Pernicious Anaemia Society
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Blue Horizon tests

Hi I have an under active thyroid currently being treated and blood results have all come back in normal range. I was advised to check the following and am posting the results for advise. I currently feel very unwell. Very clumsy extreme tiredness very anxious numbness and tingling in feet and hands. pain down whole of spine. shakiness Horrendous brain fog with very poor short term memory, dizziness and problems with eyes and difficulty hearing.

Ferritin 291.4 (20-150)

B12 253 (insufficient 140-250)

folate 12.72 (8.8 -60.8)

Dr just keeps putting it down to depression but I don't feel depressed just anxious.

Any help would be greatly appreciated as i am due to see Dr tomorrow. I also have hypertension which is well controlled on medication

4 Replies

Welcome Soozysoosop!

Ferritin: Your ferritin is raised. Have you been taking iron supplements? Alternatively this elevated ferritin may be a sign of inflammation going on somewhere in your body and may not be to do with your iron levels. Is your hypothyroid issue autoimmune in origin as this may explain this if so. Check with your GP tomorrow as if you've been supplementing iron you may have too much in your body and may need to stop. To work out if it is due to this or your thyroid issues your GP may want to do a full iron panel blood test.

B12: This is in the grey zone where you may have B12 deficiency symptoms and is only just above the insufficient range you quote. It sounds like you have a wide range of symptoms though there is a lot overlap with those of thyroid issues too. I'd ask your GP for B12 injections as per these guidelines on the basis that they should be treating your symptoms of B12 deficiency and not just going by your numbers. pernicious-anaemia-society....

I'd also ask for a anti-intrinsic factor antibody test to check for pernicious anaemia. As you are hypothyroid (especially if it is autoimmune in origin) you are at higher risk of also developing PA. The test is not perfect (~50% false negatives) so testing negative does not necessarily mean you don't have it.

Symptom lists: and pernicious-anaemia-society.... - it may help taking one of these with your symptoms marked to help encourage you GP to treat you.

For neurological symptoms (which it sounds like you have) you should get injections every other day until no further improvement (with a review at 3 weeks) then injections every 2 months thereafter.

Folate: Not sure which units these are as that is quite a wide range. Not bottom of the range but not very high either. Your GP will most likely not do anything about trying to raise this so it is probably down to you if you wish to. Many of us take 200ug or 400ug folic acid supplements to make sure we have enough to work in conjunction with B12 - it is up to you really!

I'm not a medic - so I'd discus the above with your GP especially if you have other medical issues too.

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Thanks I will try to digest all of this. I haven't been supplementing iron. I only take vitamin D and magnesium. My thyroid levels were abnormal at beginning of January so my levothyroxine was increased and liothyronine kept the same they are now slightly over treated so I've reduced dose by 25mcg as advised on thyroid unlocked. blue horizon also checked thyroid antibodies on this test and they were in normal range so I don't think inflammation is from thyroid. The folate results are nmo/L.

My mum has low B12 and receives three monthly injections.

How do I persuade GP to prescribe B12 when levels are in range. I thought normal range if above 190? I'm more than happy to try supplementing B12 but just know my GP will look at results and not me. As she just puts this down to depression.

So sorry for all the questions


I'd just ask your GP to investigate things and do some more blood tests. They may want to repeat the tests you had done re ferritin and B12 anyway (mine don't like private tests!) but surely do other things like a full blood count and others to work out why your ferritin is raised anyway. It still may be difficult to persuade your GP it is anything to do with B12 especially if your thyroid has measured abnormal recently but they should at least try to rule it out

1) given your mum is having 3 monthly injections for a b12 deficiency

2) you have a thyroid problem which means you are more likely to have a B12 deficiency or PA

Even if they won't do an Anti-intrinsic factor antibody test there may be some clues in full blood count results. In B12 deficiency there may be abnormal eg red blood cells larger than normal (macrocytotic), MCV high and RDW higher that normal as well as a few others which would indicate a macrocytic anaemia which can be a sign of B12 or folate deficiency. That said ~30% of people don't have haematological signs and but have neurological symptoms of a B12 deficiency instead.

I'd also take a copy of one or both of the symptom lists I linked to above with whichever symptoms you have marked. (things like anxiety and depression also may be symptoms of B12 deficiency!)

Possibly take these guidelines too : pernicious-anaemia-society.... with any bits you think relevant highlighted.

Good luck!

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Hi just back from GP. V frustrated!

Gave her BJH guidelines and my symptom checker that totalled 69! Highlighted tiredness Brain fog and inability to recall words are my main concern closely followed by pins and needles in hands and feet, whole spine stiffness and pain unsteadiness vertigo. Stiff hip and knees worsening eyesight. Begged for trial of B12 to be told that my levels are normal and she couldn't possibly condone this. I asked her what harm would it do and she advised Vit B12 injections can cause changes in shape in MCV! So I have come away with referral to neurology MRI scan and referral to haematologist. She did not feel that I needed any up to date bloods as All bloods done in August were normal! I did point out the BNF guidelines on not delaying treatment if neurological symptoms but again as bloods NORMAl she wouldn't condone B12 injections. I had every intention of starting injections myself as spinal pain is worsening but feel that now I have haematology referral I shouldn't jeopardise this.

Please send me your advice.


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