Log in
Pernicious Anaemia Society
16,733 members β€’ 11,584 posts



I wrote a post earlier in the year from Spain. My B12 was two weeks overdue and I was trying to find where I could buy supplies of B12, namely hydroxcobalmin, to give me a much needed boost. Suffering tiredness, itchy scalp, anxious, hair loss, breathing problems, weight gain, and the list goes on. Well didn't have success with purchasing hydroxcobalmin.

On my return I received my 3 monthly jab on 7 Feb and on 27 March I had blood tests carried out, which one set is below. (Unable to show two photographs together so will do a page two.)

I presume everything is ok as I have not been called in to the surgery to review tests, however at times I really struggle.

I am fairly active and play golf, but now are feeling a need to have a buggy to get around. Ok first 9 holes then downhill fast in energy, co-ordination and concentration levels.

I would appreciate help on the tests and hope the picture is legible.

Many thanks.

Pic 1 of 2

8 Replies
oldest β€’ newest

496 is actually quite a low reading if you are on B12 shots - that's 7 weeks

Not surprised that you are feeling exhausted.

Not going to be easy to get GP to recognise that this is actually a significantly low result for someone receiving injections and a strong indicator that you need injections more frequently but may be there are some materials on the PAS website that you can use, though you may have to join to be able to access the most relevant materials



Thank you for your reply. I felt the reading was a little on the lower side. I am not on any folic tablets, would that help.

I am a member of the PAS however perhaps I need to join something else to get on the web site. What would you suggest I do and use, your help is very much appreciated.

I am now going to wt watchers to try and get the weight off, but have wondered if it is to do with my metabolism.

Golf today and feeling really exhausted.

Thank you.


sorry but find your reply a bit difficult to follow.

when you say you are a member of the PAS are you talking about this forum or the PAS itself. The PAS sponsor this forum on HU but joining the PAS is something different from joining this forum.


I presume you have had tests for thyroid problems and diabetes


I am probably a bit confused or having a senior moment!

I thought I joined the PAS a good few years ago as have suffered with this for a long time, and didn't think then there was Healthunlocked so thought was all the PAS.

Anyway can rejoin.

My other post with picture I think shows the blood tests for the thyroid testing.

Thank you for your help.


Hi SusanMargaret47. I agree with Gambit...your serum B12 is low for someone having B12 injections...would usually expect this to be over 1000, and sometimes way over that. Your GP may think that the level is okay because it's within the normal reference range...well, not for someone with PA and the B12 deficency it causes. Given your ongoing symptoms, it sounds like you need more frequent injections - if you have neurological symtpoms, you should initially have been prescribed every other day injections until no further improvement...and once you reached this stage, injections every eight weeks (although many people need injections more frequently than than this to get and keep well).

Your folate is a bit on the low side. B12 and folate work together so when folate is low the body is unable to utilise B12 properly. Some people with B12 deficency take 400mcg folic acid daily, as a maintenance dose - might be worth considering. Then get your GP to check your folate levels again in a few months.

MPV is slightly above the reference range - not significantly over - could be caused by infection, inflammation, recent surgery, heavy blood loss...etc...your GP will interpret this according to your full medical history - he/she may want to repeat it again at a later date, just to check - but as other related results look okay...don't lose any sleep over it πŸ˜„.

Lymphocytes - just slightly under the reference range - can be due to infection, autoimmune condition, steroids....etc. again, other related results look okay so...

Not good at thyroid results - suggest you post those on the thyroid forum - the folks there are very knowledgable and will be able to help with interpretation.

Again, your serum B12 results and ongoing symtpoms indicate that you probably need much more frequent injections of B12 - though your GP mighty not recognise this - or be easy to convince. many are unaware that serum B12 levels should be high after injections, that B12 levels are no indicator of how effective treatment is...and that the thing that should be treated are symptoms (not blood test results).

I'm going to copy some links below that will give you information and guidance about all things B12 deficent - and also some B12 'myth busting' information (thing your GP won't know) that will helpyou to approach your GP and negotiate more frequent injections. Looks,like a lot of,information, but most of the links are to documents that are only,one page long - and the one longer document has summary sections, if you don't feel up to reading the whole thing (but it's very interesting πŸ˜„).

Knowing what your GP should be doing will help you to get her/him to do it πŸ˜‰.

Oh...and...before the links....didn't see any results for ferritin (one of the markers for iron deficincy anaemia)...people with PA often suffer other deficiencies...iron being one...can make you feel very ill so. Ight be worth asking your GP to check yours. Vitamin D too.

Good luck....hope all goes well and you do manage to get more frequent injections....let us know how you get on...and post again if you need more help....

So SusanMargart47....here's the links:

b12researchgroup.wordpress.... (Serious Caution Note about the use of Oral and Sublingual B12 Supplements)

evidence.nhs.uk/formulary/b... (BNF B12 Deficiency: Hydroxocobalamin Treatment Regimes)

pernicious-anaemia-society.... (PAS Symptom Checklist)

stichtingb12tekort.nl/weten... (BSH B12 Deficiency / PA Diagnostic Flowchart)

onlinelibrary.wiley.com/doi... (British Society Haematology (BSH) Guidelines: Treatment of B12 Deficiency and Folate Disorders)

cks.nice.org.uk/anaemia-b12... (NICE Guidelines Treatment of B12 / Folate Deficiencies)

onlinelibrary.wiley.com/doi... (UKNEQAS B12 Treatment Alert, Neurological Symptoms and Risk of Subacute Combined Degeneration of the Spinal Cord)

stichtingb12tekort.nl/weten... (Problems with Serum B12 Test)

stichtingb12tekort.nl/weten... (Testing B12 During Treatment)

stichtingb12tekort.nl/weten... (Misconceptions About B12 Deficiency – Good to Know Before Seeing GP)

stichtingb12tekort.nl/weten... (B12 Treatment Safety / Long Term Treatment for neurological symptoms)

stichtingb12tekort.nl/weten... (B12 Deficiency: Neurological Symptoms Can Present Even When B12 is β€˜In-Range’ and Without Macrocytosis (large red blood cells) or confirmed PA Diagnosis)

stichtingb12tekort.nl/weten... (B12 and Intrinsic Factor)

gov.uk/drug-safety-update/n... (B12 & Nitrous Oxide Contraindicated)




Very comprehensive and informative reply. Will work my way through them and print them off.

Thank you.

1 like

Gambit 62

Have just checked on the PAS and I am a Legacy member .


glad you got that sorted - you may need to upgrade if you want to make full use of the advice and support that the PAS provide.


You may also like...