Pernicious Anaemia Society
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First post- B12 and MCV results- help!

Feb 2017:B12 254 (Def<140, insufficient 140-250). Folate 10.93 (8.83-60.8 nmol/L)

Dec 2016: MCV 82 (83-101). HB 131 (120-150)

Aug 2016: B12 168 (Def <100, insufficient 100-129) & MCV 84 (83-101). Folate 7.5 (2.7-15.0ug/L). HB 124 (120-150)

After the August result I started taking 5000iu sublingual methycobalamin although don't remember even day. Should I have seen more of an increase by now?

I have hypothyroidism (hashi's) so normally on that forum. I have other results if that helps but those seem to be most relevant on here? I'm also supplementing vit d as I am deficient, b complex, k2 and magnesium. Also on ferrous fumarate although Ferritin slowly creeping up.

Should I carry on as I am with the B12 supplement? What am I aiming to get to ideally?

Thanks :-)

8 Replies

MCV is actually low - pointing to an iron deficiency

Would be useful to know what your folate levels were.

Basically you seem to have an absorption problem which is affecting multiple mineral and vitamins. This is leaving you deficient in those minerals and vitamins and because of the overlap in symptoms sorting out which is causing what symptoms is going to be very difficult.

You really need to be working with your GP as you need to identify what is the cause of your absorption problem - there are a number of possible candidates and treatments and consequences vary. Absorption problems include PA, Ceoliacs, Crohn's, drug interactions, h pylori infection. H pylori can be treated but others, at least in respect of B12, will require treatment for life - which should be with B12 shots.

Serum B12 isn't a good guide to what is going on - mainly because it measures amounts in the blood rather than what is actually happening at the cell level. Diagnosing a B12 deficiency really requires evaluation of a whole range of markers - including symptoms (clinical presentation) and it is symptoms that are actually the easiest way of monitoring progress in dealing with the deficiency. This gets complicated though if there are other things going on that have overlapping symptoms - eg iron anaemia, vit D deficiency and thyroid.

you can find a list of B12 deficiency symptoms here


1 like

Thanks gambit! It's info overload and I'm trying to educate myself as much as possible.

Apologies, I added my folate in before I realised anyone had replied! It should show in my post now I hope!

The thought of tying to work with my GP and figure things out makes me want to sob!! I've not been met with a very positive response!


thanks - folate isn't great - basically you have an absorption problem that is affecting a number of deficiencies - if you can you need to get to the bottom of what that problem is as consequences can go beyond dealing with the deficiencies that they cause.

Suggest that you look through the pinned posts for materials and put a letter together and send it to your GP and/or the practice manager - include your symptoms and references to the treatment guidelines.

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Thank you for your replies,I will continue to read more of the content on here.

One last quick question... My vit D was deficient last year and so I started supplementing 5000 but since then it's actually decreased further. I put it down to winter. But... Could this actually be because of an absorption problem?

Thanks for taking to time to give such clear explanations/suggestions- much appreciated :-)


I really haven't managed to get my head around VitD but my understanding is that exposure to sun-light certainly isn't the full picture and diet does play a part.



I have a problem with vitamin D also. Had to switch from tablet form ( I had the same problem, my D levels went down) to a sublingual form that is mixed with olive oil. It's good to take Vit.. D with oil of some kind.

I also do 5000 units a day and will recheck my levels in a couple of months.

The sublingual bypasses the stomach. I have the same absorption problems as you do.

Best wishes😊


Thank you! I didn't even realise that was an option with vit D- I'm going to look into it :-)

1 like

Yes, please do. Hopefully it will raise both our levels!🙂


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