likely cause. But there can be other, more serious reasons for this kind of result so your GP should Not be ignoring this result.

It's also important to note that a low neutrophil count can also be caused by an autoimmune response. Your GP should testt you for pernicious anaemia (an autoimmune condition) and, since you have autoimmune disease in the family history, it would be usual to run a full antibody screen, since autoimmune conditions tend to arrive in clusters - it's possible that you could have one or more autoimmune condition.

Also - ask your GP for CPR and ESR blood tests. These test inflammatory markers - won't diagnose any condition but will indicate if further investigation and specialist referral is necessary.

I've looked back at your previous post as well and agree with all - your B12 is in the grey zone - certainly low enough to give you the symptoms you describe- and you folate is on the low side too. YournGP should be treating your symptoms, not your blood results - all the guidelines state this.

And as you have neurological symptoms, you should be on an intensive course of B12 injections: your GP will likely never have heard of this.

Your should have 6 x loading doses on alternate days then injections every other day until no further improvement - perhaps for up to two years.

See you've been given lots of advice and links in your previous post - I'm a bit short of time right now and don't have time to check back properly to see what you have. I'm just going to paste some links below (in case you haven't got them) the information there will help you to understand what your GP should be doing for you - so that you can go back and ask him to do it.

Highlight anything relevant to and point those sections out to him. Take someone with you if you can. GP's are more attentive and less hostile if there is a witness in the room. Sad, but true.

Please do,post again if you have any further question or your GP proves troublesome - again. We may be able to advise and help further.


P.s. I'd be really interested toknow of the neutrophil results are presented accurately....

LINKS TO GUIDANCE (BNF B12 Deficiency: Hydroxocobalamin Treatment Regimes - Including Intensive Regime for Neurological Symptoms)

pernicious-anaemia-society.... (PAS Symptom Checklist)

pernicious-anaemia-society.... (BSH B12 Deficiency / PA Diagnostic Flowchart) (British Society Haematology (BSH) Guidelines: Treatment of B12 Deficiency and Folate Disorders - What all GP's should be Following) (UKNEQAS B12 Treatment Alert - Treat Immediately When Neurological Symptoms are Present - Even if Serum B12 Levels are Witin Reference Range) (Problems with Serum B12 Test) (Testing B12 During Treatment Not Required) (Misconceptions About B12 Deficiency – Good to know before seeing GP) (B12 Treatment Safety / Long Term Treatment for neurological symptoms) (B12 Deficiency and Neurolgocal Symtpoms can Present Without Macrocytic Anaemia or PA Being Present).



Sorry neutrophil range is 1.50 - 7.70


Phew...that's a relief 😄.

Nevertheless, your GP is a bit of a numpty if he thinks everything else is okay 😖


Thanks very much for your help, really appreciate it. Makes me feel a little better knowing I'm not imagining it all. Doc is going to call me next week about doing more blood tests and I'll make sure he does the ones recommended by you, thanks again Foggyme.

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No brave, be strong, get your highlighted evidence ready...take someone with you...and we can offer more advice if your ridiculous GP still won't treat you 😖😄

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Forgot to most likely have an absorption problem. This often causes other deficiencies too. Ask GP to check Vitamin D and magnesium levels. Low levels can make you feel very ill.

Also get ferritin levels done - another indicator of iron deficiency anaemia. Levels need to be mid range to be optimum 👍

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