Low 'normal' B12, high folate and enl... - Pernicious Anaemi...

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Low 'normal' B12, high folate and enlarged red blood cells.... And high Haematocrit...

Babybluecj profile image
14 Replies

Hi, I've had a blood test because of symptoms including fatigue, numbness/tingling in arm and hand, anxiety, irritability, mood swings (I'm a joy to live with!!), Weight gain, head neck and shoulder ache, forgetfulness....There are probably​ more. Although B12 states normal, it is in the low range - 300ish and i have been doing research that suggests the high folate can mask a B12 deficiency...

Does this sound like B12 deficiency, or pernicious anaemia, or both?

Can anyone share success about B12 treatment? I'm desperate to feel well again!

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Babybluecj
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clivealive profile image
clivealiveForum Support

Hi Babybluecj I'm not a medically trained persons but can I ask do you know what your iron level is? Iron, Folate and B12 work together to produce red blood cells.

Also what sort of diet do you have as the only natural way we obtain B12 is by eating animal products - red meat, fish, seafoods, poultry, eggs, dairy produce etc.

Although your B12 level is "normal" your symptoms do suggest that they may be caused by a deficiency and in some countries levels under 500 are treated.

There are many other reasons why people may be at risk of developing B12 deficiency as follows:

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.

Women with a history of infertility or multiple miscarriages.

Do you see yourself above in any of the people?

There are others on here who will be able to give you good advice.

I wish you well.

Babybluecj profile image
Babybluecj in reply toclivealive

Hi there, thanks for your reply, i really appreciate it.

My diet includes meat, fish, eggs and dairy so i believe i must have a problem with absorbtion rather than diet.

I have PCOS and have taken Metformin for this in the past, but not for the last 2 years. I have raised cholesterol too probably due to avoiding carbs (to help with weightloss in PCSO) but may have then eaten too much red meat/fat!

Iron level was normal. I'm going to reply to a post below with the full blood results.

I'm 33 years old.

Thanks

Deuto profile image
Deuto

Welcome as I see you are new here.

To allow the great experts here to give you advice, I see that Clivealive has given you a list of possible scenarios that may affect whether you have a B12 deficiency.

it would also be really helpful if you posted the actual results of all of your blood tests here, together with the ranges used by the lab that did your tests. For example, B12 XXX (aaa - zzz). The ranges vary from lab to lab, and also from country to country.

From the title of your post, you appear to have had a number of blood tests done as well as B12 and folate - eg you also mention enlarged red blood cells and haemotocrit ... Presumably you have therefore had the range of tests included in what is known as a Complete (or Full) Blood Count. So it would be helpful to include all of these results. And of course the results of any iron or ferriton tests done.

Your symptoms sound like those commonly experienced with B12 deficiency including Pernicious Anaemia, but can also be symptoms of a number of other conditions such as thyroid problems.

Again it would be helpful to know whether you have any other medical conditions that may be relevant, and/or whether you have had any other tests for such conditions as thyroid, diabetes or celiacs disease.

Babybluecj profile image
Babybluecj in reply toDeuto

Thank you very much. I have posted results below :-)

Babybluecj profile image
Babybluecj

Full blood results:

HbA1c - 37mmol/mol normal

(Diabetes target value is 48)

Se non cholesterol 4.9

Electrolytes all normal

Liver function normal

Serum cholesterol - 6.5 (0.0-5.0)

Triglycerides - 1.9 (0.3-1.7)

Iron - 27 umol/L (7-32)

Ferritin - 20 ug/L (10-322)

B12 - 347ng/L (211-911)

Folate - 12.4 ug/L (2.0-11.5)

Serum TSH - 2.39 my/L (0.35-5.50)

Haematocrit - 0.449 L/L (0.37-0.42)

Red blood cell dist width 15.1% (11.8-14.8

All other counts were well within normal range.

Thanks for taking the time to look at these, hopefully it will shed more light for me.

