Have been having B12 injections since 6 February at the surgery (after a long battle with GP, letter writing + enclosures of highlighted evidence from guidelines and support from PAS and members of forum = so thank you all once more) and there has been much improvement.
When GP said the guidelines state only 1 injection every 3 months after loading doses I told her that in case of neurological damage injections should be given till no further improvement was noticed. Also told her the cost of B12 injection is low (28p) she said it was the nurse's time that was a problem. Suggested I would like to be taught to self inject IM by nurse if she would agree. She agreed and am being taught by nurse now.
I also insisted GP should explain to me (not for the 1st time but to no avail, except "it's what could be expected with my health issues"!!) what an overproduction of RBCs meant. So she finally told me my RBCs are of smaller size therefore microcytic cells. No other explanation nor help, and the consultation came to an end. Must pursue conversation about this problem and would therefore appreciate further sensible advice from members of the forum before I see GP again, next Thursday (16/3). Clearly does this suggest microcytic anaemia? or what else? Although gp vehemently denied in the past 2 months I was anaemic. So how do I navigate this situation please? Clearly I need to understand what is happening in order to prevent further problems down the line. What investigations should GP recommend regarding this problem?
I requested a form for further FBC as well as Thyroid function tests. I noticed my level of RBCs has gone up a little more since my last results of 16 December 2016, (above range before and now) as well as Mean Cell Volume and Mean Cell Haemoglobin levels having gone further down (both below range before and now).
These are my latest results:
Total white blood count: 6.50 10*9/L (4-10)
Red blood count: 5.30 10*12/L (3.8-4.8) Above Range mentioned by lab.
Haemoglobin concentration: 141 g/L (120-150)
Haematocrit: 0.424 (0.36- 0.46)
Mean cell volume: 80 fl (83-101) Below Range mentioned by lab.
Mean cell haemoglobin level: 26.6 pg (27-32) Below Range mentioned by lab.
Mean cell haemoglobin concentration: 333 g/L (315-345)
Platelet count - observation :252 10*9/L (150-400)
Neutrophil count: 4.14 10*/9 (2.0-7.0)
Lymphocyte: 1.73 10*9/L (1.0-3.0)
Monocyte: 0.43 10*9/L (0.2-1.0)
Eosinophil: 0.17 10*9/L (0.02-0.5)
Basophil: 0.03 10*9/L (0.02-0.1)
Percentage nucleated red blood cells: not detected
Nucleated red blood cell count: not detected
THYROID FUNCTION TEST:
THS: 0.85 miu/L (0.3-5.5)
Free T4: 23.1 pmol/L (12.0-22.0) Above Range mentioned by lab
Free triiodothyroine: 3.8 pmol/L (3.1-6.8)
Thyroid peroxydase antibody: 18 ku/L (< 34.0)
I went to the lab first thing in the morning (about 8 am), fasted, only drank water and no T4 taken for 24 hours.
I take T4 100 mcg and 0.75 mcg on alternate days. I had a partial thyroidectomy (but only a very small part of thyroid remained) in 1980 and post operation it was disclosed I had papillary carcinoadenoma, had a 4 nodules goitre).
Thank you for reading my post and awaiting your comments.
Best wishes to all.