Come from Thyroid UK forum

[Arty_58]

I have come here from the Thyroid UK forum as I have hypo/Hashimotos. GP is not doing anything about current results and I have recently been sacked and struck off from my last job due to inability to retain information, brain fog, memory loss, poor concentration, clumsiness and fatigue. Any help would be appreciated.

Ferritin - 44 (15 - 150)

Folate - 2.8 (4.6 - 18.7)

Vitamin B12 - 106 (190 - 900)

Total 25 OH vitamin D - 20.2 (>75 adequate)

[Foggyme Administrator]

Hi Art58. Hello and welcome. I'm so sorry that you're having such a tough time and feeling so very unwell.

I'm at a loss to understand how your GP can just ignore these results.

You are severely deficient in vitamin B12, deficient in folate and vitamin D and you ferritin level is too low (needs to be at least 80 - 100 would be better).

Your GP should be treating you with B12 injections, folate supplements (5mg a day) iron and vitamin D supplements.

Your GP should not treat your folat deficency without first treating your B12 deficency - folate should begin 24 - 48 hours after the first B12 injection (to avoid neurological damage - your GP may not know about this).

I note you have an autoimmune condition (Hashimoto's): people with one autoimmune condition often go on to develop other autoimmune conditions and it's not uncommon for those with Hashimoto's to also suffer for pernicious anaemia - and the B12 deficency it causes.

So...your GP should test your for anti-IF antibodies - the test for PA and also do a full blood count (FBC) - these should be done before any B12 injections to avoid skewing the tests.

Most GP's know very little about B12 deficency or pernicious anaemia (evidence by the fact that your results have been completely ignored). The best way to deal with is is to become well informed yourself so that you can help your GP to help you.

I'm going to paste in some links at the borrow of this reply that will give lots of information about B12 deficency and pernicious anaemia - don't be daunted - most of the information is only one page long - with the exception of the BSH cobalamin treatment guidelines which are slightly longer - just eat that little elephant in chunks. It's important that you read these before you see your GP because then you'll know what your GP should be doing for you - and will be able to ask for the correct treatment.

Look in particular for the symptoms checklist - check all the symptoms you have, and pay attention to the neurological symptoms. If you have these your GP needs to start your treatment immediately - and you will need the intensive B12 regime - details of that are in the BNF treatment guidelines - in one of the links below.

Your GP may say ah ha, but we don't know if you have pernicious anaemia so you don't need that. Wrong. That's a moot point. The treatment for PA is the treatment for the B12 deficency it causes. And you most definately have B12 deficency (and there are other causes of B12 deficiency - though your GP may not know that).

It's a good idea to highlight the main things related to you case and take them along to discuss with your GP. If you can take someone with you, even better. GP's are often more attentive and less hostile if a witness is in the room 😖

Another thing - GP's often say results are normal so,if,you want to,post all your results here, we can help with interpretation.

B12 deficency and pernicious aneamia are quite complex conditions so please do post any questions you have - and you're likely to have more once you've read through the information.

So...finally, suggest you make an urgent appointment with your GP, take along your highlighted information, and ask him to treat your obvious deficiencies.

A thought - is there another GP you can see?

If you have trouble getting the treatment you need - quite quickly, I'd say - then please post again and we can advise further.

Good luck 👍

evidence.nhs.uk/formulary/b... (BNF B12 Deficiency: Hydroxocobalamin Treatment Regimes)

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

stichtingb12tekort.nl/weten... (BSH B12 Deficiency / PA Diagnostic Flowchart)

onlinelibrary.wiley.com/doi... (British Society Haematology (BSH) Guidelines: Treatment of B12 Deficiency and Folate Disorders)

onlinelibrary.wiley.com/doi... (UKNEQAS B12 Treatment Alert, Neurological Symptoms and Risk of Subacute Combined Degeneration of the Spinal Cord)

stichtingb12tekort.nl/weten... (Problems with Serum B12 Test)

stichtingb12tekort.nl/weten... (Testing B12 During Treatment)

stichtingb12tekort.nl/weten... (Misconceptions About B12 Deficiency – Good to Know Before Seeing GP)

stichtingb12tekort.nl/weten... (B12 Treatment Safety / Long Term Treatment for neurological symptoms)

stichtingb12tekort.nl/weten... (B12 Deficiency: Neurological Symptoms Can Present Even When B12 is ‘In-Range’ and Without Macrocytosis (large red blood cells) or confirmed PA Diagnosis)

👍