Silver_Fairy profile image
Silver_Fairy in reply toBabybluecj

Some of your symptoms point to hypothyroidism and your TSH is a bit high. Many people feel better with it around 1. You might want to ask your GP to test FT 3 and FT4.

Babybluecj profile image
Babybluecj

My diet includes meat, fish, eggs and dairy so i believe i must have a problem with absorbtion rather than diet.

I have PCOS and have taken Metformin for this in the past, but not for the last 2 years. I have raised cholesterol too probably due to avoiding carbs (to help with weightloss in PCSO) but may have then eaten too much red meat/fat!

Iron level was normal. I'm going to reply to a post below with the full blood results.

I'm 33 years old.

Thanks

Marz profile image
Marz

As suggested by Silver_Fairy your TSH is a little high - albeit in range. However the TSH is a pituitary hormone and tells you very little about the thyroid activity. I would suggest having the FT4 and FT3 tested - along with Thyroid anti-bodies - TPO and Tg. If your GP is not co-operative - very few are due to Guidelines - then I suggest you have a Home Testing Kit sent to your home for a Finger Prick Test. Do ask if you would like more information ....

Your raised cholesterol could be due to being Hypo. In days before Thyroid Testing in the early 70's - people with raised cholesterol had their thyroids treated. Cholesterol is mostly made in the body and for GOOD reason. We need it for our brains and for ALL hormone production including VitD.

thyroiduk.org

Babybluecj profile image
Babybluecj in reply toMarz

Hi, thanks for this, why are GPs so reluctant to test the thyroid do you think? How do i go about doing the test at home? Thank you

Marz profile image
Marz in reply toBabybluecj

Go to the link I posted above and look down through the menu on the left for Private Testing. Am not good at doing links on my phone 😊 The company that is well used is Blue Horizon also Medichecks ....

Sadly docs are taught that the TSH is the gold standard. Labs also cutting back even when GP's have made a request. We have to be well informed to keep on top of things.

Hope you soon find some answers.

thyroiduk.org.uk/tuk/testin...

20ard20ken profile image
20ard20ken in reply toMarz

Marz right I have hypo thyroid and trying get doc do other thyroid tests near on impossible.

I joined British thyroid society I went for lecture I was told thyroxin is only a part of the hormone and need extra t3tablet unfortunatly doc have been suspended for prescribing it and NHS has stopped doc from doing full thyroid spectrum,the blood forms bounced back an endocrinologist can do test but even then they got be thyroid licensed.It was real eye opener at how little NHS allows

Marz profile image
Marz in reply to20ard20ken

Please pop across to the Thyroid UK forum here on HU and you will see how to tackle this issue. Click onto posts and also check out Clutter who has posted today about T3 ...

I posted the link above to the available Home Testing kits for private testing. It is also the main website for Thyroid UK. Did you manage to look at it ?

Not sure who the British Thyroid Society are ??

I am T3 only and have been on the Thyroid forum for almost six years. I am not a medic - a Hashimotos suffeter with a B12 issue 😊

Apologies to Babybluecj for hijacking this thread ...

Gambit62 profile image
Gambit62Administrator

The Red Blood Cell distribution width is high which may indicate macrocytosis - but would need to have MCV and MCH to confirm that. This is a classic symptom of B12 and folate deficiencies ... and as your folate is high that would leave B12 the logical thing to explore.

high folate can mask the development of macrocytosis but this is only a symptom of B12 deficiency and isn't one of the first symptoms to develop in 25-30% of those who are B12 deficient.

serum B12 is a problematic test just because people vary a lot in how B12 in blood relates to how much B12 they have at the cell level so if used as a single measure it is going to miss 25% of those who are deficient - but also pick up 5% who aren't.

Suggest you try to get GP to look into macrocytosis and if that is present it would point to a B12 deficiency ... and follow up on comments re thyroid from others.

Gambit62 profile image
Gambit62Administrator in reply toGambit62

PA is one potential cause of a B12 deficiency - others listed in the details clivealive gave. The symptoms associated with PA are the symptoms of the B12 deficiency it causes.

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