I have just popped over onto this forum from Thyroid Health unlocked, my question is for my partner who has been very ill, a quick run down he is 61 usually in excellent health had a nasty bout of flu 4 weeks ago. Since then he has suffered with drenching night sweats, insomnia, anxiety, very irritable and also has a fine tremor of the hands.
He has had a full blood count done all normal but his b12 is 177 range 115---1000 also his Serum Folate came in at 13.4ug/L sadly no range with it.
He is also feeling very depressed which is not like him at all, other than all this he has no health problems.
I was advised by my Thyroid forum to come on here and ask for advice any thoughts would be brilliant
Many thanks
Dotti
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dotti
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generally symptoms creep up over a period of time getting worse and worse rather than being precipitated by something like a bout of flu. Sometimes it can take a while to recover from a viral infection and unfortunately low mood etc can be part of the aftermath of an infection.
Unfortunately the serum B12 test isn't an easy one to interpret on its own as people vary quite a bit in how they respond to B12 so going just by the range is going to result in missing 25% of people who do have a deficiency but also picking up 5-10% of people who don't have a deficiency.
The folate looks as if it is actually around middle of the range.
His B12 level is at the low end of the scale and as Gambit62 says his Folate is probably "mid range" and how he is feeling now may be the aftermath of the 'flu.
However a B12 deficiency can produce symptoms similar to those he is experiencing.
Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:
Vegetarians, vegans and people eating macrobiotic diets.
People aged sixty and over
People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).
People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.
People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.
People with a history of eating disorders (anorexia or bulimia).
People with a history of alcoholism.
People with a family history of pernicious anaemia.
People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).
People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.
People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.
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I have only highlighted the sixty and over
because as we age the level of acid in our stomach lessens making it more difficult to absorb essential vitamins, but can you "see" your partner in any of the other people?
I am not a medically trained person but there are others (like Gambit) who will be able to give you good advice.
Perhaps you can encourage him to eat more red meats, fish, seafoods, eggs, poultry and dairy produce as these are the foods we naturally derive Vitamin B12 from.
In addition eating leafy green vegetables such as sprouts, broccoli, asparagus, spinach.basil, beans, peas etc will provide Folate which is essential to process the B12 - the two work together.
Hi Dotti. When I started taking B12 (5000mcg methylcobalamin sub-lingual) my B12 was 284 (199-900 range) and the only things off the list that applied to me were that I was 65 and I take a PPI with my anti-inflammatories BUT I can't tell you what a difference they make. I feel 10 years younger and wouldn't give them up if you paid me! You can't overdose on B12 so why not give it a try? Good luck x
Being low in one vitamin can increase the possibility of low levels in others.
D deficiency or insufficiency can present some similar symptoms to low b12.
Being low in D is very common here in the UK especially at this time of year. The further you are from the equator the worse it gets because we make it when strong sun light hits our skin. We get it from food too but not enough to stay topped up if we can't get enough sun.
Like b12 it's fairly easy to correct once you know the problem exists.
Low Vitamin D is implicated in low mood and weaker immune response which could explain the situation.
It's recommended now that D3 is used rather than D2 and it's apparently best taken with vitamin K2 and with a diet with good levels of vitamin A in it.
My son!s anxiety intensified extraordinarily after flu, with palps, tremor etc. No one could explain it, and he went on to sinusitis, tinnitus, restless legs and circadian rhythm disorder. His ferritin was below range, and I wondered whether the fact that the body blocks absorbtion of iron in times of infection had produced some of these symptoms, his iron dropping even further.
The symptoms may be a coincidence of course. If symptoms persist you will return to the gp? Night sweats can be a serious symptom and should be checked.
If you are I'd recommend reading "BSH Cobalamin and Folate Guidelines". It's a UK B12 document that gives guidance on diagnosis and treatment of B12 Deficiency and PA (Pernicious Anaemia).
b-s-h.org.uk/guidelines/ click on box that says "Diagnosis of B12 and Folate deficiency" should be on page 3 of listed guidelines.
Flowchart above makes it clear that UK patients who are symptomatic for B12 deficiency (with low B12 or an in range B12 result) should have an IFA (Intrinsic Factor Antibody) test and start initial B12 treatment. IFA test can help to diagnose PA but is not always reliable.
Is he symptomatic for B12 deficiency? See lists of B12 deficiency symptoms below.
All websites above have other info about B12 deficiency/PA
Pinned posts on this forum have a lot of useful info too.
B12 books
"Could it Be B12" by Sally Pacholok and JJ. Stuart
"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" By Martyn Hooper. Martyn Hooper is the chair of the PAS (Pernicious Anaemia Society).
"He has had a full blood count done all normal"
Did he get a copy of results? I learnt to always get copies of my blood tests after being told over the phone or face to face that everything was normal then finding some abnormal results on the copies. Can be clues on FBC that indicate teh possibility of iron deficiency, folate or B12 deficiency.
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