Advice please

[mand82]

Just got my surgery to give me copies of my last few blood test results as I was curious to see if it show my b12/iron dipping for a long time or suddenly and my blood test from February 2016 when I was taken into a&e with acidosis shows my b12 at 128 & folate at 2.4 , do you think acidosis could of affect the b12 somehow or it was probably just been slowly going down over time, the other three blood tests that week hadn't included b12 or iron etc nor the blood test back in September and the blood test this February says b12 117 & ferritin 19 & folate 4.8,

[clivealive Forum Support]

Hi mand82 without knowing the ranges <from - to> used by the laboratory it is difficult to comment other than on the face of things they look to be "bumping along the bottom"

Do you have any of the symptoms of a B12 deficiency which may include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss

Diarrhoea

Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness

Irritability

Memory loss

Dementia

Depression

Psychosis

I am not a medically trained person but there are others on here who will be able give you good advice.

I wish you well

[mand82 in reply to clivealive]

The ferritin range is 20-275, b12 range is 180-914 & folate range is 2.7- 34,

I don't know if any of my symptoms are b12 related or part of my preconditions as I suffer from chronic migraines, asthma, cubital tunnel syndrome, carpol tunnel syndrome ,tinnitus , dyslexia

I get bad headaches, pains in my legs/arms/back/neck, lose my balance when trying to put my clothes on, don't have enough strength to pull myself up when I'm on the floor, fatigue, lose of motivation I just don't feel like doing things even if it's something I really want, lose of appetite I see the food but just can't always feel it like I used to even tho I'm hungry, lose concentration a lot , breathless at times just for walking a few yards, faster heartbeat (88-100) quiet a few times a day been tachycardia (101-116),

[Gambit62 Administrator]

ketoacidosis can be a side effect of B12 deficiency but it is very rare.

[mand82 in reply to Gambit62]

The doctor told me I got ketoacidosis due to poor eating & high dose of topiramate , at the time I was eating normal then I started feeling more fatigued , more breathless , most painful migraine ever, & pain in legs that I had trouble walking & then I lose my appetite only eating yogurts which contains small amounts of b12/D/b6 and 3 days after lose of appetite that's when I went into hospital , had my medication lowered by the doctor to stop a repeat, & got shoved on insulin/glucose drip ,

[Gambit62 Administrator in reply to mand82]

this is article on a case of ketoacidosis related to problems metabolising B12

ncbi.nlm.nih.gov/pmc/articl...

this is link to symptoms of B12 deficiency

pernicious-anaemia-society....

Are you being treated for the B12 deficiency? Three days of not eating would not be sufficient to cause the drop in B12 that you have experienced.

[mand82 in reply to Gambit62]

Thanks, I've had my loading doses but that's it till June 1st when I have another blood test then I'll see the nurse again about the results & find out then what's gonna happen,

[Gambit62 Administrator in reply to mand82]

did the fatigue lift at all when you were on the loading doses?

[mand82 in reply to Gambit62]

No, when having the first one till having the last one I didn't feel at all different to what I was feeling days/weeks before the injections

[Gambit62 Administrator in reply to mand82]

few more questions: what loading regime was used - 3x week for 2 weeks or something else?

do you know if your bloodwork showed any signs of macrocytosis (red blood cells larger and rounder than normal?)

sometimes it takes a while for symptoms of B12 deficiency to go - and sometimes it can actually make you feel worse (more pain) before you start to feel better ... but also possible that something else going on causing the symptoms.

[mand82 in reply to Gambit62]

The loading doses were every two days for two weeks,

The blood results say that the mean cell volume was 94 FL the range was 76-96

[Gambit62 Administrator]

mand82 - thanks for the MCV - getting towards the high end but not particularly high ... and do you have the MCHC?

If your iron tests come back as indicating that you are deficient then the result above would be highly significant and imply that the effect of the B12 deficiency on your blood is quite significant as an iron deficiency acts in the opposite direction and usually it is the iron deficiency that wins out in terms of red blood cell size.

The loading doses are correct assuming that you don't have neurological symptoms. However, the pains in your legs etc would probably put you in the class of neurological symptoms, for which the treatment would be 3xweekly until the symptoms stop improving (review at 3 weeks) - though the fact that you didn't notice any improvement in the 2 weeks of the shots suggests that that may be a mute point. However, maintenance would be 2 monthly going forward rather than 3 monthly.

Macrocytosis - larger rounder blood cells takes 3-4 months to correct completely so if symptoms are due to the haematological effects of B12 then they will take a few months at least to start to improve.

Have you made a complete list of symptoms that you have? - from the link I provided - there may be things on there that don't seem connected and may be things that have been going on for years but as a full blown B12 deficiency can take decades to develop they may still be related - symptoms just tend to snow ball at the end so become much more noticeable.

[mand82]

I don't know what the Mchc is as it doesn't say it together just separate haemoglobin concentration 12.7 g/dl (11.5-16.5) haematocrit 0.385 (0.37-0.47) unless its mean cell haemogloblin level which is 30.9pg (27-32)

The doctor said I was iron deficiency as well as my level was 19ng/ml (20-275)

Yes I've made a complete list from the link you posted , I've always been feeling like this for over 10 years but the last two years felt worse