my son has been suffering from symptoms of fatigue, concentrating problems ++ (with A levels looming) memory problems ++, some mild personality changes , headaches. He had a short anaesthetic 2 years ago to fix a broken nose and feels he has declined since then. He still falls within range for B12 /folate, so some advice on how to proceed would be appreciated. B12 deficiency run in both sides of our family. Not vegetarian Awaiting MMA and Thyroid results. Just wondering if we should start on B12 sublinguals, iron and it D supplements in the meantime.
I am hoping to chat with the doctor soon about this.
I'm really sorry but I can't read results. Is it possible for you to type out at least some of them particulary B12, folate, ferritin and full blood count?
"Just wondering if we should start on B12 sublinguals, iron and it D supplements in the meantime."
My personal experience is that supplementing with B12 prior to tests/consultations can make it virtually impossible to get a diagnosis. See link below.
In UK, the "BSH Cobalamin and Folate Guidelines" make it clear that patients who are symptomatic for B12 deficiency should have an IFA (Intrinsic Factor Antibody) test and start initial b12 treatment. This applies whether B12 is low or within range.
IFA test can help to diagnose PA (Pernicious Anaemia) but test is not always reliable and a person can still have PA even if IFA test result is negative. (called Antibody Negative PA).
Full blood count (FBC) can give clues as to whether iron deficiency, folate deficiency or B12 deficiency is a possibility. Low iron can lead to small red blood cells (microcytosis). low B12 or low folate can lead to enlarged red blood cells (macrocytosis). A person with both low iron and also low B12 and/or low folate may appear to have a normal MCV on FBC becuase effects of low b12/low folate on red blood cells can be masked by effects of low iron.
If a patient has both low iron and low B12/low folate then doctors may consider a blood smear/film which may show up both macrocytic and microcytic cells in teh same sample.
If you're in UK, I'd recommend reading whole BSH Cobalamin and Folate Guidelines. Sadly there are some GPs in UK who may not be aware of these guidelines (I gave my GPs a copy).
1)Try to spend some time reading Pinned Posts on this forum. I found Fbirder's summary of b12 documents helpful. link to his summary in third pinned post.
6) Book "What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper. Martyn is the chair of PAS.
I think he mentions teenagers with B12 deficiency in this book.
He has written two other books about PA and B12 deficiency. I also found "Living with Pernicious Anaemia and Vitamin B12 deficiency" useful because it had several case studies.
7) Book "Could it be b12" by Sally Pacholok and JJ. Stuart (USA authors).
Very comprehensive book about B12 deficiency with lots of case studies.
I did notice that they mentioned "B12 cafe" on website. I took this to mean support groups in Netherlands but I may have misunderstood as I don't speak Dutch. Perhaps there is one near you.
There were e-mail contacts for areas listed underneath.
I have found articles online and in books that suggest it is possible to be symptomatic for B12 deficiency with levels that are within normal range. I was highly symptomatic with normal range results.
May be something in this link that is useful although info aimed at UK patients.
I'd strongly recommend reading "Could It Be b12" by Sally pacholok and JJ. Stuart. Think this book mentions patients who were symptomatic with normal range results.
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Your advice please - not sure what to do next
what to do
Advice for next consultant visit
